CMS Rescinds October 8th MA Commission Guidance

[scottfree]

Sigh, this forum is a crack up. Especially this time or year.

I posted just to yank Rick's chain for fun. He knows I am not serious, it was kind of a private joke since I refer all my MA/MAPD to him.

Lighten up, I was just having some fun with Rick.

Well I had no idea that you were messin with Rick.

Just very frustrated with this whole situation. I have been running appointments for the last couple of weeks and would like to know what I am getting paid.

I am going to recommend the best plan no matter what my commission is just frustrated with jerks like Stark that has to put his 2 cents in right when we were finally going to get the final numbers.

This whole situation is just ridiculous

 

[GreenSky]

Well I had no idea that you were messin with Rick.

I'm sending this while driving to Gilroy to kick some ass!

Rick

 

[Dave020]

I'm sending this while driving to Gilroy to kick some ass!

Rick

I've got cold Moosehead, Oktoberfest by Biersch and a couple of Coronas if you are inclined that way

Be sure to pick up some pizza on the way LOL
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Well I had no idea that you were messin with Rick.

Just very frustrated with this whole situation. I have been running appointments for the last couple of weeks and would like to know what I am getting paid.

I am going to recommend the best plan no matter what my commission is just frustrated with jerks like Stark that has to put his 2 cents in right when we were finally going to get the final numbers.

This whole situation is just ridiculous

I feel your pain (in my best Bill Clinton voice). I was just having a little fun is all. Probably they will not make serious changes to the commissions, maybe on the renewals.

The rules are sooooo strange.

 

[fostever]

I agree lock-in was a stupid rule. I think since CMS regulates all aspects of MA plans they do have a say in how a company pays commissions, since they are contracted through them. They should eliminate confusion by calling them Medicare HMO plans or Medicare PPO plans and leave it at that. Medicare Advantage leaves too much room for temptation to hide the fact that these are network related plans. Also they should base renewals on retention percentage of an agent's existing book of business. Reward the compliant agents and hit the non-compliant agents where it hurts, in their greedy pocketbooks. At our last meeting the company said all "first year commissions" are now called "first year renewals" to get around the rule of limiting first year commissions when a client moves from another MA plan. You think CMS won't react to that? I expect swift backlash. It's like legal ping-pong right now.

 

[jdeasy]

I agree lock-in was a stupid rule. I think since CMS regulates all aspects of MA plans they do have a say in how a company pays commissions, since they are contracted through them. They should eliminate confusion by calling them Medicare HMO plans or Medicare PPO plans and leave it at that. Medicare Advantage leaves too much room for temptation to hide the fact that these are network related plans. Also they should base renewals on retention percentage of an agent's existing book of business. Reward the compliant agents and hit the non-compliant agents where it hurts, in their greedy pocketbooks. At our last meeting the company said all "first year commissions" are now called "first year renewals" to get around the rule of limiting first year commissions when a client moves from another MA plan. You think CMS won't react to that? I expect swift backlash. It's like legal ping-pong right now.

CMS is not limiting the companies profits. Why should they have a say in agent commissions?

Why doesn't CMS standardize the plans if they want quality control?

The agents are getting a raw deal in all this mess. There are a few bad agents, but, very damn few. The ones some call bad agents are doing the companie's bidding. You can't tell me that Pyramid, Coventry and Wellcare are oblivious to how I do business. Whether I do it right or wrong, {I believe I do it right}, they know.

Still, any problems with MA, real or imagined, would be solved by doing away with lock in. Companies that do not offer good plans will lose that business if someone is better. Agents that don't do due diligence and explain to clients why a particular plan is best for them will lose that business to an agent that does. That would handle the commission problem, if there is a problem, as well.

 

[scottfree]

CMS is not limiting the companies profits. Why should they have a say in agent commissions?

Why doesn't CMS standardize the plans if they want quality control?

The agents are getting a raw deal in all this mess. There are a few bad agents, but, very damn few. The ones some call bad agents are doing the companie's bidding. You can't tell me that Pyramid, Coventry and Wellcare are oblivious to how I do business. Whether I do it right or wrong, {I believe I do it right}, they know.

Still, any problems with MA, real or imagined, would be solved by doing away with lock in. Companies that do not offer good plans will lose that business if someone is better. Agents that don't do due diligence and explain to clients why a particular plan is best for them will lose that business to an agent that does. That would handle the commission problem, if there is a problem, as well.

