Dr. Oz says commission churning for MA plan is big issue

[DonP]

The maintaining Dual SEP is gone. Has to be a change in status to qualify for the SEP in 2025.

So what's to prevent call centers from lieing on every app using sep " change of status " ? Carriers don't ask for proof as of now .In reality I got 3-4 people every month losing and gaining Medicaid . I'll be monitoring my business very close . If I see call centers trying to take my clients still I'll be 3 way calling the carrier filing complaints the client never had any change . Carriers want the business and won't check crap

 

[sman]

Correct before this past aep i never moved more than 20-30 current clients people during any aep . I hate moving people . This aep i had 64 termed plans alone .I was well prepared this aep as i started getting scopes .drugs and doctors in Aug. I stop soliciting new business in mid aug .What I'm saying in todays chaos of massive plan changes and terms if you go to a new fmo your going to be moving plans . Listening to podcasts of some big fmo's with big relationships with carriers 2026 is going to be chaos again

Yes, many of us had to move clients because of termed plans. That had zero to do with who your FMO is.

 

[DonP]

Yes, many of us had to move clients because of termed plans. That had zero to do with who your FMO is.

No it doesn't matter who your fmo is but the whole pt of why I mentioned it is the fmo almost makes 2x ($250) the commission vs a renewing policy ($12.50 a month or $150 a yr) . My pt in mentioning this is an agent with a big block of business is now extremely valuable to an fmo . We all have to move many more people that yrs ago . The agent makes no more whether he moves the client to a new plan or it just renews . There's zero financial incentive for an agent to flip his book unless he's desperate for up front cash . Every good agent wants to leave all clients alone and concentrate on new business . But there's a huge financial benefit for the fmo to have agents flip there book with 2 times the override .

 

[Winters Ins Agcy]

So what's to prevent call centers from lieing on every app using sep " change of status " ? Carriers don't ask for proof as of now .In reality I got 3-4 people every month losing and gaining Medicaid . I'll be monitoring my business very close . If I see call centers trying to take my clients still I'll be 3 way calling the carrier filing complaints the client never had any change . Carriers want the business and won't check crap

I would hope that it gets caught at CMS. But I'm 100% with you on how to respond if it doesn't.

 

[EckoRomeo]

So what's to prevent call centers from lieing on every app using sep " change of status " ? Carriers don't ask for proof as of now .In reality I got 3-4 people every month losing and gaining Medicaid . I'll be monitoring my business very close . If I see call centers trying to take my clients still I'll be 3 way calling the carrier filing complaints the client never had any change . Carriers want the business and won't check crap

You've stated that most of your business is transfers. How are you going to maintain your production after OEP?

 

[EckoRomeo]

My view of churning is from the investment world where a broker constantly makes trades to earn additional commissions.

But that's not how churn is being used here. Churn is simply attrition.

In the MA world, from the agent perspective, there's no real incentive to move your own client from plan to plan (churn) other than it's the right move. I'd LOVE to be able to leave all my clients on their plans. Less work, same commission.

While not a strong incentive, marketing money and HRA bonuses make churning clients within your book profitable. Many agents receive per app money from their FMO. Combine that with a potential HRA and an agent can receive more than $100 over the commission rate. Which, depending on the time of year, is anywhere from about 30% - 125% of the commission you get for a transfer.

 

[EckoRomeo]

If I see call centers trying to take my clients still I'll be 3 way calling the carrier filing complaints the client never had any change .

That's an interesting. You'd be fighting CMS violations by committing a CMS violation. Also kinda hypocritical considering some of the sales tactics you've admitted to *door-knocking*...

 

[Medicare bro]

But that's not how churn is being used here. Churn is simply attrition.

While not a strong incentive, marketing money and HRA bonuses make churning clients within your book profitable. Many agents receive per app money from their FMO. Combine that with a potential HRA and an agent can receive more than $100 over the commission rate. Which, depending on the time of year, is anywhere from about 30% - 125% of the commission you get for a transfer.

HRA don't exist anymore as far as I know.

 

[EckoRomeo]

HRA don't exist anymore as far as I know.

I think UHC still pays for C/D SNP and Cigna still pays them on everything.

Aetna and Devoted still do as well.

 

[straightnochaser]

The maintaining Dual SEP is gone. Has to be a change in status to qualify for the SEP in 2025.

There's a monthly SEP for full duals in states with HIDE/FIDE which is what I am talking about.

I also see call centers using change in status even if it doesn't apply. I doubt carriers will check.