CMS Changes Are Going to Lead to Commission Cuts for MAPD

[G.Gordon]

I'd read the guidelines from the plan in question before believing a manager. My experience is that you get the first year rate monthly until that plan is one year old, in your example, December of the 2nd year would be your first month at the renewal rate.

 

[bpenn9]

I'd read the guidelines from the plan in question before believing a manager. My experience is that you get the first year rate monthly until that plan is one year old, in your example, December of the 2nd year would be your first month at the renewal rate.

Sounds right to me.....

 

[Nikita]

Sounds right to me.....

Yes guys, I agree that is the way it has been in the past. According to my manager, who by the way is pretty sharp, there are CMS mandated changes to the MAPD commission structures that are going to change all that. There is a conference call today at 1pm where this is all going to be announced and also supposedly a mass email going out to all MAPD agents contracted with United Health. Per my manager, all agents who sell MAPD will be affected by this change, not just UHC agents. So we'll see what happens....

 

[SecureHealth1]

Yes guys, I agree that is the way it has been in the past. According to my manager, who by the way is pretty sharp, there are CMS mandated changes to the MAPD commission structures that are going to change all that. There is a conference call today at 1pm where this is all going to be announced and also supposedly a mass email going out to all MAPD agents contracted with United Health. Per my manager, all agents who sell MAPD will be affected by this change, not just UHC agents. So we'll see what happens....

Are these changes for 2015?

 

[Chazm]

I wouldn't get my panties in a bunch just yet over what some unknown manager says

 

[unic.consulting]

At this point, I'm waiting to see what UHC sends me about it.

 

[Chazm]

Just check my Coventry statement as they have been doing this already. Signed up a client in June. Got paid $107 right away, $106 2 months later and just this week got $213

 

[Nikita]

Just check my Coventry statement as they have been doing this already. Signed up a client in June. Got paid $107 right away, $106 2 months later and just this week got $213

Chazm what you are describing here with regards to your Coventry payments is not what I was told was going to happen, it was an entirely different situation. I was told the email was going out today and I have a call into my manager right now to find out if there are any updates.

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I just received the email from UHC:

Changes to Commissions in 2014
Commissions payment process changes for Medicare Advantage (MA) and Part D Plans

Thank you for your support, continued business, and commitment to helping our members live healthier lives. As you may know, CMS has issued new industry guidelines for commission payment processing that will change how we pay and process commissions to agents and upline overrides. These changes do not apply to Medicare Supplement plans.

CMS has clarified that a plan year is defined as January 1 through December 31, regardless of effective date of the enrollment. UnitedHealthcare's current policy defines a plan year as a continuous twelve (12 months). For example, for a July 1 enrollment, our current process is to pay a full twelve months in the year of the enrollment and to begin renewal payments in July of the following year. Furthermore, CMS has clarified that plans may not advance commission payments for more than one year at a time with the exception that plans may advance payments during the Open Enrollment Period (OEP) for the upcoming plan year.

As a result of the new CMS guidelines, UnitedHealthcare will be making the following changes to the commission payment process:

Beginning with enrollments effective February 1, 2014, UnitedHealthcare will process specifically identified MA plans, all Dual SNP plans, and all Part D plans that qualify for initial year (i.e., New To Medicare (NTM)) compensation at an annual rate. In these cases, the full annual commission rate will be paid regardless of effective date - view list of MA plans specifically identified for "full" annual payment. For plans that do not qualify for the initial compensation (i.e., NTM) rates we will pro-rate and pay commissions based on the number of months the member is enrolled during the plan year of enrollment. In both instances, renewals will begin on a per member per month basis in January of the next plan year.
Beginning with the enrollments effective February 1, 2014, UnitedHealthcare will pro-rate and pay commissions based on the number of months the member is enrolled during the plan year of enrollment for specifically identified MA plans - view list of MA plans specifically identified for "pro-rata" payment. * For example for a July 1, 2014 enrollment, we will pay 6/12ths of the commission rate for the first plan year - which means if the annual renewal rate is $200, we will pay $100 for a July effective date. This new process applies to specific MA Plans regardless of whether the member qualifies for the renewal year or initial year (i.e., NTM) rate and also applies to upline overrides. Renewals will begin on a per member per month basis in January of the next plan year.
UnitedHealthcare's current process of pro-rating only partial commission payments for involuntary terminations, which permits agents to retain any true up dollars (the difference between the renewal and the initial year rate) will also conclude for all plan types, beginning with January 1, 2014 effective dates, and all commission payments including true up dollars will be pro-rated.
See the Sample New Methodology Payment Grid for examples on each of the above payment methodologies.

Modifications to our commission system are required in order to administer the above changes for February and forward commission payments. Due to these required system changes we will need to hold commissions for February and forward effective date enrollments. Once these changes have been implemented in mid-February, we will release payments for applications with February 2014 and forward effective dates.

What is not changing

Payments for sales of January 2014 effective dates will process per our normal schedule, and will not be affected by these changes.
UnitedHealthcare Non-Commissioned MA Plans for 2014
As you are aware, UnitedHealthcare periodically updates its contracts to include new and/or modified commission schedules for the coming plan year and other updates and changes to agreements.

As a result, we will be modifying the Agreement by adding the following select MA plans as non-commissioned, beginning with applications signed on January 19, 2014, with 2014 member effective dates. An updated contract amendment will be forthcoming with additional details.

Contact
If you should have additional questions, please contact the Producer Help Desk at [email protected]. Please include your agent writing number in the subject line of the email.

*Note, these rules will also apply to any CMS approved retroactive enrollments for 2013 and prior effective dates received on or after January 1, 2014.
December 20, 2013. Confidential and proprietary. For internal/agent use only. Do not distribute.


Yup, pretty much what I was told. Apparently not all MAPD plans are affected but the major MAPD plan here in Iowa is on the list and there's gonna be alot of unhappy agents.

 

[WCMason]

I had received a memo from Aetna couple of months ago regarding changes in commission structure for MA plans. From what I remember the plan will be to prorate the current year then begin renewals in January for everyone enrolled.

Edit: and the post above which was posted the same minute mine was seems to confirm this. No unhappiness here.

 

[hassy99]

Just heard tonight from my regional manager that due to some CMS changes, first year commissions for ALL advantage plans are going to be reduced. You will only get the entire first year commission if the plan is sold in January. After that commission will be pro-rated, i.e. a plan sold in July will receive only 6 months of first year commission and then starting Jan 1, the agent will receive monthly renewal rate (50% of first year commission)....So if you enroll someone with 12/1 effective date, you will receive 1 month of higher first year commission and then on 1/1 you will receive 50% of that rate (i.e. the renewal rate) for remaining commissions - so essentially losing almost one-half of first year commissions!

Just received my new commission agreement for2014. With uhc. Prorated for new enrolled. Then jam will be renewal (if you enroll a new member in July. You would get about $200 advanced then start receiving income jan of next year based on renewal amount)

Med supps are looking better and better