Market Exits and Commissions, Medicare Advantage

[jmeyer210]

Hi,

I am wondering if anyone has ever tried to contact CMS about chargebacks on commissions from clients who were enrolled in a company that then exited the market for medicare advantage? Or tried to get a whole first year commission on a T65 when the client turns 65 some time during the year other than 1/1? Is it possible?

 

[jdeasy]

Hi,

I am wondering if anyone has ever tried to contact CMS about chargebacks on commissions from clients who were enrolled in a company that then exited the market for medicare advantage? Or tried to get a whole first year commission on a T65 when the client turns 65 some time during the year other than 1/1? Is it possible?

It's hard to understand what you are asking, but, I'll try. It wouldn't do any good to contact CMS about chargebacks when a company exits the market because you are supposed to be charged back when that happens for any unearned advances.

For a T^% you would get a full 1st commission no matter when they turned 65 during the year as long as they are new to MA.

 

[MrMack]

If you try to contact CMS, they will probably come after you. They don't care about you. We had to fight them just to get our $$.

 

[jmeyer210]

It's hard to understand what you are asking, but, I'll try. It wouldn't do any good to contact CMS about chargebacks when a company exits the market because you are supposed to be charged back when that happens for any unearned advances.

For a T^% you would get a full 1st commission no matter when they turned 65 during the year as long as they are new to MA.

I will give you an example I had 3 individuals who T65 in November of 2008 and I wrote them into Wellcare. I was paid the full commission of $400. Then I was charged back the full commission of $400 because of rapid disenrollment because of the companies market exit. The new company that I enrolled them in 2009 only paid me a renewal commission because they had previously been enrolled in a plan. In this particular case I was paid $400 by Wellcare and charged back $400 by Wellcare and then I only received $200 from the company in 2009. Basically I paid $200 to have these three enrollments. Since that experience, with other customers that I had in Wellcare or Coventry and Aetna I was charged back for any months of a partial year enrollment even on T65 clients. I have spoken to the companies and they tell me that I am charged back for months the member is not enrolled but I don't receive a continuation of that 1st year commission from the company that I enroll the new member in because the member has been previously enrolled.

 

[jdeasy]

I will give you an example I had 3 individuals who T65 in November of 2008 and I wrote them into Wellcare. I was paid the full commission of $400. Then I was charged back the full commission of $400 because of rapid disenrollment because of the companies market exit. The new company that I enrolled them in 2009 only paid me a renewal commission because they had previously been enrolled in a plan. In this particular case I was paid $400 by Wellcare and charged back $400 by Wellcare and then I only received $200 from the company in 2009. Basically I paid $200 to have these three enrollments. Since that experience, with other customers that I had in Wellcare or Coventry and Aetna I was charged back for any months of a partial year enrollment even on T65 clients. I have spoken to the companies and they tell me that I am charged back for months the member is not enrolled but I don't receive a continuation of that 1st year commission from the company that I enroll the new member in because the member has been previously enrolled.

That's how it works. You don't get paid for months they are not enrolled and you don't get 1st yr commissions when a person has been previously enrolled.

I am so glad that I exited that market.