Pdp $$

Caveat, I am not an insurance agent.

When I first joined the site and read posts in this sub-forum, one message that came across, with one or two exceptions, was Medicare agents' belief that doing PDP reviews for their Medigap clients was a necessary service to retain the Medigap client and commission on the related Medigap policy.

A number of agents commented along the lines of: The PDP review was so important to Medigap client retention that the agents did the PDP reviews even though they (the agent) received no commission for the PDP sale. It was cheaper to retain the Medigap client, and related Medigap commission, with PDP reviews rather having to replace the client because they went elsewhere to obtain help with PDP review.

Comments in this thread suggest agent views about the PDP product may be changing, to say the PDP is a product separate from Medigap coverage, and the PDP should not be handled if it does not provide separate agent compensation.

I think underwriting has become more strict making it harder to change that using the PDP as the "wedge" to re-write someone else's Med Supp client. (the old, I'll help you with the PDP if I can re-write your Med Supp --- oh... you take Prolia / ....guess I can still do that PDP but the old agent still keeps your supp?).

Also, tech has "caught up" a bit - so some of it really can be hands off whereas in the past, it couldn't.

I think those are two things that have changed --- also, it'll depend on the size of the book someone is sitting on. You have 223 clients and you'll want the PDP/Med Supp more than when you have a bigger book.
 
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The word I heard is that CMS stated on a phone call yesterday that PDP plans will have the option to either pay no commission or the full Fair Market Compensation. Seems like to me allowing carriers to go non-commissionable goes directly against the entire thrust of the latest final rule (eliminating the incentive for agents to market only certain plans based on comp).
 
In addition to basic economics and insurance, you also need to learn how to read:
From the article:

"In 2023, 30.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 51 percent, of the eligible Medicare population, and $454 billion (or 54%) of total federal Medicare spending (net of premiums)."

"
Key highlights include:

  • More than half (51%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2023."
"In 2023, more than half (51%) of eligible Medicare beneficiaries – 30.8 million people out of 60.0 million Medicare beneficiaries with both Medicare Parts A and B – are enrolled in Medicare Advantage plans."

In 2023, nearly two-thirds of Medicare Advantage enrollees are in individual plans that are open for general enrollment.​


One in five (about 5.4 million) Medicare Advantage enrollees are in a group plan offered to retirees by an employer or union.​


KFF is obviously including group plans in the Medicare Advantage numbers


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WHAT DID I TELL YOU ABOUT FACTS, SIR?!?!?
 
The word I heard is that CMS stated on a phone call yesterday that PDP plans will have the option to either pay no commission or the full Fair Market Compensation. Seems like to me allowing carriers to go non-commissionable goes directly against the entire thrust of the latest final rule (eliminating the incentive for agents to market only certain plans based on comp).

The new rules makes the carriers eat the cost of the part d standard model 590.00 deductible , whether or not the plan has a deductible and also eat the 25% coinsurance if a member reaches the 2000.00 cap.IMO if more PDP plans are non commishy in 2025 it will be plans with no/low deductible and robust formularies.Metformin we pay you.Ozempic-no commision for you!
 
Caveat, I am not an insurance agent.

When I first joined the site and read posts in this sub-forum, one message that came across, with one or two exceptions, was Medicare agents' belief that doing PDP reviews for their Medigap clients was a necessary service to retain the Medigap client and commission on the related Medigap policy.

A number of agents commented along the lines of: The PDP review was so important to Medigap client retention that the agents did the PDP reviews even though they (the agent) received no commission for the PDP sale. It was cheaper to retain the Medigap client, and related Medigap commission, with PDP reviews rather having to replace the client because they went elsewhere to obtain help with PDP review.

Comments in this thread suggest agent views about the PDP product may be changing, to say the PDP is a product separate from Medigap coverage, and the PDP should not be handled if it does not provide separate agent compensation.
PDP has increased in work load over the years. A few years ago, we could just do the PDP comparison on the medicare dot gov website, and there was a unique numeric code we could save for each person, to access again each year.

Now, we have to have our own third party platform, and enter the drugs in manually. There are a lot of steps involved, if you accidentally choose CAP instead of TAB, it can make a big difference in plan outcomes. Also, as I think somebody else pointed out, now we have to do a scope, and record the calls. I even have to do that on the smartsaver plans... when I am not even getting paid. I'll do that for a long time client, but it still sucks when a few months into the year they are confused and calling about issues with the PDP.

A person might argue that the client can have their own login, to compare drug plans, but even that has pitfalls. Im sure a few other agents have noticed how when a person is about to lose LIS, the medicare portal doesnt recognize it, and recomends plans as though the LIS well renew.

Also, I think most of the agents on this forum have a lot more clients than they did when you first joined, and as such, they are doing quite a bit of PDP work.
the reason the views have changed is because of bidenflation.
Looking at the data, it appears several leaders from the last decade (+) have racked up quite a bit of national debt, printing a lot of new money, the ripple effect is ongoing. Biden might even pass up Trump, but he's not quite there yet... trump is still winning... could they both be unfit for the role, or do we have to pick a side?

The word I heard is that CMS stated on a phone call yesterday that PDP plans will have the option to either pay no commission or the full Fair Market Compensation. Seems like to me allowing carriers to go non-commissionable goes directly against the entire thrust of the latest final rule (eliminating the incentive for agents to market only certain plans based on comp).

If they all go non-commissionable, perhaps there won't be an enrollment option on all the sunfire and connecture platforms etc.

The new rules makes the carriers eat the cost of the part d standard model 590.00 deductible , whether or not the plan has a deductible and also eat the 25% coinsurance if a member reaches the 2000.00 cap.IMO if more PDP plans are non commishy in 2025 it will be plans with no/low deductible and robust formularies.Metformin we pay you.Ozempic-no commision for you!

I guess we just wait and see. I have been expecting wellcare to follow the smartsaver business model, and go non-commissionable. Ive just been loading up on them until they do. The PBM's will also play a major role in all of it. Imagine a company goes non commissionable, and the PBM gets greedy, and the pharmacies dont want to take it.... it could backfire on the carriers.

If I was a carrier, I might take another look at Mutual of Omaha's approach, and sit it out for a year.
 
Comments in this thread suggest agent views about the PDP product may be changing, to say the PDP is a product separate from Medigap coverage, and the PDP should not be handled if it does not provide separate agent compensation.

Every conversation an agent has with someone is a liability. One complaining phone call can cost the agent massive amounts of time, energy, and lost revenue simply trying to defend themselves.

Add your signature to the line and it doubles. The reward of selling a PDP is marginal, but worth it if they're a Med Supp client.

Just selling several PDPs alone even at today's commissions will expedite an agent's path to the poor house. Any agent who says "But, I do it because I love to help people!" is either a terrible business person or already financially stable and loves the validation of telling everyone that.

Not only can it be the most time-consuming process of all, but it also comes with the highest risk to both the agent and the clients. Let us not forget, that they can only change their plan once per year.

One tiny thing goes wrong with their plan and the first words they utter are: "But my agent told me..."

So 100% risk, and zero reward.

Dial 1-800-MEDICARE.
 
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It seems to me the thrust behind @hockeyday 's statement was that many agents will be making noticeably more than 50% of their current, new, sales with MAPD's rather than a Medigap -- PDP combination of products.

I think your chart supports that idea.
 
caveat, you're not an agent.
@hockeyday can speak for himself.
All right.

I will speak for myself as a non-agent forum member.

I think the graph you posted says the new MAPD business written by lots of agents each year exceeds 50% of their new and renewal business written that year by some number noticeably over 1%.

I am not a math expert, so maybe you have math that proves otherwise.
 
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