Ritter Insurance Marketing, Craig Ritter

Changes to 2018 Medicare Marketing Guidelines: What Agents Need to Know

CMS published their 2018 Medicare Marketing Guidelines a couple weeks back.  The document is 124 pages long, so there’s a lot to digest and not 100% of the material is totally relevant to agents, so I like to talk about what’s DIFFERENT from one year to the last and focus on what’s most important…

4 Aug 17
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CMS Lifts Sanctions on Cigna MAPD

Cigna, whose Medicare Advantage business has been under sanctions for 18 months, is once again free to enroll customers in MA plans beginning July 1, according to a filing from the Securities and Exchange Commission. The Centers for Medicare and Medicaid Services lifted a suspension placed in January 2016 after “widespread and systemic” failures…

16 Jun 17
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Health Insurance Exchange Enrollment Trends

CMS recently released two reports that shed some light on health insurance exchange enrollment trends and why shoppers leave exchange plans. 2017 Effectuated Enrollment Report Findings To get a precise count of enrollees, it’s more accurate to look at the number of people who have paid their premiums than it is to look at the number of…

15 Jun 17
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2018 Maximum Broker Commissions for Medicare Advantage & Medicare Part D

For the third year in a row, CMS has raised maximum broker commissions for Medicare Advantage and Medicare Part D initial enrollments. Note, insurance providers are NOT REQUIRED to pay the maximum commission rate. We’ll report when insurance companies’ release their 2018 filings in the coming months. Medicare Part D Maximum Broker Commissions Initial commissions increased…

31 May 17
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2016 Medicare Parts C & D Audit & Enforcement Findings

Last Tuesday, the Centers for Medicare and Medicaid Services (CMS) released their 2016 Medicare Parts C and Part D Program Audit and Enforcement Report. This report summarizes the audit findings on carriers’ Compliance Program Effectiveness (CPE), Part D Formulary and Benefit Administration (FA), Part D Coverage Determinations, Appeals, and Grievances (CDAG), Part C Organization…

16 May 17
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CMS Increases 2018 Payments to Insurers

In a press release issued April 3, the Centers for Medicare & Medicaid Services (CMS) announced an average 0.45% payment increase for 2018 Medicare Advantage and Part D plan insurers. After factoring in plan coding for member diagnoses, the average increase will be about 2.95 percent. The 2018 rate hike is higher than the…

5 Apr 17
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CMS Releases 2018 Advance Notice & Draft Call Letter

We’ve got the 159-page 2018 Advance Notice and Draft Call Letter from CMS calling for a modest 0.25% payment increase to Medicare Advantage plans in 2018. But take note: If there’s an increase in risk scores, that figure could rise to as much as 2.75%. Currently, CMS determines risk scores based on a blend…

21 Feb 17
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Highmark Will Stay in ACA Marketplace

Highmark recently announced it has no plans to leave the ACA Marketplace. Unlike other carriers who have dropped out or scaled back coverage for 2017, Highmark plans on sticking with the exchange in Pennsylvania, Delaware, and West Virginia. The announcement came alongside the company’s financial results for the first half of 2016. During the…

30 Sep 16
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Sanctions Against Cigna to Continue into AEP

Annual Enrollment 2016 is coming, but Cigna will be spending this one on the bench as CMS sanctions to their MAPD program continue. The Centers for Medicare and Medicaid Services red-shirted the Connecticut-based company back in January citing, “widespread and systemic failures.” In a recent regulatory filing, Cigna admitted that they “probably can’t fix…

7 Sep 16
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Boosting the ACA Single Risk Pool

Maintaining the single risk pool has been one of the biggest challenges of the Affordable Care Act. Health and Human Services (HHS) recently proposed a change that aims to boost the ACA risk pool by limiting individual short-term health coverage. In planning stages, the ACA single risk pool was made up of primarily healthy…

31 Aug 16
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