Missouri GI and the Modernized Supplements...

[Frank Stastny]

Interesting response.

Thanks for taking the time to find out and for sharing.

 

[trailhiker]

I recently started selling med supps here in MO, and for the last 8 months or so, have been putting people in plan J>>before I got educated by the likes of Frank and others here. So my question regarding this matter, if after next june J rates aren't as competitive as others, are my folks just gonna be stuck with what they have if they can't qualify for something else? That's how I see it. This has given me a new way to look at it all.

 

[G.Gordon]

I recently started selling med supps here in MO, and for the last 8 months or so, have been putting people in plan J>>before I got educated by the likes of Frank and others here. So my question regarding this matter, if after next june J rates aren't as competitive as others, are my folks just gonna be stuck with what they have if they can't qualify for something else? That's how I see it. This has given me a new way to look at it all.

Jeebus these guys kill me. Reading are hard.

"4. Paragraph (12)(B)8 shall include any Medicare supplement policy offered by any issuer, but only a policy of the same plan as the coverage in which the individual was most recently enrolled, if available, or, if not so available due to changes in the Medicare supplement plan designs, a policy with a benefit package classified as Plan A, B, C, F (including F with a high deductible), K, or L."

If you're selling J with U.O then they will gaurantee the client any other plan they sell at any time. It's in the bullentin.

 

[retread]

Look at pp 1805+ here: http://www.sos.mo.gov/adrules/moreg/current/2009/v34n17/v34n17a.pdf

I know this is off topic, and I mentioned this before in another thread, but want to take the opportunity to flag this to everyone's attention, since this proposal is quoted here....

[(14)](16) Permitted Compensation Arrangements.

(A) An issuer or other entity may provide commission or other compensation to an insurance producer or other representative for the sale of a Medicare supplement policy or certificate only if the first year commission or other first year compensation is no more than two hundred percent (200%) of the commission or other compensation paid for selling or servicing the policy or certificate in the second year or period.​

(B) The commission or other compensation provided in subsequent (renewal) years must be the same as that provided in the second year or period and must be provided for no fewer than five (5) renewal years.​

(C) No issuer or other entity shall provide compensation to its insurance producers and no producer shall receive compensation greater than the renewal compensation payable by the replacing issuer on renewal policies or certificates if an existing policy or certificate is replaced.​

(D) For purposes of this section, "compensation" includes pecuniary or non-pecuniary remuneration of any kind relating to the sale or renewal of the policy or certificate including but not limited to bonuses, gifts, prizes, awards,

and finder's fees.

I think you will see this is the same structure as compensation for MA plans. This will require CMS to "authorize" FYC and agents will be paid renewal until CMS gets around to "authorizing" FYC to the MS carriers like they do with MAOs. I didn't get my FYC "true-up" commissions for 7 months for last years AEP MA sales. I expect another similar fiasco will come up with the implementation of this proposal into law. Stand by....​

 

[retread]

In Missouri, when writing a GI policy, the agent must write the same exact plan, writing a "lesser" policy is not permitted.

We have no idea what companies are going to let agents write, in Missouri, if it is GI and the plan they currently have is no longer going to be available.

<ahem> Frank...

Excerpted from the Show-Me Senior Shopping Guide: Found on Missouri DIFP website and reformatted for emphasis (mine)​

Changes for 2010



There are a number of changes to plans coming in June of 2010. These changes do not affect your current Medicare Supplement policy.

·The available number of plans drops from 14 to 11 as of June 1, 2010.​

· Deleted plans: Plan E, Plan H, Plan I, Plan J and High Deductible Plan J will no longer be offered for new customers, but if you have one of these plans you will be able to keep it beyond June 1, 2010.​

· There are two new plans for 2010 designed to give beneficiaries new options for higher beneficiary cost-sharing with a lower premium.

oPlan M - covers 50% of the Part A deductible but none of the Part B deductible.​

oPlan N - includes full coverage of the Part A deductible but no coverage for the Part B deductible. In addition, coverage for the Part B coinsurance (as part of the Basic benefits) is subject to a new copay structure. The copay is up to $20 for office visits and up to $50 for emergency room visits.​

· If you have a Medigap policy but would like one of the new 2010 plans, you may switch during your annual guaranteed open enrollment period. See page 6 for more information.

