How many of your clients MAPD plans are being dropped?

[PCBI]

For the agents here that have large MAPD books, how many of your clients are you having to find new coverage for this AEP because their plan will not be available in 2025. Personally the majority of my book is Medigap + PDP but what I do have in MAPD I am having to find new coverage for 40% of my Humana and about 15% of Aetna. I don't think Humana or Aetna are cross walking these to other plans....is this correct?

If these percentages are any indication of others I can't imagine someone that has 500+ with Humana if they had to replace 40% of theirs.

Just curious as what others are seeing?

Yep Humana in Columbus Ohio getting hammered. Also in Pinehurst NC

 

[somarco]

Lol what state are you in,

All of them.

Every meeting is F2F and he drives to all of them . . . still manages to write 100+ apps a week and maintain his national top producer status.

He is a beast!

 

[DonP]

Yep Humana in Columbus Ohio getting hammered. Also in Pinehurst NC

Humana getting hammered tons of places .Not only with the termed plans but also out of network hospital systems .It’s happening all over the country . Humana will get there wish not only the 10% of clients they wanted dropped they might lose 20%. Humana and Aetna are the main reasons we have all these non commissionable plans hitting . The big air pocket in 2 mil plus mapd termed plans has caused massive influx of business to many plans they can’t handle . I’ve written 5 carriers hard this aep as I’m i’m spreading my business out

 

[603Broker]

I have over 450 MAPD clients that have to move. We lost Aetna, Humana, Wellcare and Harvard Pilgrim Stride, which was a local non profit HMO which had a great network benefits and customer service. I had over 350 people with them alone. This AEP has been actual hell. The disruption in my county in NH has been hit the hardest in the country. I have moved 85% of my clients to either a different MAPD or back to OM with a sup, and finishing up with the other 15% in the following weeks. I have been working 14 hour days including Saturdays taking only Sunday offs. It is a nightmare.

 

[yabadabadoo1026]

high MOOPs look bad but i use them primarily as a tie-breaker in comparisons, small % people in their lifetime i would suspect hit a 7000 MOOP, am i wrong?

 

[AgentGeneral]

So much fun compared to how I thought this AEP was going to go

Lets just say, I thought it would be a laid back AEP, and not much switching.

Then BOOM! Humana no longer in network in main Hospital and Doc network. In fact, not only is Humana out, so is every other national carrier at least as far as the counties I work with one main major network.

Just thought I'd pop back in and update what's up in Mi.

Absolute Mayhem and I'm here for it!!

 

[axeman462]

high MOOPs look bad but i use them primarily as a tie-breaker in comparisons, small % people in their lifetime i would suspect hit a 7000 MOOP, am i wrong?

I'm not sure of what the percentage is of people that hit the MOOP, I reckon it is low. But cancer (other than skin) will make someone hit the MOOP every time.

With a MOOP as high as $7,000, you may want to discuss hospital indemnity and/or a cancer policy with your clients. You can often tack it on for an extra $50/mo, sometimes even less if they're still younger

 

[yabadabadoo1026]

I have just over 500 MAPD ppl. 8 are losing their plan, all Humana in a couple of rural counties. All in all not bad. Not a lot of benefits being cut in the counties I work in TN either. UHC marginally worse, Humana marginally worse ,BCBST PPO is def. better overall for 2025. All are cutting the OTC but that's not a big deal imo. But I don't deal with Duals so may be different there

these folks love that wayyyyyyyyyy over-priced OTC out of catalogues, why Humana would cut that out completely on some plans is head-scratching as they are losing clients because of it. $40 of that over-priced OTC is really only worth $15-----get that stuff at Dollar Tree for 1.25

 

[yabadabadoo1026]

I'm not sure of what the percentage is of people that hit the MOOP, I reckon it is low. But cancer (other than skin) will make someone hit the MOOP every time.

With a MOOP as high as $7,000, you may want to discuss hospital indemnity and/or a cancer policy with your clients. You can often tack it on for an extra $50/mo, sometimes even less if they're still younger

humana took MOOP to 9350 in Ga

 

[yabadabadoo1026]

My cell phone is how I conduct all business. Plus, I just think it’s absolutely ridiculous that small mom and pop agents have to bug their clients.

But I also think it’s way too formal and puts people on edge right from the get-go….

“Oh wait, I can’t talk to you until I turn my phone-bugging device on, and read this disclaimer that makes it sound like I’m scamming you.”

Nah, no thanks. I’ll just do everything in person and via text and email.

Text and email is all you need to save your rear end, anyway. Plus, I have zero interest in paying for storage, and storing a city’s-worth of audio recordings about intimate details until…… who even knows when?

If agents want to do it, I’m all for it, but it should be completely voluntary. It’s absolutely not necessary to force agents to do this.

The problem is, was, and always will be the call centers. Not us. They even said that, after they conducted research.

Of course, said research was AFTER they made the rule. Yet we still have to record? No thanks. Not doing it.

totally agree with your attitude on stupid compliance that restricts us while the call centers are the problem. The Scope i do and call it a stupid CMS thing to the client laughing at it------the 48 hr is more BS that makes no sense