Revised Guidance on Qualifying Criteria for 2009 Agent/Broker Ini

[kennethbroyles]

From Ritters blog. Thanks Craig, where else would we get this... not my MAO....

FYI.....

DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Center for Beneficiary Choices 7500 Security Boulevard, Mail Stop C4-23-07 Baltimore, Maryland 21244-1850 [FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]M[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]EDICARE [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]D[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]RUG AND [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]H[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]EALTH [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]P[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]LAN [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]C[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]ONTRACT [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]A[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]DMINISTRATION [/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]G[/FONT][/FONT][FONT=Book Antiqua,Book Antiqua][FONT=Book Antiqua,Book Antiqua]ROUP [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]MEMORANDUM [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]DATE: [/FONT][/FONT][FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]July 31, 2009 [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]TO: [/FONT][/FONT][FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]All Medicare Advantage Organizations (MAO), Prescription Drug Plan (PDP) Sponsors, and 1876 Cost Plans [/FONT][/FONT]
[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]FROM: [/FONT][/FONT][FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Teresa DeCaro, RN, M.S. [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Acting Director, Medicare Drug & Health Plan Contract Administration Group [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]SUBJECT: [/FONT][/FONT][FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Revised Guidance on Qualifying Criteria for 2009 Agent/Broker Initial Compensation Amount [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]On July 2, 2009, CMS sent an HPMS email indicating that we were examining our guidance on criteria for paying initial agent/broker compensation amounts for 2009. In that email we stated that more detailed guidance would be forthcoming. The purpose of this notification is to inform you of our recent policy change and provide the details regarding its implementation. [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Effective immediately, CMS is requiring plans to pay independent agents and brokers initial compensation amounts for enrollments in 2009 that meet one of the following criteria: [/FONT][/FONT]​

1. [FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman][/FONT][/FONT][FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]
   [*]An enrollment of a beneficiary into an MA, Cost plan, or PDP who is completely new to Medicare.
   [*]An enrollment of a beneficiary into an MA, Cost plan, or PDP who is currently in Original Medicare only.
   [*]An enrollment of a beneficiary into an MA plan who is currently in Original Medicare with a PDP.
   [*]An enrollment of a beneficiary into a PDP who is currently enrolled in an MA-only plan.
   [*]An enrollment of a beneficiary into a PDP with Original Medicare who is currently in an MA plan.[/FONT][/FONT]

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]2009 Compensation Reports [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]

As a result of this policy change, new compensation reports identifying the enrollments that must be paid at the initial compensation amount were released to plans beginning on July 20, 2009. The first report contained all enrollments with an effective date of January 1, 2009, that qualify for initial compensation. We anticipate that the reports covering the months of February through June will be released to plans by July 29, 2009. After which, monthly reports will be released during the third week of the month following the month in which the enrollments were effective.​

[/FONT][/FONT]

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Compensation Payment Reminder [/FONT][/FONT]​

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]

Plans are reminded that while the use of independent agents and brokers is optional, if a plan chooses to use them, they must follow our compensation regulations at 42 C.F.R. §422.2274 and §423.2274. In particular, when a beneficiary moves from one plan to another plan within the same parent organization, the agent must be paid the appropriate compensation amount for the plan change.​

If you have questions, please send your questions to the MIPPA mailbox
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[MrMack]

Re: Revised Guidance on Qualifying Criteria for 2009 Agent/Broker

From Ritters blog. Thanks Craig, where else would we get this... not my MAO....

FYI.....

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman][/FONT][/FONT]


[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]Effective immediately, CMS is requiring plans to pay independent agents and brokers initial compensation amounts for enrollments in 2009.[/FONT][/FONT]


Well I have not been paid yet, still waiting.......

UHC says not until tonight will info be available to look at.​

 

[retread]

Re: Revised Guidance on Qualifying Criteria for 2009 Agent/Broker

[FONT=Times New Roman,Times New Roman][FONT=Times New Roman,Times New Roman]5. An enrollment of a beneficiary into a PDP with Original Medicare who is currently in an MA plan.[/FONT][/FONT]
[/quote]

In addition to the items 1 - 4 , Please note that they are now saying if an agent enrolls a beneficiary into a PDP only, effectively disenrolling them from a MAPD plan, they will still get a commission (although small... $25 renewal)!

What a reversal.... just a little over a month ago, they had almost entirely eliminated all commissions.

Ya think this will change right after the end of AEP this year like they did last year? Wanna bet? Any takers?

 

[Mega producer]

Re: Revised Guidance on Qualifying Criteria for 2009 Agent/Broker

This came in today from UHC.


Good News! - Update on PDP to MA/MAPD Commissions

On Friday, July 31, 2009, the Centers for Medicare & Medicaid Services (CMS) sent UnitedHealthcare the additional 2009 effective PDP to MA/MAPD conversion enrollment data to be paid at the initial-year commission rate. In addition, we have received the remaining files from the June 2009 Initial Enrollment Period (IEP) and Initial Coverage Election Period (ICEP) initial-year commissions.
We remain committed to processing the commissions this week as promised. We have received not only the complete enrollment files from CMS, but also the updated enrollments for conversion. Due to the large amount of information, we will process commission payments using the following schedule:

• Tuesday, August 4 - MA & PDP new sale commissions and January 2009 effective PDP-MA/MAPD initial-year commissions; AARP® Medicare Supplement standard commission processing will be delayed one week
• Thursday, August 6 - MA & PDP new sale commissions, February through June 2009 effective IEP, ICEP and PDP-MA/MAPD initial-year commissions
• Tuesday, August 11 - standard processing of new sale commissions (all products) and AARP® Medicare Supplement monthly processing

We will process each run and post payments using our normal process of Electronic Funds Transfer and paper check processing.