Archive for the ‘Florida’ Category

Here is the story as reported by Robert Pear of the New York Times.  Scott now joins 6 other Republican governors who have decided to accept the Federal Government’s subsidies to expand Medicaid in their states.  A massive expansion of Medicaid was a cornerstone the Affordable Care Act to cover more of the low income population with Health coverage.  The Supreme Court ruled that the states have the option of rejecting the Medicaid expansion subsidy without losing ALL of their Medicaid funding which was initially the hammer to force Medicaid expansion.

The downside of accepting the expansion is that the federal subsidies decline over time, leaving the states with more financial responsibility to fund the expansion going forward.  In the early years, the federal subsidy is extremely generous, which makes it difficult turn down.  Currently, there are 22 states who have accepted the subsidy, 17 who have rejected it and 11 who are undecided.

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This occurred a few weeks ago, but I missed blogging about this.  The United/BayCare battle put a number of Medicare advantage members in Tampa, Florida in a difficult position as the two struggled mightily to reach an agreement.  The new agreement is a five year deal between BayCare and United Healthcare.  The terms of the agreement were kept confidential.

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Quality Health Plan of FL has been ordered to be liquidated as of 12/1/2012.  Here is the story from TheLedger.com.  The plan had 10,242 members as of September of 2011 who will be automatically enrolled in a Humana drug plan and Original Medicare as of 12/1/2012.  All of the members will also get a Special Election to choose a new plan and have guarantee issue rights to obtain Medigap coverage, if they so choose.

Here is a breakdown of the plan’s membership by county obtained from a CMS report:

Bradford 11
Brevard 477
Charlotte 79
Citrus 170
Clay 241
Duval 682
Hernando 121
Hillsborough 187
Indian River 1,044
Lake 147
Lee 154
Manatee 83
Marion 107
Martin 317
Okeechobee 389
Orange 166
Osceola 118
Palm Beach 20
Pasco 426
Pinellas 360
Polk 2,696
Sarasota 109
Seminole 44
St. Johns 33
St. Lucie 660
Sumter 103
Volusia 918

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CMS issued guidance last week to put a cap on referral fees, particularly those in the South Florida market.  Apparently, Medicare Advantage carriers were paying referral fees which were equivalent to the initial Medicare Advantage commission ($402 or $403) for both initial and replaced Medicare advantage referrals.  In most cases, this made it more lucrative to refer a piece of business than it was to process the enrollment yourself (not to mention the certification process, etc.)

Now, CMS is asking the Medicare Advantage carriers to cap their referral fees at no more than $100.  This could spell a big shake up in the way agents in South Florida need to approach the Medicare Advantage market.

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The Miami Herald writes a piece on the story of the rise of Preferred Care Partners, a Florida based Medicare Advantage Organization (MAO).  PCP was started in 2001 as Florida’s first Provider Sponsored Organization (PSO).  In 2010, PCP grew to $450 million in Revenue.  Based on a strong 2011 AEP, they should exceed $500 million in 2011.

Here is the full story from the Miami Herald.

Ritter Insurance Marketing signed an FMO contract with PCP in late 2010.  Agents registered with the Ritter Insurance Marketing website can obtain licensing paperwork here.  Agents can register for the Ritter Insurance Marketing website by clicking here (registration is free).

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Molina January Training

Molina Medicare offers competitive products and benefit plans that you can market year-round with rich value-adds to meet your customers needs.  Now that the AEP is coming to an end, come hear about the plans that Molina Medicare offers that can be marketed year around!
Space is limited so please make sure to RSVP to one of the Webinars or Live Trainings!

Click here for a full list of Molina Training events during January.


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