CMS Changes Are Going to Lead to Commission Cuts for MAPD

[unic.consulting]

Wow! That sux for real. Here in Florida, at least with the MAPD companies I rep, we get the typical $214 (give or take a few dollars) for people already in an MAPD and about $425 for the ones who never enrolled in a MAPD plan before. To get less is going to hurt because I am sure most of us don't get a bunch of chargebacks! Most of mine are because of death! The math is simple...we know if we want to make $10K per month we have to enroll about 50 people. Now, with this new model...never mind...my head hurts.

BTW, charge backs suck anyway. They don't charge back the doctors or anyone else up the food chain but us agents. So annoying.

Actually, they do charge back the doctors and anyone else they can squeeze money out of.

 

[Daytona_Guy]

I started my insurance career with United Healthcare in 1995 when they first moved into the small business market in Florida. Boy have they changed since then.

At the National Medicare Supplement conference in Scottsdale, AZ this past year,
Susan Morisato, President, Insurance Solutions, UnitedHealthcare, made some very interesting comments on her thoughts on the independent agent.

My take away, not her exact words, was that they are irritated by having to work with independent agents, want to go it alone with direct-to-consumer marketing, and have every intention of reducing comp to the indy.

Seems that's coming true. I've never seen a company compete so strongly against the independent agent - to say nothing of their required brainwash training of the heavenly endeavors of such a benevolent organization AARP is.

 

[craig_ritter]

From what I understand, there are now 3 tiers of commission payment with UHC depending on the plan you sell. Group 1 is not commissionable. Group 2 is "pro-rata". Group 3 is "Full". UHC has PDF documents that list out each of the 3 groups.

Group 1 is pretty easy to understand.

In Group 2, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example: Sell a 12/1/14, you get 1/12th of $207 or $17.25. If the case is a "true up" or "initial" or whatever you wanna call it, you get the same amount again (both the first half and second half are pro-rated). That's payment in full for the calendar year. Then, if it renews in 2015, you get paid monthly as earned. So, if you sell a T-65 in group 2, it will take you 23 months to finally earn your $425.

In Group 3, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example is the same as group 2. If the case is a "true up", you would get trued up to the FULL $425 (they would pay an additional $407.75 as a true up payment). Then, if it renews in 2015, you get paid monthly as earned. So, if you're fortunate enough to be selling this group, you would actually get $425 for one month and then monthly as earned the following month.

Anyway, that's what I've been able to figure from this. Some other companies are treating everything like group 3 and some companies are treating everything like group 2. UHC is the only company I'm aware of that's segmenting how they handle true up commissions based on the plan you sell. For now, at least.

Maybe others can confirm, but this is how I understand it. I'm not sure I will follow it exactly until I see it on the commission statements.

Regardless, CMS wants to change the way they pay agents starting in 2015, so this whole system may get scrapped in a year.

 

[Todd King]

They also have a 4th group. That's the one where they don't pay you anything for a particular county. I think it's call the Screw You Plan!

 

[Knoble]

From what I understand, there are now 3 tiers of commission payment with UHC depending on the plan you sell. Group 1 is not commissionable. Group 2 is "pro-rata". Group 3 is "Full". UHC has PDF documents that list out each of the 3 groups. Group 1 is pretty easy to understand. In Group 2, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example: Sell a 12/1/14, you get 1/12th of $207 or $17.25. If the case is a "true up" or "initial" or whatever you wanna call it, you get the same amount again (both the first half and second half are pro-rated). That's payment in full for the calendar year. Then, if it renews in 2015, you get paid monthly as earned. So, if you sell a T-65 in group 2, it will take you 23 months to finally earn your $425. In Group 3, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example is the same as group 2. If the case is a "true up", you would get trued up to the FULL $425 (they would pay an additional $407.75 as a true up payment). Then, if it renews in 2015, you get paid monthly as earned. So, if you're fortunate enough to be selling this group, you would actually get $425 for one month and then monthly as earned the following month. Anyway, that's what I've been able to figure from this. Some other companies are treating everything like group 3 and some companies are treating everything like group 2. UHC is the only company I'm aware of that's segmenting how they handle true up commissions based on the plan you sell. For now, at least. Maybe others can confirm, but this is how I understand it. I'm not sure I will follow it exactly until I see it on the commission statements. Regardless, CMS wants to change the way they pay agents starting in 2015, so this whole system may get scrapped in a year.

If your hearing CMS might scrap the whole system in 2015 any idea on what the new system will look like or what they're leaning towards?

 

[Norwayguy]

If your hearing CMS might scrap the whole system in 2015 any idea on what the new system will look like or what they're leaning towards?

Yeah a good feeling for helping people.

 

[sman]

They also have a 4th group. That's the one where they don't pay you anything for a particular county. I think it's call the Screw You Plan!

That's actually Group 1 as Craig outlined. But I like your name for it much better since it describes it much more clearly.

 

[Midlevel]

I'm a proud member of group 1!!!!!

 

[Nikita]

From what I understand, there are now 3 tiers of commission payment with UHC depending on the plan you sell. Group 1 is not commissionable. Group 2 is "pro-rata". Group 3 is "Full". UHC has PDF documents that list out each of the 3 groups.

Group 1 is pretty easy to understand.

In Group 2, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example: Sell a 12/1/14, you get 1/12th of $207 or $17.25. If the case is a "true up" or "initial" or whatever you wanna call it, you get the same amount again (both the first half and second half are pro-rated). That's payment in full for the calendar year. Then, if it renews in 2015, you get paid monthly as earned. So, if you sell a T-65 in group 2, it will take you 23 months to finally earn your $425.

In Group 3, when you sell a case, you get advanced pro-rata based on the number of months the member is projected to be in the plan for the current calendar year. Example is the same as group 2. If the case is a "true up", you would get trued up to the FULL $425 (they would pay an additional $407.75 as a true up payment). Then, if it renews in 2015, you get paid monthly as earned. So, if you're fortunate enough to be selling this group, you would actually get $425 for one month and then monthly as earned the following month.

Anyway, that's what I've been able to figure from this. Some other companies are treating everything like group 3 and some companies are treating everything like group 2. UHC is the only company I'm aware of that's segmenting how they handle true up commissions based on the plan you sell. For now, at least.

Maybe others can confirm, but this is how I understand it. I'm not sure I will follow it exactly until I see it on the commission statements.

Regardless, CMS wants to change the way they pay agents starting in 2015, so this whole system may get scrapped in a year.

I was on the phone this week with the Commissions department at UHC Producer Help Desk discussing all of these changes...the woman had the audacity to tell me that UHC had nothing to do with any of these commissions cuts, that they were all ordered by CMS!! I asked, why would CMS mandate that UHC create these different groups or categories essentially allowing agents in certain states to make full commission for selling some MAPD plans, while agents in other states taking huge pay cuts for essentially selling the same plan. And the other carriers like Coventry haven't created these "groups" with different commission structures...what a bunch of BS, blaming all this on CMS. I told her did she think we were all idiots to believe that line of BS....UHC is really pissing me off big time, problem is they are the only MAPD plan available in my area, otherwise I would quit them in a heartbeat!

 

[Norwayguy]

I'm a proud member of group 1!!!!!

Proud of the screwing or that at least they are upfront letting you know they don't want your business.