MA Plans

[Josh]

I have read every word of your postings. I don't agree with you. I think you are just throwing up a smokescreen so that you can keep recruiting.

Why do keep insisting that I'm not reading your posts simply because I don't them to as educational as you seem to thin they are. In fact, they are downright unintelligible. They are the company line, not reality.

The clients I'm referring out are not my MA clients. If you had taken time to read, you would know that I said I no longer do MA plans. Most of the reasons have been detailed in this thread. Also, all we have here is PFFS. Two of the best plans here are going out of that arena with nothing to replace them. I refuse to sell Humana or anything associated with AARP, so that leaves out UHC. Pyramid's MA only plan costs $69/mo here and people can get a med sup for around $100/mo. Who in their right mind would try to justify a $30/mo savings to a person in a PFFS plan?

There is a regional HMO here that is expanding. They want me to rep. that. I going Wed. to see what they have to see if it's a good fit to move some of my Wellcare and Coventry clients to when they lose their current plans. They told me they have free leads. I told them I don't want any leads as I'm not going to prospect for them or try to get new enrollees.

The MA market has been being slowly killed by the carriers because of their greed. They hire newly certified agents, mostly thru FMO's with the same greed, to go out and just enroll everyone with a pulse. The agents do not understand the plans, nor do most of the FMO's. They do not understand CMS rules and the carriers wink at violations as long as they are getting enrollments.

I chose to not be a part of that circus anymore.

I insist you're not reading the posts because you ask questions about things I've already discussed. You also referred to me as "reading challenged recruiter" because you didn't think I read or acknowledged your use of the word "almost", but if you read my post it's clear that I did. Most of my recruiting efforts now have nothing to do with MA because it's no an attractive product to actively market. I'm not recruiting for for MA this season because I don't think the added marketing costs that came along with MIPPA and the reduced commissions make it nearly as attractive to market as other senior products such as FE or Med supps.

I'm completely aware that you're not doing MA anymore, but if you have done so much with it and have clients that are a good fit for it, it doesn't make sense to me why you'd give your commissions away. It's generous of you to let other agents have money you found for them.

Greed is killing the MA business? You and I might have to just agree to agree on that one. I think that everyone wants a piece of the pie and that's a part of what made things get out of hand. I think blaming the companies and the FMO's alone is only a piece of the puzzle, agents are just as greedy if not more so. In the few years before MIPPA commissions we're getting out of control. There is no reason why an agent needed to get paid over $1,000 for enrolling a husband and wife in an MA plan. I'm not saying agents shouldn't be able to earn a living or that it should be any lower than what it is now, but the commission war between carriers was getting so out of hand FMO's were paying up to at least $950/application. Carriers also haven't really been held accountable for doing a better job at managing healthcare dollars than original Medicare, a prime example of that is exactly your example of a $69/month MA vs $100/month Med supp, it doesn't make sense to not go with the Med supp. In order to really help seniors, the MA model needs to be completely restructured. Eliminating lock-in and commission advances would not address major issues like cost control or improving the quality of plans that are offered. For you to so strongly believe that eliminating those two issues would fix most of the problems with MA is proof that you don't understand the MA program as well as you claim you do. Not even entertaining the idea that there are pieces of the puzzle you can't see from your perspective is willful ignorance.

 

[jdeasy]

I insist you're not reading the posts because you ask questions about things I've already discussed. You also referred to me as "reading challenged recruiter" because you didn't think I read or acknowledged your use of the word "almost", but if you read my post it's clear that I did. Most of my recruiting efforts now have nothing to do with MA because it's no an attractive product to actively market. I'm not recruiting for for MA this season because I don't think the added marketing costs that came along with MIPPA and the reduced commissions make it nearly as attractive to market as other senior products such as FE or Med supps.

I'm completely aware that you're not doing MA anymore, but if you have done so much with it and have clients that are a good fit for it, it doesn't make sense to me why you'd give your commissions away. It's generous of you to let other agents have money you found for them.

