New MA App Vs. Renewal

[midwestbroker]

So what is CMS considering a new MA?

My understanding is that someone coming off a supp, group, or age in are new MA's.

Another agent told me they thought that anyone that has Part D is considered a renewal.

Any word on this?

 

[retread]

So what is CMS considering a new MA?

My understanding is that someone coming off a supp, group, or age in are new MA's.

Another agent told me they thought that anyone that has Part D is considered a renewal.

Any word on this?

I can't see how they can mix the Part C and Part D commission rates since the "Parts" are separate. They set the rule that anyone joining a Part C plan for the first time is FYC for MAs, and conversely joining a Part D plan for the first time is FYC for PDPs. If someone joins a Part C for the first time and already has a Med Sup and a Part D, they would be FYC for any MA or MAPD plan. If they try to make this last situation a renewal, they must accept the certaincy of a lawsuit. If they try this, I will be the first in line at the courthouse.

 

[midwestbroker]

That is what I was to believe as well, but I wanted to make sure that I was not missing something.

I too think a class action lawsuit against CMS would be fitting if they try and mix Part C and Part D as mentioned above.

 

[Joe Moore]

I can't see how they can mix the Part C and Part D commission rates since the "Parts" are separate. They set the rule that anyone joining a Part C plan for the first time is FYC for MAs, and conversely joining a Part D plan for the first time is FYC for PDPs. If someone joins a Part C for the first time and already has a Med Sup and a Part D, they would be FYC for any MA or MAPD plan. If they try to make this last situation a renewal, they must accept the certaincy of a lawsuit. If they try this, I will be the first in line at the courthouse.

Retread,

This is exactly the way I interpret the rules, but I have a further question.

What happens if someone HAS previously been in a MAPD, say in 2007; they went to a Med Sup and a Part-D in 2008, and now came back to a MAPD for 2009? Is this a Renewal or would it qualify for FYC? One of our agents asked this question last week, and I had no answer.
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That is what I was to believe as well, but I wanted to make sure that I was not missing something.

I too think a class action lawsuit against CMS would be fitting if they try and mix Part C and Part D as mentioned above.

Midwestbroker,

I agree with what you are saying, but I seriously doubt CMS would be subject to class action. Probably exempt.

 

[midwestbroker]

Good question. I would assume that it is a new MA since they have parted from Part C, but who knows how CMS will look at those.

I am sure there will be 15+ regulation changes on that before we are paid.

 

[patch36]

Retread,

This is exactly the way I interpret the rules, but I have a further question.

What happens if someone HAS previously been in a MAPD, say in 2007; they went to a Med Sup and a Part-D in 2008, and now came back to a MAPD for 2009? Is this a Renewal or would it qualify for FYC? One of our agents asked this question last week, and I had no answer.
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Strictly speaking they are not new to MA, but...we have all seen CMS at work and I don't believe they will have the computer power or records to track it that closely. Aside from the fact that a lot of us need the commissions check sooner that later, this is going to be interesting to see what a cluster______ it will be figuring this all out for the insurance companies and CMS. Which brings another question, do the insurance companies receive less for an MA to MA? I think not, but don't know for sure. If they do not, the wrong people are pocketing the money we have been forced to forfeit by the new rules.

 

[midwestbroker]

NEW MIPPA UPDATE:

All carriers are required to send out a jar of Vaseline with each commission check to help ease the pain.

 

[retread]

Which brings another question, do the insurance companies receive less for an MA to MA? I think not, but don't know for sure. If they do not, the wrong people are pocketing the money we have been forced to forfeit by the new rules.

I mentioned this earlier. This is a very good point to consider. Why focus on agents (one piece of the equation) to the exclusion of the whole. CMS pretends to be looking out for the beneficiaries, protecting them from rogue agents, but their actions are akin to using a hammer to fix a watch. (Not that there is a similarity of Medicare to a watch!!)

The other point I want to make is that I think it is unethical for them to change contractual rules in the middle of a contract period. Not only that, but to not make a final decision until the end of the AEP is downright disgusting. This runs counter to business standards, and not only is reprehensible, but questionable legally. I intend to seek legal counsel about what I can do about this. I know trying to file lawsuits against government agencies is futile, but I am going to name names.

 

[jdeasy]

I mentioned this earlier. This is a very good point to consider. Why focus on agents (one piece of the equation) to the exclusion of the whole. CMS pretends to be looking out for the beneficiaries, protecting them from rogue agents, but their actions are akin to using a hammer to fix a watch. (Not that there is a similarity of Medicare to a watch!!)

The other point I want to make is that I think it is unethical for them to change contractual rules in the middle of a contract period. Not only that, but to not make a final decision until the end of the AEP is downright disgusting. This runs counter to business standards, and not only is reprehensible, but questionable legally. I intend to seek legal counsel about what I can do about this. I know trying to file lawsuits against government agencies is futile, but I am going to name names.

From everything I have read, these commission restrictions only apply to the writing agent. The companies, the FMO's and the GA's all get the same money they got before, {or more}, whether or not it's a churning or a new app.

There has been no information that would show the capitulation rate to be any less than ever. In fact, evidence tends to show that it is higher.

Writing agents have been made the patsies and bear the brunt of these regulations. CMS is the bad guy, but, they have been in collusion with the companies, especially the captives, on this. Humana was outed right here on this board as being a party to stuff.

 

[retread]

From everything I have read, these commission restrictions only apply to the writing agent. The companies, the FMO's and the GA's all get the same money they got before, {or more}, whether or not it's a churning or a new app.

There has been no information that would show the capitulation rate to be any less than ever. In fact, evidence tends to show that it is higher.

Writing agents have been made the patsies and bear the brunt of these regulations. CMS is the bad guy, but, they have been in collusion with the companies, especially the captives, on this. Humana was outed right here on this board as being a party to stuff.

"capitulation rate"? Yeah! That's what I was thinkin'... just capitulate to the demands of CMS. They're not losing any money.....

(I know you meant "capitation rate".... prolly a Freudian slip)