There would even be different problems if there was not a lock in. People would be switching plans to whatever they needed or were going to need. Know they need to go to the doctor several times-switch to a plan with $5 co-pays, Need an operation-switch to a plan with lowest hospital stay-need glasses-switch to a plan that has vision coverage for glasses. etc.

I just wish they could have election period during a 90 day period from August to October and plans going into effect Jan 1. Something similar to group plans and not during the holidays when everyone is so busy with Thanksgiving and Christmas.

I wish for a lot of things but.....well not going to happen.

 

[retread]

There would even be different problems if there was not a lock in. People would be switching plans to whatever they needed or were going to need....

You have a good point here... I know that some Medicaid "beneficiaries" will sign up to a different plan each month if the sales agent tells them they can get $1 better deal. It can also backfire... happened earlier this year to one of my clients. Signed up for a MA only plan that kicked them off the co-ordinated MAPD plan I sold them, and then complained they no longer had Rx coverage! This took me several days and many hours to unravel.

As to the so-called outrage by Sen. Stark, perhaps he should have accompanied me on a call I went on last week. Drove over 100 miles to assist a disabled lady on Medicaid that I find is not qualified for Medicare until December. She thought she was losing Medicaid because she said "you can't have both!" I tried to persuade her that she was wrong, that she will be dual qualified come December. While there I explained to her the difference between SSDI and SSI. Why can't Social Security explain these things so they understand?

Bottom line: I helped her by consoling her that she was on the best plan being on Medicaid (MO HealthNet), and that Medicare would become primary and Medicaid would move to secondary coverage. I made no money.

 

[jdeasy]

There would even be different problems if there was not a lock in. People would be switching plans to whatever they needed or were going to need. Know they need to go to the doctor several times-switch to a plan with $5 co-pays, Need an operation-switch to a plan with lowest hospital stay-need glasses-switch to a plan that has vision coverage for glasses. etc.

I just wish they could have election period during a 90 day period from August to October and plans going into effect Jan 1. Something similar to group plans and not during the holidays when everyone is so busy with Thanksgiving and Christmas.

I wish for a lot of things but.....well not going to happen.

I shouldn't have said all problems would be solved by doing away with lock in, but, most would be. Especially the drummed up charge of churning just for commission sakes.


I do a lot of dual eligibles. I don't have a problem with clients leaving as I don't mislead them and I explain things in detail. That a pretty tall order as I only do PFFS as that's all we have here.

I even like the fact that they can get out of it if a 3rd party convinces them that they shouldn't have enrolled. A person feeling forced to keep something makes for many problems down the road and hurts referral business.

There is no magic bullet, but, CMS doesn't even have a clue as to where to start.
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You have a good point here... I know that some Medicaid "beneficiaries" will sign up to a different plan each month if the sales agent tells them they can get $1 better deal. It can also backfire... happened earlier this year to one of my clients. Signed up for a MA only plan that kicked them off the co-ordinated MAPD plan I sold them, and then complained they no longer had Rx coverage! This took me several days and many hours to unravel.

As to the so-called outrage by Sen. Stark, perhaps he should have accompanied me on a call I went on last week. Drove over 100 miles to assist a disabled lady on Medicaid that I find is not qualified for Medicare until December. She thought she was losing Medicaid because she said "you can't have both!" I tried to persuade her that she was wrong, that she will be dual qualified come December. While there I explained to her the difference between SSDI and SSI. Why can't Social Security explain these things so they understand?

Bottom line: I helped her by consoling her that she was on the best plan being on Medicaid (MO HealthNet), and that Medicare would become primary and Medicaid would move to secondary coverage. I made no money.

Man, look at your post count. make one more post quickly.

 

[retread]

I shouldn't have said all problems would be solved by doing away with lock in, but, most would be. Especially the drummed up charge of churning just for commission sakes.


I do a lot of dual eligibles. I don't have a problem with clients leaving as I don't mislead them and I explain things in detail. That a pretty tall order as I only do PFFS as that's all we have here.

I even like the fact that they can get out of it if a 3rd party convinces them that they shouldn't have enrolled. A person feeling forced to keep something makes for many problems down the road and hurts referral business.

There is no magic bullet, but, CMS doesn't even have a clue as to where to start.
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Man, look at your post count. make one more post quickly.

Yeeks!

 

[Dave020]

Good move. If you hadn't posted by midnight you would have seen bloody Mary in your bathroom mirror.