Response from Chevell L. Thomas with CMS Regarding Initial MA Payments

[kennethbroyles]

This is political.... so IMO we need a full spectrum offense. We need politicians Senators and Congressmen to work for us. I have called mine here in GA. I don't think as many agents as we think are even aware of this situation. I just got my mailed statement from UHC today in the mail. Craig Ritter is a loud voice and being very active. Thanks Craig I am going to contract/team with on on MedSup business.

 

[jdeasy]

He is correct, CMS never told you anything about the commission levels. Everything came thru the companies and they gave their version of what CMS was supposedly saying.

 

[kristin]

who is correct? What are you talking about. Cms is in charge of the regs. That's what we are talking about not the amount of commission!!

 

[mississippiagent]

The commissions need to be talked about also because it is not enough... the insurance companies are not paying what they
said,a thief is a thief
what do you think will happen will advantage in the next year?

 

[jdeasy]

who is correct? What are you talking about. Cms is in charge of the regs. That's what we are talking about not the amount of commission!!

I'm talking about the op. He sent an email to the CMS guy accusing CMS of lying. The CMS guy said they didn't lie, that what they are saying now is exactly what they told the companies all along.

I belive that is probably correct. If you go back and look at my post from last fall thru now I've said that this would be the outcome. I wish I was wrong as I'm owed the second half on about 70 plans.

Can you show me something from CMS that says different than what they are saying now? I certainly never got anything from CMS and I represented about 8 different MA companies. Everything I got was from the companies or from an FMO telling me what the regs were. I would love see something that came directly from CMS last AEP that says differently than what they are sayiong now.


Surely you have such evidence to attack me in such a manner?

 

[kdover]

No need to be attacking each other. Nobody knows where the responsibilities lie. CMS says one thing, the companies say another. At this point we need to be screaming at CMS, all the MA Companies as well as our Congress men and women.

Call your FMO and ask them what they are doing on your behalf. I have heard NOTHING from mine!!!

Kudos to you Craig Ritter.

Call your MA companies and let them know your aren't going to lay down on this one. Email Mr. Thomas, unless someone has a better contact and scream some more. Finally and probably most importantly contact your local Congressman or women by clicking the link below. Enter your Zip Code in the top right hand of the page, then click on each Representatives/Senators name; Click contact; then contact by web form and write them an email.

Congress.org - Congressional Directory

Don't stop being LOUD!!!

 

[Joe H]

"Can you show me something from CMS that says different than what they are saying now?"

The CMS regs from last Nov & Dec have been posted multiple times on these boards....and they say basically ....if new to MA from Original Medicare will pay initial year......

 

[AgentOrange]

I think they could have went either way and they took the lazy road of just cross referencing all pdp subscribers to 09 OEP enrollees. Agents get jacked by everyone, FMOs, carriers, and the Gov ...

http://www.cms.hhs.gov/ManagedCareMarketing/Downloads/CompStructureRepMemo_011609.pdf

CMS requires organizations to pay the renewal rate for all enrollments except those of beneficiaries newly entitled to Medicare or enrolling in an MA plan, Cost plan or PDP for the first time. This means for example that for 2009 MA plans with an initial year commission amount of $400 will pay a commission of $200 to their agents and brokers, unless the enrollment is for a beneficiary newly entitled to Medicare or enrolling in a MA plan for the first time.

 

[jdeasy]

"Can you show me something from CMS that says different than what they are saying now?"

The CMS regs from last Nov & Dec have been posted multiple times on these boards....and they say basically ....if new to MA from Original Medicare will pay initial year......

Then you should be able to show me something you got directly from CMS that told you what you would get paid for enrolling someone into an MA plan.

 

[Joe Moore]

I would have been in the middle of this before now, but I am having to deal with some health issues myself. Here is what I have written my Congressman, if we bombard congress, maybe someone, somewhere will listed:

Phil,
I am Joe Moore of Morristown. I think you have talked to my son, Greg Moore a few times concerning healthcare in the last few months. My sons and I own an Insurance Marketing Organization (IMO), known locally as Tennessee Senior Benefits, and nationally as National Senior Benefits (www.nationalseniorbenefits.com)
We have become very active in the Medicare Advantage and Part-D Markets, offering products locally to Medicare enrollees, and contracting agents nationally to offer the products of companies such as AARP (United Health Care), Coventry, Blue Cross, etc.
As you may or may not be aware, contracted agents by these companies commissions are basically being controlled by Center for Medicare Services (CMS) and are just the past week getting paid for what CMS is calling a TRUE-UP commission. Agents are in shock as to what is CMS's interpretation of what commissions should be. Most agents (including myself) are looking at about 25% of what we thought it would be.
January 16, 2009, CMS put out the following memo:
CMS requires organizations to pay the renewal rate for all enrollments except those of beneficiaries newly entitled to Medicare or enrolling in an MA plan, Cost plan or PDP for the first time. This means for example that for 2009 MA plans with an initial year commission amount of $400 will pay a commission of $200 to their agents and brokers, unless the enrollment is for a beneficiary newly entitled to Medicare or enrolling in a MA plan for the first time.
Emphasis should be placed on the verbiage "enrolling in an MA plan for the first time". Because CMS has now decided if an enrollee was in a PDP and now newly enrolled in a MAPD, the agent is only entitled to a "Renewal" Commission.
Agents are contracted with the respective companies, and the contracts all show the earnings as much higher than agents are being paid. By keeping the agent's money they have worked for and earned, it is not saving the government a dime. The companies get to keep the extra money and it goes to their bottom line?
I am looking at this issue as not even being close to fair for the agents. They have already performed the duties they were contracted to do, and now (6 months later) they are getting paid about 1/4th of what they were contracted to be paid. A lot of agents have probably more money invested in the marketing than they will receive back. Ethically, I think CMS appears to have some issues that should have to be addressed.
Also, since when does the US Government control the pay of sub-contractors to get the job done. Agents are sub-contractors to the contracted insurance companies.
The January 16th entire memo can be read at:
http://www.cms.hhs.gov/ManagedCareMarketing/Downloads/CompStructureRepMemo_011609.pdf