Medi C & D Insurers Plummet

[Newby]

jdeasy and I are in the same general area. I've never met him but we spent a couple of hours on the phone a couple of nights ago. I can say this about him...he really comes across as a respectable guy who is trying to do the right thing out there for his clients. He has a real knowlege of ALL the Medicare Advantage plans and Medicare and Medicaid in general.

I was pretty amazed that he hasn't sold any Medicare Supplements because I explain both to my senior clients and about half take the supplement and half take the Advantage plans. But it has to do with what he truley believes in...not what pays better commission.

We didn't agree on everything but jdeasy definitely comes across with good ethics and knowlege of what he's doing.

 

[GreenSky]

We didn't agree on everything but jdeasy definitely comes across with good ethics and knowlege of what he's doing.

I was a little (okay, a lot) hard on him but I agree with you. He is obviously a person of high ethics. Don't understand about not selling supps though but I know it's not because of commission issues.

I disagree about the value of the Duet plan and in fact am no longer appointed with WellCare because I expressed this. My son has an appointment so if their plan (other than Duet/Melody) is good for client, he can deal with it.

My feeling a few years ago was that PFFS was the greatest invention since canned beer but I've changed my tune. Taxpayers should not be paying almost 20% more for someone to be in these plans, doctors do change their mind regarding deeming, and entire systems (ie. Baptist Health in Florida) have refused to take them.

Although I am not a fan of HMO plans due to access, I believe I'll be focusing on them this season. I never try to move someone from a supplement into managed care, but if I can help a person move from their current HMO into a better plan and get paid for it, I'm more than happy to do that.

Perhaps if I was in antther area my feeling would be different. Perhaps if Medicaid here (MediCal) didn't provide such a rich benefit and the doctors would get on the PFFS bandwagon I would be selling duals the Duel plan. But here, there really is little value. The only plans that MIGHT be worthwhile are the SNPs.

Rick

 

[mcleanbr]

If the question is why would a dual eligible sign up for a SNP, I would offer a couple of benefits. 1st is they receive additional products such as glasses or in some counties in GA dentures. These folks have trouble finding the money to replace their glasses or teeth. They receive an over the counter benefit of varied amounts. The other benefit would be the benefit of having a better "default" plan. It is common for people to lose their Medicaid and they are in a better place with a SNP versus straight Medicare. I haven't had many upset dual clients in Evercare. I have many problems with Wellcare. I enrolled people in Wellcare (non dual) this year and have had many problems.

 

[jdeasy]

I was a little (okay, a lot) hard on him but I agree with you. He is obviously a person of high ethics. Don't understand about not selling supps though but I know it's not because of commission issues.

I disagree about the value of the Duet plan and in fact am no longer appointed with WellCare because I expressed this. My son has an appointment so if their plan (other than Duet/Melody) is good for client, he can deal with it.

My feeling a few years ago was that PFFS was the greatest invention since canned beer but I've changed my tune. Taxpayers should not be paying almost 20% more for someone to be in these plans, doctors do change their mind regarding deeming, and entire systems (ie. Baptist Health in Florida) have refused to take them.

Although I am not a fan of HMO plans due to access, I believe I'll be focusing on them this season. I never try to move someone from a supplement into managed care, but if I can help a person move from their current HMO into a better plan and get paid for it, I'm more than happy to do that.

Perhaps if I was in antther area my feeling would be different. Perhaps if Medicaid here (MediCal) didn't provide such a rich benefit and the doctors would get on the PFFS bandwagon I would be selling duals the Duel plan. But here, there really is little value. The only plans that MIGHT be worthwhile are the SNPs.

Rick

I didn't take anything you said as being hard on me, so, that's all good. I guess it's this tough ass skin we have to develop to work in this business.

I have to present a tougher exterior than I have or I will be taken advantage of. I'm a union guy atheart. I was a local union presdient and the benefits rep for a 500 member local union representing a major tire company.

My heart is with the average blue collar worker that's living paycheck to paycheck. When my plant closed, I worked for the international union in the education division and also in the pension dept. I helped low income folks get proper job retraining and job placement and used the TJTC to help achieve that end. We were under contract with the Dept of Labor. When W got elected, he issued a mandate for the government to not contract with labor unions. We had just just signed a contract before he got in, so, we were OK for a few years, when it came up for re-newal, we were out of there. That's how I got into insurance. Every apptitude test I took said that I should work for myself and that insurance was the field.. Because of that background, I bring a different perspective to the field than anoy other agent I've run across.