Greed is killing the MA business? You and I might have to just agree to agree on that one. I think that everyone wants a piece of the pie and that's a part of what made things get out of hand. I think blaming the companies and the FMO's alone is only a piece of the puzzle, agents are just as greedy if not more so. In the few years before MIPPA commissions we're getting out of control. There is no reason why an agent needed to get paid over $1,000 for enrolling a husband and wife in an MA plan. I'm not saying agents shouldn't be able to earn a living or that it should be any lower than what it is now, but the commission war between carriers was getting so out of hand FMO's were paying up to at least $950/application. Carriers also haven't really been held accountable for doing a better job at managing healthcare dollars than original Medicare, a prime example of that is exactly your example of a $69/month MA vs $100/month Med supp, it doesn't make sense to not go with the Med supp. In order to really help seniors, the MA model needs to be completely restructured. Eliminating lock-in and commission advances would not address major issues like cost control or improving the quality of plans that are offered. For you to so strongly believe that eliminating those two issues would fix most of the problems with MA is proof that you don't understand the MA program as well as you claim you do. Not even entertaining the idea that there are pieces of the puzzle you can't see from your perspective is willful ignorance.

Willful ignorance is your refusal to see it anyway except from the companyman standpoint.

Eliminating lock-in would solve most of the problems with MA plans. Stevie Wonder can see that, too. Of course, Stevie is not willfully blind.

Eliminating lock-in would most likely hurt some companies, so what? They shouldn't have been in the market if their product is inferior that it fizzles because people had a choice.

So, I do understand the market. I do understand how it was supposed to work and I do understand why it hasn't. I also understand why it has been good for many people and I hate it for those people that lose good plans.

I also know that you will never understand my referring out now, or "giving away commissions" as you call it. It is quite obvious that you would never understand that.

 

[Josh]

Eliminating lock-in would solve most of the problems with MA plans.

Eliminating lock-in would most likely hurt some companies, so what? They shouldn't have been in the market if their product is inferior that it fizzles because people had a choice.

Eliminating lock-in would not solve most problems with MA plans, feel free to review the points I made in an earlier post that are problems lock-in has not caused.
The biggest piece of the problem with a continuous enrollment that you are completely missing is that it penalizes the plans that offer the most competitive benefits. It will result in adverse selection and carriers know that. You have clearly demonstrated that you can only look at the situation from your narrow perspective and have no interest in understanding anything better. That's not a company line, that's what an independent agent who's worked for carriers and done consulting work is telling you. Maybe a part of the reason you got out of this business is because you had no place in it to begin with. Maybe you're just another agent who wrote a lot of business and feels they've earned an honorary degree in healthcare finance.

Thanks for the lively debate, it's been really interesting. Happy Selling!

 

[jdeasy]

Eliminating lock-in would not solve most problems with MA plans, feel free to review the points I made in an earlier post that are problems lock-in has not caused.
The biggest piece of the problem with a continuous enrollment that you are completely missing is that it penalizes the plans that offer the most competitive benefits. It will result in adverse selection and carriers know that. You have clearly demonstrated that you can only look at the situation from your narrow perspective and have no interest in understanding anything better. That's not a company line, that's what an independent agent who's worked for carriers and done consulting work is telling you. Maybe a part of the reason you got out of this business is because you had no place in it to begin with. Maybe you're just another agent who wrote a lot of business and feels they've earned an honorary degree in healthcare finance.

Thanks for the lively debate, it's been really interesting. Happy Selling!

I have reviewed your talking points. I do not agree with your talking points.

Your personal insults just go to show that you have nothing of substance on which to base your arguments. That's always a sure sign of a loser.

 

[GreenSky]

How did I manage to participate in this discussion and not either be insulted, or insult someone else?

I must be slipping.

Rick

 

[sman]

How about we just standardize MA plans just as we have with Med Supps? All benefits the same (maybe 10 different type of benefit plans, but the same among all carriers). Then the carriers could just price them based on what would be profitable for them and the lower priced plans win. Just like with Med Supps. Seems simple enough.

