alemagency
New Member
- 5
I've seen some horrible contracts, but this is by far the worst contract that I've ever read. I'm in Illinois and I work in the lower income neighborhoods of Cook, Boone, & Winnebago counties. I used to write a lot of business for another local MAPD carrier, until they DENIED ME MY INITIAL NEW TO MAPD PAYMENT (that's another post) for 4 clients! As I was looking for a carrier with comparable benefits, I remembered that I had a contract with the local MAPD's main competitor: Meridian Health Plan. After having such a horrible payment issue, I decided to dot my I's and cross my T's and read my entire contract in detail, versus just skipping to the commission rates. Well imagine my surprise when I came across the following passage in my contract--- "For each selling year where the General Agent’s annual disenrollment rate exceeds twenty percent (20%), General Agent shall pay Meridian a one-time fee of $750 for each disenrolled member. This per member payment shall only apply to any disenrollment beyond the twenty percent and is not intended to apply for all members that disenrolled that selling year. Meridian will provide Notice to General Agent in accordance with Section 5.9 of this Agreement if General Agent is liable to Meridian for any amount under this Section 1 (h), and General Agent shall have thirty days to make such payment." So if I write 10 members and 3 dis enroll, I now owe you $750 in addition to the amount that I will be charged back? Suppose the plan loses the clients doctors, or hospitals? What if the client needs a procedure that isn't covered by HMO doctors? Additionally, the max compensation for a new to MAPD application is $455, and most MAPD applications are plan changes meaning the agent only receives the renewal rate of $222 (assuming a January 1 effective date). What if the disenrolling member had a 10/1 effective date and the agent only received $55.50? It's fair to charge someone $750 in addition to the $55.50 that they are already losing? Clearly whomever wrote this contract does not care about the independent agents representing their plan. I could better understand this charge if Meridian was paying their IA's a salary, providing health/vision/dental/disability or life benefits, but IA's receive nothing but a commission, so why punish them for things that are beyond their control? I'm so glad that my Humana & Aetna contracts don't have this clause, or I would be forced out of the MAPD business.