As far a the med sups, it looks at though I will be forced to sell them to clients as the PFFS goes away and the whole MA program will follw since the PFFS is the backbone. I see that as a sad day now. Maybe I will change my mind as I do them?

It's still all about what's best for the clients. I see insurance as a necessary evil. We have to have it and I do my level best to get folks the coverage they need at the very best value. Not price, value. For the medicare folks, that happens to be the PFFS plans in my area. If med sups were the best value, that's what I would do.

Plase post anything you want and, if it's taking me to task, I'm fine with that. I am here to learn. I found this site because I was googling insurance questions in order to learn. I have learned quite a bit in the week I've been here. Looks like I'm even going to do business with one member here.

I appreaciate the honesty and frankness here.

 

[MedSuppPro]

An agent from a nearby state showed me an Anthem letter that reads like this:

...unfortunately the benefit design has resulted in adverse selection and very high loss ratios on this block of business. (MA and MAPD-plan name withheld). The negative financial impact of this business has forced us to make difficult business decisions surrounding these plans. We find it necessary to discontinue paying new business commissions associated with the PFFS (MA and MAPD) plans.

Although this is for new business only, it does point to a disturbing trend in some of the plans that we have been led to believe to be "over funded".

 

[theinuranceguy]

An agent from a nearby state showed me an Anthem letter that reads like this:

...unfortunately the benefit design has resulted in adverse selection and very high loss ratios on this block of business. (MA and MAPD-plan name withheld). The negative financial impact of this business has forced us to make difficult business decisions surrounding these plans. We find it necessary to discontinue paying new business commissions associated with the PFFS (MA and MAPD) plans.

Although this is for new business only, it does point to a disturbing trend in some of the plans that we have been led to believe to be "over funded".

Is that their MSA?

And Secure Horizons recently did this to some plans in AZ and FL

 

[Winter_123]

An agent from a nearby state showed me an Anthem letter that reads like this:

...unfortunately the benefit design has resulted in adverse selection and very high loss ratios on this block of business. (MA and MAPD-plan name withheld). The negative financial impact of this business has forced us to make difficult business decisions surrounding these plans. We find it necessary to discontinue paying new business commissions associated with the PFFS (MA and MAPD) plans.

Although this is for new business only, it does point to a disturbing trend in some of the plans that we have been led to believe to be "over funded".

Kind of weird the way it is worded. They are not saying the plan is being terminated, only that they wont pay anyone to sell it. Probably has to do with the fact that they are committed under CMS rules to continue offering it throughout 2008 so cutting the commissions is the closest they can come to pulling the plug on it midyear.

Winter

 

[jdeasy]

An agent from a nearby state showed me an Anthem letter that reads like this:

...unfortunately the benefit design has resulted in adverse selection and very high loss ratios on this block of business. (MA and MAPD-plan name withheld). The negative financial impact of this business has forced us to make difficult business decisions surrounding these plans. We find it necessary to discontinue paying new business commissions associated with the PFFS (MA and MAPD) plans.

Although this is for new business only, it does point to a disturbing trend in some of the plans that we have been led to believe to be "over funded".

I got a similar notice to that from Chesapeake about their PFFS. They are still gonna pay the agents, but only on an as earned basis. I have never written any of their business, but, I'm contracted with them thru one of my GA's.

That's what Wellcare have done with the Duet/Melody in Ky and In. It's still being sold, but won't commission the agent son it. That effectively stops it from being sold.

 

[MedSuppPro]

Speaking of WellCare... We all know about their fabulous $1,000. hearing-aid benefit. But, have you ever asked yourself; What does your client's do with their old pair of hearing aids after they upgrade. According to top secret CMS documents, WellCare has figured this out. Starting in 2009, WellCare will offer an enhanced benefit with no co-pay through Blendtec.

 

[MedSuppPro]

[FONT=&quot]In the Medicare business for the elderly, for which UnitedHealth is the market leader, gross margins declined in plans that provide prescription drugs and specialized coverage for people with chronic diseases, the company said...[/FONT]

[FONT=&quot][/FONT]
[FONT=&quot]"UnitedHealth no longer offers competitive, affordable products to the marketplace that people want to buy, especially with all their customer service, claims payment and provider relationship issues,'' Skolnick said.[/FONT]


[FONT=&quot]Bloomberg.com July 2, 2008[/FONT]


[FONT=&quot]UnitedHealth cuts 4,000 jobs by Healthcare -- Revver Online Video Sharing Network[/FONT]