NO Commissions on Fed Exchange W/ Subsidy

[AllenChicago]

Well she can always use the bully pulpit, but if the carriers don't want to play they will simply ignore her and then what will she do?

She can't force them to participate.

She will tell (ask?) President Obama to call an emergency meeting of Congress and request that Medicare-For-All be instituted ASAP, because evil insurance companies will not play along.

 

[Ann H]

I love it! Ummm, America, it's mid-2013 and we just found out the rates are shockingly high, the market is disrupted and choices are narrow. Republicans still oppose us 100%, and I just realized this task is harder than I ever thought it would be. Let's open this up to "fix-it" legislation in Congress.

 

[Yagents]

I believe I read that HHS is accepting all compliant plans at all prices for the first year or two (no time or resources to do so), they will scrutinize plan prices starting in year 3.

FFE's is a "passive" purchaser model. The state exchanges can be an "active" purchaser model, and eliminate plans based solely on price.

 

[somarco]

But . . . what if there are no carriers willing to play in HIX?

Nothing definitive here, but I would be surprised if anyone other than KP and BX show up on 10/1/13

 

[Ann H]

Oh, c'mon... There will be lots of competition! (sarcasm inserted) Haven't you heard of these carriers that YAgents said have also been approved for the Oregon exchange?

• ODS Health Plan Inc.
• PacificSource Health Plans
• Trillium Community Health Plan, Inc.
• ATRIO Health Plans Inc.
• BridgeSpan Health Company.
• Family Care Health Plans, Inc.
• Freelancers CO-OP of Oregon.
• Mid Rogue Health Plan Inc.
• Oregon's Health CO-OP (incorporated as Community Care of Oregon).
• Providence Health Plan.

 

[smokin goose]

My 11 year old son catches bigger fish than that ... Seriously.

 

[Focus LTC]

That commission rumor is fiction, according to everything we have heard so far.

How would you know? You haven't heard anything so far...

5 months away from "the biggest enrollment drive in history" and still no commission schedule...

 

[Ann H]

How would you know? You haven't heard anything so far...

Yes, we have heard carrier reps say the commission is based on the full premium, not just the unsubsidized portion, which was the question the original poster asked. What we haven't heard are the final published commission schedules.

 

[Focus LTC]

Yes, we have heard carrier reps say the commission is based on the full premium, not just the unsubsidized portion, which was the question the original poster asked. What we haven't heard are the final published commission schedules.

I'm not trying to get into a pissing match with you but CMS/DHHS has a reputation for making up their own definitions when it comes to agent compensation. "Full Premium" to them could mean only the portion that the policyholder pays.

I point to the Medicare Advantage agent commission debacle 3 yrs ago. CMS tried to redefine "Medicare Advantage initial enrollment" as anyone who enrolled in a part D plan in the past. This would have cut agent commissions to the tune of 50%.

All these terms like "Full Premium" will have to be defined in the commission schedules. Sooooooooo like I said earlier, you haven't heard anything so far so you really don't know anything. You may have some confidence one way or another, but you don't know anything. Someone knows, but they are not telling us, which means it's BAD NEWS.

Commission Schedules for IFP health insurance are like unicorns. I've made my position on unicorns pretty clear.

 

[taterpeeler]

well, to tag onto annh comment I as well have been told on public webinars that the comp is on the overall premium and this position has been well vetted.... also, hhs has indicated that the commission matter is up to the insurance companies so one could say, there, matter settled...... however

mapd plan have a celling set by cms I think .... and if cms, hhs, dodf or whoever else reads this let the record reflect if you pay me only on the non subsidy amount... have fun, I will take my 20 years of experience ball and go home aint going do it, I can spin my marketing dollars 100% into medicare.... HHS, you will pay me what I deem fair value or your sol
- - - - - - - - - - - - - - - - - -
also, if you only pay on the non subsidy premium how will you handle the charge backs on agents when someone flops into the HIX like October and now the client is due a subsidy? I say this since it seems an SEP is created when someone is out of the subsidy range and now falls into it