CMS Commission Change

[GreenSky]

To spin that government intrusion into our lives and telling the insurance companies how much we are worth is a positive move. By reducing commissions only the carriers have profited.

I don't like the idea that I can be paid to help my client for 5-6 years and after that only another agent can be paid. But most PFFS plans cease to exist in 2 years (and that seems to be what most people are selling) so all this may be moot. We'll be back to working wtih HMO plans and maybe PPOs. I made a pretty good living at $300 each with zero renewals.

But since there is nothing that we can do about this commission situation (not be confused with the CMS bullshit and backflips we must do to see a prospect) and the carriers have proven how little they care about agents, I agree with Chuck that it is what it is. There is no sense in complaining as our voices have never been heard. I don't see that waste of time called NAHU coming to our rescue.

Although the reality is the glass is half empty, we must pretend that it's half full. I'll be focusing on IFP, CI and term life (yes, ROP) for the forseeable future.

Rick

 

[sman]

Let me start by saying I don't work in Arizona. But I can go on the Medicare website and view the available plans in Arizona. With that said, I'm curious to know which Aetna plans AZBroker offered his clients in 2008. The red flag goes up when I see a carrier offering substantially higher commissions than other carriers and that particular carrier offering the higher commissions does a lot of business. So I decided to check Aetna's plans in Phoenix. They have 3 plans there. One is an HMO with a zero premium and the other two are PPO's with premiums of $60.20 and $85.20 per month. ALL THREE PLANS HAVE LESS THAN 250 DOCTORS IN THEIR NETWORK. Yes, with the PPO plans you can go out of network and pay a 20% copay. But you get that with Medicare so why pay a premium for that benefit?

As I look at some of the other plans available I see that the Health Net Ruby Option 1 & 2 plans have pretty much lower costs across the board (they are an HMO with 3001-3500 doctors in the network).

I see the Humana Gold Plus HMO has comparable benefits with 1501-2000 doctors in network.

I see the AARP plan has comparable benefits with 2001-2500 doctors in network.

All of these plans have lower inpatient hospital stay copays. If you had a choice of a plan with less than 250 doctors in network or 1500-3000 and slightly better benefits, which one would you choose (as the client)?

Again, I don't work in Arizona, but from the outside looking in, it appears that there may have been better plans for people in Arizona than the Aetna plan. But then again, the other plans weren't paying the broker $625 per enrollment. Of course, all of AZBrokers clients doctors could have been in the Aetna network and the plan worked for them. But as I said, I am always suspicious when a carrier is paying much higher commissions than all the other carriers. Makes you wonder if agents are pushing business to that carrier because they are making $200+ more per enrollment. Just a thought.

 

[AzBroker]

SMAN,
In 2008, Aetna was in 6 counties, in 2009 2 counties. The PFFS plans dominated in 2008 in the other counties, now go do your homework.

 

[patch36]

I think he did, and I think you answered his questions by not answering his questions.

 

[AzBroker]

Green,
I've been reading this form about 6 months now and have enjoyed your knowledge and common sense posts. I signed on just the other day to relay some info and generally complain about the the rip off we are getting from CMS, Insurance Companies, and FMO'S.
What are these forms for; to learn, friendly banter, complain and everything else. You've complained in some of your posts about the situation as have most others, now was my time too. Now, when some newbie yahoo keeps posting comm have went up or we're getting paid for 5 years, so what, we are all losing alot of money! I've moved on but it does'nt change things.
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Patchie
Sticking your nose in where it doesn't belong, again, maybe you can figure it out, newbie? I'm not going to hand you any info like your wife does all the time.

 

[Russ]

Let me start by saying I don't work in Arizona. But I can go on the Medicare website and view the available plans in Arizona. With that said, I'm curious to know which Aetna plans AZBroker offered his clients in 2008. The red flag goes up when I see a carrier offering substantially higher commissions than other carriers and that particular carrier offering the higher commissions does a lot of business. So I decided to check Aetna's plans in Phoenix. They have 3 plans there. One is an HMO with a zero premium and the other two are PPO's with premiums of $60.20 and $85.20 per month. ALL THREE PLANS HAVE LESS THAN 250 DOCTORS IN THEIR NETWORK. Yes, with the PPO plans you can go out of network and pay a 20% copay. But you get that with Medicare so why pay a premium for that benefit?

As I look at some of the other plans available I see that the Health Net Ruby Option 1 & 2 plans have pretty much lower costs across the board (they are an HMO with 3001-3500 doctors in the network).

I see the Humana Gold Plus HMO has comparable benefits with 1501-2000 doctors in network.

I see the AARP plan has comparable benefits with 2001-2500 doctors in network.

All of these plans have lower inpatient hospital stay copays. If you had a choice of a plan with less than 250 doctors in network or 1500-3000 and slightly better benefits, which one would you choose (as the client)?

Again, I don't work in Arizona, but from the outside looking in, it appears that there may have been better plans for people in Arizona than the Aetna plan. But then again, the other plans weren't paying the broker $625 per enrollment. Of course, all of AZBrokers clients doctors could have been in the Aetna network and the plan worked for them. But as I said, I am always suspicious when a carrier is paying much higher commissions than all the other carriers. Makes you wonder if agents are pushing business to that carrier because they are making $200+ more per enrollment. Just a thought.

In Phoenix,Arizona....

They had 3 plans in 2008. In 2009 they only offer 2 plans....(1)HMO w/zero premium.(2)PPO for $77.30 per month.

Problem with both of them....below 250 physicians and providers. Also, if you go in the hospital it's a $200 per day co-pay for days 1-5, each time. If you're in a skilled facility over 20 days it's $100 per day from day 21-100.

On the HMO...if you're in excellent health your total annual estimated costs is $2,250. If you're in good health it's $2,900. Poor it's $5,300.

Great deal if your providers honor it and your healthy. If not?

 

[AzBroker]

Russ,
Think PFFS plans in other counties, not PPO & HMO plans in Maricopa.

 

[Russ]

Russ,
Think PFFS plans in other counties, not PPO & HMO plans in Maricopa.

Great deal if your providers honor it and your healthy. If not?

Aetna Medicare Open Basic Plan

In Tucson,Arizona...PFFS...General
$0 monthly plan premium in addition to your monthly Medicare Part B premium.
$4,000 out-of-pocket limit.

 

[AzBroker]

Russ,
We're talking about 2008.
Aetna Medicare Open Value Plan.
$2500MOOP, $15 co-pay specialist, Part B drugs $45 co-pay.
What about The Medicare Open Premier Plan, did you see that one?
If you see a better plan than eithe one of those for 2008, let me know.
By the way, most of my clients in Maricopa for 2008 chose the Health Net $0 HMO Plan.
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As for Doctors in Az, we've had very, very, very few doctors not accept PFFS Plans!

 

[GreenSky]

Russ,
We're talking about 2008.
Aetna Medicare Open Value Plan.
$2500MOOP, $15 co-pay specialist, Part B drugs $45 co-pay.

After confirming that the largest medical group in a particular county would accept Aetna, I wrote a bunch of them last year. Great plan and since it's Aetna, I literally never had a doctor's office say "no" to accepting it.

It's not bad for 2009 and in fact, I moved exactly zero of my clients from last year. Hope I get the raise in renewals from $96 to $175.

Rick