Mlr

[AllenChicago]

Amen to that, Insurehound. In a nutshell, you summed up this entire sordid process perfectly!

 

[Crabcake Johnny]

This sums it up:

Healthcare Roundup: One step closer to medical-loss ratio rules - The Hill's Healthwatch

And if you're still holding out hope that our commissions will be protected - here it is:

"While disappointed the NAIC did not believe it has the authority to modify the MLR definition to accommodate agent commissions," the group's President Terry K. Headley said in a statement, "NAIFA is hopeful that the NAIC and HHS will side with consumers by recognizing that agents need to be compensated for the vital assistance they provide consumers in managing day-to-day healthcare issues."

So what does this all mean without the BS spin? HHS lawyers successfully convinced the NAIC that exempting broker commissions from the MLR calculations could be illegal.

The NAIC caved in instantly and withdrew the amendment with HHS stating that they would "work with brokers through a subgroup."

Let me state this as clear as possible. It is over. Broker comp will be included in the MRL calculations. That HHS will give a rat's ass about brokers? You decide.

My "it is over" statement doesn't mean our careers are over - just that the fight to exempt broker comp from the MLRs is over.

Moving forward with certain comp reductions, health insurance agents will need to sell multiple products.

That said, and I've had many discussions about this from many of my association members, it all really depends on your situation. Are the days of "Marking six figures in your underwear" over? Likely. In my opinion, 20%+ advanced comp is gone.

Most of the agents who were indeed making six figures "in their underwear" were buying high volumes of leads. If comp drops yet lead prices stay the same the only choice brokers with deep pockets will have it go suck up less ROI and buy even more leads. Will they do that? Yet to be seen.

However, many agents have expressed that they'd have no problem at all putting in 10K in premium a week for say, 8% and earn 40K a year working from home. Again, depends on that agent's financial financial situation and goals.

And that NAHU scored a huge victory? They must have been watching a different game.

 

[jbage007]

This whole "May be illegal" thing really gets my ire up. First, since when does the Gov't care if something "may be illegal?" See Obamacare.

20 something states are suing over the legality of the entire Act. Were Gov't lawyers in there arguing to Congress, "Psst, better not pass this - it *may* be illegal"? I think not.

So why now? Why is the Gov't stepping up and effectively arm twisting commissioners - people who, by the way, SHOULD KNOW BETTER?

I think it's obvious - the Fed Gov't doesn't give a rat's ass about insurance brokers.

And they certainly don't think consumers should be paying anything more than 1 or maybe 2 percent of premiums for "sales charges" - and even that is probably too high in their view.

Screw 'em all.

I truly hope one of those federal courts declares the whole damn law unconstitutional (which in my opinion, it is).

 

[Crabcake Johnny]

It was a bluff. It was a way to remove the amendment to exempt broker commissions from the MLRs.

 

[VolAgent]

I think it's obvious - the Fed Gov't doesn't give a rat's ass about insurance brokers.

That is about the most intelligent thing you've said in awhile.

You are projecting your desires onto reality and getting confused.

Commissions are not a medical expense. Even a kid in kindergarten could tell you that. To try and claim they are opened the door to all kinds of problems if the law stands. NAIC was right to cave and not try to claim that commissions are a medical expense. What NAIC should have done and hopefully will try to do later, is claim that commissions are a benefit to the consumer and try to exclude them from MLR. The proper argument is that commissions compensate brokers for helping consumers navigate the complex medical insurance world, and are necessary to help consumers get the advice they need to make an informed decision. Therefore, any premium dollars allocated to broker compensation should be excluded from MLR and not be counted towards administrative or medical expenses.

 

[Rivers1]

HHS never had agents/brokers in mind when they came up with this MLR scenario. Just as they did when the reform bill was voted on, they're gonna "push it through" no matter what or who it affects just to get it done. We are an after thought and that's sad.

Agents will be exiting the market. Just like the rest of the bill, this will blow-up in their face once consumers sift through 150+ options and become more confused than ever with little or no one to turn to for help.

 

[Dave020]

That is about the most intelligent thing you've said in awhile.

You are projecting your desires onto reality and getting confused.

Commissions are not a medical expense. Even a kid in kindergarten could tell you that. To try and claim they are opened the door to all kinds of problems if the law stands. NAIC was right to cave and not try to claim that commissions are a medical expense. What NAIC should have done and hopefully will try to do later, is claim that commissions are a benefit to the consumer and try to exclude them from MLR. The proper argument is that commissions compensate brokers for helping consumers navigate the complex medical insurance world, and are necessary to help consumers get the advice they need to make an informed decision. Therefore, any premium dollars allocated to broker compensation should be excluded from MLR and not be counted towards administrative or medical expenses.

Exactly, and well-said. NAHU got a concession from NAIC (and probably HHS) to form a sub group to deal with agent comp. Absent that effort, there would be no further conversation about it.

 

[Crabcake Johnny]

Not to make this sound too simple but at the end of the day the carriers need one thing; new business. They can play any card they want but if it doesn't result in enough new business we'll see some changes being made.

 

[insurehound]

Not to make this sound too simple but at the end of the day the carriers need one thing; new business. They can play any card they want but if it doesn't result in enough new business we'll see some changes being made.

Yeah but their new business will come from the Goberment, not the agents. The only way we will be included is if the carriers and those new, experienced Navigators screw things up so massively that the industry needs us.

We should have organized before it was too late. We've let others' put us out of the Health Care business.

Maybe we should sue the Goberment & the carriers & the NAIC?

 

[ksigmtsu]

Wait till the exchange goes into effect. There will be basically 0 experts willing to help with no pay, people who don't know what they're buying are going to cause 4-6 hour waits on customer service lines to try to find out why their insurance doesn't do what they think it does. They'll be complaining to the government about the unaccountable "helper" that made the recommendation to buy what they bought and how they can't get help on it.

Solution will either have to be single payer or bringing agents back by paying them, either of which is preferable to not being able to sell. We'd be better off if the market shifted to single payer medicare for all with supplemental coverage than we are with a 5% comp market.