PFFS Plans available for 2 years

Dec 28, 2006

  1. midwestbroker
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    I have heard through the grapevine that the Government has passed a bill allowing PFFS plans to be offered for the next 2 years, with no lock-in.

    Stips are that they are MA only plans (no PDP), since the lock-in still applies to the Part D side of Medicare.

    Anyone heard of this? One of my brokers told me about this. I looked on Google and did not find anything (but I did not dig very deep).
     
  2. Insuranceman
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    I heard the same thing too from my broker. He said he heard it from a couple different reliable sources.
     
  3. Frank Stastny
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    That would make a lot more sense.

    I was told the same thing yesterday but cautioned not to start making plans yet until more information is available. Hopefully that won't take too long.

    I went to the CMS site but didn't see anything.
     
  4. midwestbroker
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    I asked the powers that be here at Humana and they said that they have heard something about it. And that is all I got out of them. Prob because in the Kansas City market we only have PFFS plans with Part D tied into it.

    But this is only a trouble for the Supplement companies, for the simple fact that if they have a MAPD plan, they are locked in unless they want to drop their Part D coverage.
     
  5. sman
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    Midwest,

    Why do you think this is trouble for supplement companies? I'm finding more and more people who would prefer to have the supplement (assuming they can afford it) due to the problems they've incurred on the MA plans. In addition, MANY doctors here Georgia are starting to refuse to accept Humana's PFFS plan. They are citing slow to reimburse, low reimbursements and poor customer service as their reasons.

    While I welcome a "year-round" open enrollment for MA plans, I don't see this as a problem for supplement carriers. However, I do see it as an administrative nightmare for CMS. Can you imagin those that have the premiums taken from their social security check and how that would work if they switched from month to month on MA plans?
     
  6. James
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    If the bill hasn't gone through Congress yet I doubt it will for the next two years. MA plans will not be a staple till they lift the lock out, which makes no sense to me at all but it is what it is. Plus according to Sterling, Humana hasn't petition for the lock out to be done away with in the last few years in DC meetings, according to Sterling CEO. Now that is coming from Sterling, Humana might have another take on the story. Yet though, I hear more cuts are coming with Humana this year? More talk about Humana being in trouble, but what is new. You know Humana owned Hospitals in KY are no longer excepting the Humana Plans, that has been out for a while now.
     
  7. Frank Stastny
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    I tried to call CMS this morning and that was totally a waste of time.

    I then called Senator Kit Bond's office and they said they didn't know of anything recently. They gave me a number for Congressional Search Services and I got the recording saying that it was not a working number.

    I called Pyramid and all they said is they too had heard the rumor but couldn't direct me to any specific information.

    It is kind of strange that a rumor like that would surface yesterday, the day I first heard about it, considering that Congress has been adjourned for the last two weeks.
     
  8. Guest
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    The bill has been proposed but has NOT passed yet. That is why you will not get a definitive answer from anywhere.

    If it does pass they will NOT be able to switch every month, but instead it allows people to get into a PFFS plan any time of the year--but with limitations such as switching one time in a calender year.

    This is a good idea--most people are still clueless about MA plans and their availability. CMS needs to get the word out more before imposing a lock-in.

    CMS is already a nightmare--I recommend doing automatic bank drafts as opposed to Social Security deductions.
     
  9. midwestbroker
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    I see this as a problem for supp companies because of their premium increases. When you have plan F that is $165 a month (about the average I see here in KC) vs. a PFFS plan that is $30 a month, people really start to think about how much they need their supps.

    Humana has been in Kansas City since about 1991, so we have a very established network of Docs and Hospitals. So, the network here is typically not an issue. Sure on a supp, you can see any doc you want, but if they are all in a HMO or PPO network, why pay more? That is where it becomes a co-pay vs. supp premium.

    For CMS it very well could be a nightmare, but I am willing to bet too that there will be a limit on the number of changes you can make. Social Security has been a nightmare when it comes to doing the whole premium thing. I too rec. bank draft, as that is how most supp companies do it as well.
     
  10. Zydo
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    Just received notification of the limited continuous open enrollment period april 1 thru Dec 31, 2007. MA's may be sold thru 12/31/07 based on certain criteria.

    Commissions may be cut 50 to 75% in designated counties.

    For those of you marketing the MA's, what do you think of this?
     
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