As for lock-in, that was nothing more than a negotiating tactic by the insurance carriers and I don't blame them. That way they guarantee that they receive the money for an extended period of time. Could you imagine the nightmare of having to administer the program if Medicare had to send a payment to a different carrier each month because a person decided to switch plans?

As it stands right now, there are 4 1/2 months out of the year that a person can change plans. I really don't care whether we have a lock-in period or not. If you're offering the best plan for your clients specific situation, you shouldn't have to worry about it being changed.

As for the cost issues, the only thing that is going to reduce overall healthcare costs (as far as Medicare goes) is a reduction in benefits. Plain and simple. You can't do it any other way. This reduction could be in the form of reimbursements to providers or rationing of care. Either way, you are opening Pandora's Box.

 

[Frank Stastny]

How did I manage to participate in this discussion and not either be insulted, or insult someone else?

I must be slipping.

Rick

You're getting old. Just stick to your knitting and you will be okay. In a couple of years you will be able to hide your own Easter eggs. Something to look forward to.

 

[mississippiagent]

An agent in Ohio told me that by way of CMS.....there will be no advances paid for the replacement of a MA plan with another MA plan...it would simply be the renewal amount...about $16 per month????????????

I thought UHK was advancing for these replacement MA plans as we speak??????

The problem I see in not the as earn part of the renewal but the no commission part. So if they just don't pay the first year and then pay the $16.00 or whatever in the second year,you will lose your $200.00 first year.

 

[magagent]

Market medicare supplements and final expense and the problem goes away for you..

 

[Josh]

How about we just standardize MA plans just as we have with Med Supps? All benefits the same (maybe 10 different type of benefit plans, but the same among all carriers). Then the carriers could just price them based on what would be profitable for them and the lower priced plans win. Just like with Med Supps. Seems simple enough.

As for lock-in, that was nothing more than a negotiating tactic by the insurance carriers and I don't blame them. That way they guarantee that they receive the money for an extended period of time. Could you imagine the nightmare of having to administer the program if Medicare had to send a payment to a different carrier each month because a person decided to switch plans?

As it stands right now, there are 4 1/2 months out of the year that a person can change plans. I really don't care whether we have a lock-in period or not. If you're offering the best plan for your clients specific situation, you shouldn't have to worry about it being changed.

As for the cost issues, the only thing that is going to reduce overall healthcare costs (as far as Medicare goes) is a reduction in benefits. Plain and simple. You can't do it any other way. This reduction could be in the form of reimbursements to providers or rationing of care. Either way, you are opening Pandora's Box.

I'm so glad others have joined the conversation. Standardizing plans and letting companies compete on price would be a significantly better solution than simply eliminating lock-in. Plans only change every year, so if beneficiaries took a look at their options each year and picked a plan, then there wouldn't be a reason for them to change unless they developed or diagnosed with a costly condition and didn't opt for the plan which had the most comprehensive coverage for that condition. Giving seniors the option to switch plans continually would allow situations like the following to happen:
The seniors pick a plan that receives $800+/month for 5 months (over $4k) and only pays out a $400 in doctors visits and tests before the senior gets diagnosed with a serious condition and wants to change plans. The first plan gets to keep $3,600 (less commissions and admin expense) and then the new plan the senior switches to would start receiving $800/month, but be forced to pay out $20k/month or more in claims, they'd be getting penalized for offering richer benefits. Under that model companies would be less likely to offer plans with rich benefits because they'd be opening themselves up for huge loses. Part of the reason why so many companies have expanded their service areas and even more have entered into the MA business is because reimbursements have raised, carriers receive additional money for having members with certain health conditions, and lock-in exists.
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How did I manage to participate in this discussion and not either be insulted, or insult someone else?

I must be slipping.

Rick

Maybe someone has been slipping something in your coffee?