Page 6--->

Renewing
Each year, you have the right to renew your current plan. While your rates may increase, your insurance company cannot refuse to renew your coverage or impose any waiting period based on pre-existing conditions, as long as you stay in the same plan as before. Example: Plan F to Plan F

Changing to a new plan
You have the right to switch insurance companies each year during the 30 days before or after your policy's anniversary date. For example, if your policy expires June 30, you can switch policies between June 1 and July 30.
If you change to a like plan - for example, from Plan F at Insurer XYZ to Plan F at Insurer ABC, the new insurer cannot deny you coverage and cannot impose any waiting period based on preexisting conditions.

To demonstrate that you qualify to change insurers, you are required to show only minimal proof. Simply produce a renewal notice (from your old insurer), invoice, the old policy OR other confirmation of policy ownership to the agent or new company. If you are told that you don't qualify, contact the Insurance Consumer Hotline immediately.

If you change to a plan with lesser benefits, such as from Plan F to Plan C, you will not be subject to underwriting.

>>> If you elect to go with a more extensive plan (later in the alphabet, such as from Plan C to Plan F) you will likely be subject to underwriting, and you may be denied coverage or the insurance company may impose a waiting period, based on a preexisting condition, for any new benefits under your new plan.

Once you receive the new policy and you are certain it meets your needs, you should cancel the old policy. Please note you will not qualify for a premium refund. Be sure your new policy has taken effect before your old policy is canceled. If you switch to Medicare coverage with an HMO, you will lose the benefits of your Medicare Supplement policy.

 

[JMO Fan]

Interesting discussion of Missouri. These plans are from a uniform Federal standard. Just curious - are other states doing it differently?

 

[G.Gordon]

Mr. Howser,



I appreciate your time to get me an answer, but now I have a conflict. I just read the "SHOW ME SHOPPER" and if you'll read:

Look at page 7, top left paragraph...

If you change to plan with lesser benefits, such as Plan F to Plan C, you will not be subjet to underwriting.



So is this a new addition to the current regs? When does this apply? NOW?



If it is part of the current reg and applies now could you send me a copy of that reg?

Gordon Brown




[FONT='Calibri', 'sans-serif']It's not so much a specific regulation as more a function of guarantee issue. The minimum requirement is for companies to issue the same policy on a guarantee issue basis. Companies may, at their option, give the proposed insured the right to move to any plan they market, but are not required to offer that. If a person wants to move "up" with additional benefits, then it stands to reason the company may underwrite the additional benefits. By the same token, if a person wishes to move "down" to a lesser plan, since they have already met underwriting for the "higher" plan they are leaving, the company should not be allowed to underwrite for lesser benefits. Once again, this is all at the option of the issuing company. They are only required to issue the same plan under which the person was most recently covered. Some companies do allow a person to move down to a lesser plan as an added incentive. It would almost work like a non-forfeiture benefit for long term care insurance by allowing a person to opt for a lower level of coverage in order to avoid, or lessen, a rate increase. [/FONT]
[FONT='Calibri', 'sans-serif']It is my impression that, for the Medicare Supplement annual policy anniversary provision, not that many companies allow someone to opt for a lesser plan.[/FONT]



[FONT='Calibri', 'sans-serif']My reply..[/FONT]

[FONT='Calibri', 'sans-serif']But... you understand the way that paragraph in the SHOW ME SHOPPER looks? It is a state publication making a statement of authority that if a person switched to a lower plan such as F-C, G-D, J-C, D, E, F, or G. etc. then they CAN'T USE UNDERWRITING. That is the way it will be intrepreted and demanded if someone knows of that wording in that official publication.


Gordon Brown
[/FONT]

 

[retread]

Interesting discussion of Missouri. These plans are from a uniform Federal standard. Just curious - are other states doing it differently?

Only MO and CA have annual GI regs as far as I know.

 

[Frank Stastny]

The safest way to handle it may be to call the company when the situation arises and ask underwriting. They are going to have the "final say" anyway.

At least that is how I intend to handle it. That way I know exactly what they will accept and allow. I don't like to assume anything when submitting an app. Not even when I think I know what the DOI has said.