Rumours

Apr 17, 2008

  1. policy doctor
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    I'm hearing that CMS wants all MA agents to be appointed thru their state DOI. (revenue for doi). Ture or False? I hear Wellcare has already announced this.

    ALSO


    CMS to pay 3.6% more to MA plans, drug deductible goes to $295 from $275 in 2009
    <IMG height=31 width=60 align=left border=0> 2009 UpdatesCMS on Monday announced that average reimbursements to providers of private Medicare Advantage plans will increase by 3.6% in 2009, the AP/Houston Chronicle reports. CMS, which increased average reimbursements to sponsors of MA plans by 3.5% last year, previously estimated an increase of 3.7% for next year.

    And, the drug plan providers also got a small boost in the form of higher deductibles for prescription drug plans next year.
     
  2. AgentPipeline
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    AgentPipeline Super Genius

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    Re: Rumors

    Most carriers have been against appointing agents with the states. WellCare has stepped up to start appointing current and future agents. Humana and UHC have always gone through the appointment process. I'm sure we'll start seeing others (Coventry, Cigna, Aetna, etc.) take a hard look at it.

    The one advantage to appointing agents with states is that the DOI's will be able to police the bad apples that caused the end to the LOEP last year.

    Since MA companies and AHIP haven't done anything, bad agents can jump from company to company with out any type "black list" to keep track of them.

    It's not the best answer, but the industry needs additional oversight other than CMS.

    I can't believe I just said that...:skeptical:
     
  3. The Rabbi
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    Re: Rumors

    I'm waiting for a single certification with CMS to cover all the MA plans. I hear it's in the works.:wub:
     
  4. AgentPipeline
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    Re: Rumors

    AHIP released training for Marketing Medicare Advantage and Part D Prescription Drug Plans:

    Here is a link: AHIP Insurance Education

    AHIP may be the one who works with the companies and CMS for universal certification.
     
  5. Non-golfing Agent
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    Re: Rumors

    I was told by my FMO last friday that agents can market Wellcare Melody in most, if not all, states the first or second week of August.

    I had my doubts until the e-mail from Wellcare this afternoon. They're doing background checks on all agents who haven't had one in the last 90 days and the checks should be completed in 7 business days.
     
  6. jdeasy
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    Re: Rumors


    I got that same email about the background checks. They just did one in March for me, so, I suppose they will do another. I can't imagine that anything has changed for me since March.

    What's this all about anyway?
     
    jdeasy, Jul 25, 2008
    #6
  7. Non-golfing Agent
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    Re: Rumors

    If I had to guess it would be their way of trying to weed out the agents who have bad persistency ratings without having to spend extra resources to find out why their business isn't staying on the books.

    I was told a few months ago that the persistency rating before the phone enrollment became mandatory was around 50%. That's horrendous.
     
  8. Non-golfing Agent
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    Re: Rumors

    Wellcare should be sending out an e-mail this week concerning Melody and agent commissions. It should return in a few states this month and then 16 states will be added in September.



    :jiggy:
     
  9. Slim
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    Slim Super Genius

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    Re: Rumors

    Thanks for the heads up.

    In my brief, but valuable MAPD experience , the agent is always the scapegoat. Probably , knowing human nature
    a good part rests on their (our) shoulders.

    However, when health care professionals (who PARTCIPATE in network and who work with patient/client) get the patient upset, and disoriented, and complain to the client, and fuss at the agent, then the professional health care community needs to stand up and take a bow for confusion and problems as well.

    Don't act as though the agents who earn a buck legitimately, and then service the need afterward and offered
    client a new plan and documented and yada yada... don't slam us alone.

    The gov't plans can go out and change on a dime anyway.

    The Company pays the professionals long after they sign on to participate. The profits are dispersed long after agents' commissions are spent.

    And when the pros have something to do with a great policy falling off the books, because they bad mouth the process then the ax needs to shave them a bit too.

    I believe only one doctor out of a hundred may get whacky like described, but lots of others who work for and with them have really made it lousy along the way just because they may have some extra computer documenting or phone calling or getting used to something. "We don't have the manpower in this office..."???

    If a lot of forethought and a good policy has been given to a client for a great price then some pros should get behind a client/patient's right to exercise personal freedom and control and go for a better policy if they got one.

    i better bite my tongue. sounds like a rant . i luv the market though.

    BTW my support has been awesome to keep my enrollees on the books and happy and healthy.
     
    Slim, Sep 11, 2008
    #9
  10. honestagent
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    Re: Rumors




    I know many many doctors that get whacky like described; and that's no rumor, consequently.