- 106
I thought this was interesting, especially the part about the AEP change from Oct 15th to Dec 7th starting in 2011. And there is virtually NO OEP anymore except for going back to original medicare.
"The Obama administration delivered on its promise to damage the Medicare Advantage
program. Short of a repeal or non-funding by a Republican-controlled Congress, MA plans will
face the most change and adversity of all Medicare-related programs. In a report detailing how
the recently passed reforms would impact different categories of health insurance, The Centers
for Medicare & Medicaid Services (CMS) predicted that Medicare Advantage enrollment
will be cut in half due to the new laws. The report forecast that reductions in Medicare
Advantage payments—which will lead to less generous benefits for enrollees—will reduce
total MA enrollees to 7.4 million by 2017—roughly half the number of enrollees today.
But there are opportunities as well. Here are key changes resulting from Health Care Reform:
1. You know those quality ratings you see on Medicare.gov? Those aren’t consumer ratings
but scores determined by CMS. The five star ratings will carry some teeth in the future.
Only one-in-four Medicare Advantage plans garner a four star rating. They will be the big
winners with reimbursement rate quality bonuses of up to 10% in certain markets.
2. A minimum loss ratio of 85% will be required. Beginning in 2014, plans will be required to
return the difference to CMS if loss ratio is too low. Plans can be suspended if loss ratios
remain below 85% for two or more consecutive years, or terminated for five consecutive
years. Any squeeze on profit margins means the carrier will have to operate on lower
expenses. That can’t be good news for agent commissions.
3. Payment rates for 2011 are frozen at 2010 levels, so MA carriers aren’t facing any immediate
cuts. Beginning in 2012, the payment methodology changes for insurance carriers.
Counties will be classified in one of four county quartiles with some rural and suburban
areas receiving up to 115% of the traditional Medicare amount and more urban, populous
counties as low as 95% of standard Medicare rates. In 2010, 34% of Medicare Advantage
beneficiaries are in counties slated to receive the higher reimbursement rates in the future.
Carriers will be even more selective where they choose to market their products.
4. For those agents who hated selling during the heavy retail selling season and the holidays,
there is reason to smile. The Annual Election Period (AEP) will change in the fall of 2011
to October 15th through December 7th. The Open Enrollment Period (OEP), starting in
January, 2011, will be 45 days reserved only for those beneficiaries who want to leave a
Medicare Advantage plan and return to Original Medicare and a Part D plan. Say goodbye
to the traditional OEP and like-to-like switches."program. Short of a repeal or non-funding by a Republican-controlled Congress, MA plans will
face the most change and adversity of all Medicare-related programs. In a report detailing how
the recently passed reforms would impact different categories of health insurance, The Centers
for Medicare & Medicaid Services (CMS) predicted that Medicare Advantage enrollment
will be cut in half due to the new laws. The report forecast that reductions in Medicare
Advantage payments—which will lead to less generous benefits for enrollees—will reduce
total MA enrollees to 7.4 million by 2017—roughly half the number of enrollees today.
But there are opportunities as well. Here are key changes resulting from Health Care Reform:
1. You know those quality ratings you see on Medicare.gov? Those aren’t consumer ratings
but scores determined by CMS. The five star ratings will carry some teeth in the future.
Only one-in-four Medicare Advantage plans garner a four star rating. They will be the big
winners with reimbursement rate quality bonuses of up to 10% in certain markets.
2. A minimum loss ratio of 85% will be required. Beginning in 2014, plans will be required to
return the difference to CMS if loss ratio is too low. Plans can be suspended if loss ratios
remain below 85% for two or more consecutive years, or terminated for five consecutive
years. Any squeeze on profit margins means the carrier will have to operate on lower
expenses. That can’t be good news for agent commissions.
3. Payment rates for 2011 are frozen at 2010 levels, so MA carriers aren’t facing any immediate
cuts. Beginning in 2012, the payment methodology changes for insurance carriers.
Counties will be classified in one of four county quartiles with some rural and suburban
areas receiving up to 115% of the traditional Medicare amount and more urban, populous
counties as low as 95% of standard Medicare rates. In 2010, 34% of Medicare Advantage
beneficiaries are in counties slated to receive the higher reimbursement rates in the future.
Carriers will be even more selective where they choose to market their products.
4. For those agents who hated selling during the heavy retail selling season and the holidays,
there is reason to smile. The Annual Election Period (AEP) will change in the fall of 2011
to October 15th through December 7th. The Open Enrollment Period (OEP), starting in
January, 2011, will be 45 days reserved only for those beneficiaries who want to leave a
Medicare Advantage plan and return to Original Medicare and a Part D plan. Say goodbye
.
