The New Way of Paying the New to MA Enrollees

[wehotex]

As most of you know, the carriers started complying with the new way of paying True-Up commission on new to MA. If a prospect has existing Part D for part of the year and enrolls into MA, we are now paid the remaining number of months of MA membership times 2 (true-up for the remaining months plus pro-rated MA commission). I just went to a home where the Medicare only + Part D prospect had enrolled with a CIP plan for January 1, 2017 effective date. Since the prospect was diabetic, she could have qualified for a Nov 1 effective date with Chronic SEP. Why didn't the agent put her on for a Nov 1 instead?, I thought. It dawned on me that a Nov 1 effective date would generate $34.50 ($17.25) x 2, while a January 1 effective date would generate the new higher 2017 commission rate (x) 2, BUT WITH 12 months of True-Up instead. Is that the way that it works? Is there a perverse incentive to enroll this member for January instead of November?

 

[FLM2]

As most of you know, the carriers started complying with the new way of paying True-Up commission on new to MA. If a prospect has existing Part D for part of the year and enrolls into MA, we are now paid the remaining number of months of MA membership times 2 (true-up for the remaining months plus pro-rated MA commission). I just went to a home where the Medicare only + Part D prospect had enrolled with a CIP plan for January 1, 2017 effective date. Since the prospect was diabetic, she could have qualified for a Nov 1 effective date with Chronic SEP. Why didn't the agent put her on for a Nov 1 instead?, I thought. It dawned on me that a Nov 1 effective date would generate $34.50 ($17.25) x 2, while a January 1 effective date would generate the new higher 2017 commission rate (x) 2, BUT WITH 12 months of True-Up instead. Is that the way that it works? Is there a perverse incentive to enroll this member for January instead of November?

I am always paid the full true up regardless of the effective month but the renewal commission is pro-rated.

If the agent in question didn't put a Nov 1st effective date that agent must be ignorant because the January effective date won't get paid until January while a November effective date would pay the 2 months plus the True Up.

 

[wehotex]

I am always paid the full true up regardless of the effective month but the renewal commission is pro-rated.

If the agent in question didn't put a Nov 1st effective date that agent must be ignorant because the January effective date won't get paid until January while a November effective date would pay the 2 months plus the True Up.

Are you referring to a "NEW TO MEDICARE", "T65"? This particular prospect in question turned 65 a few years back and has already has had a Part D for all of those months since she turned 65. I can't find the information (of course) of the comp changes in UNLIKE plan changes. I've already been dingdonged on some of these that before would have been paid the pro-rated renewal months plus another amount that together would equal the ENTIRE year plus true-up commission. Nowadays, we only get the remaining pro-rated months x (2) when it's an Unlike plan change.

 

[Chazm]

I mean he'd be losing out on 2 months that he could of got commission. So I don't know how that benefits him.

It's possible that he just went in the home with 2017 apps and just signed the lady up using AEP as the enrollment not really thinking that because it's a chronic plan she can start earlier.

 

[wehotex]

I mean he'd be losing out on 2 months that he could of got commission. So I don't know how that benefits him. It's possible that he just went in the home with 2017 apps and just signed the lady up using AEP as the enrollment not really thinking that because it's a chronic plan she can start earlier.

The benefit to him is the 12-month true-up for a January 1 instead of the piddly 2-month true-up for the Nov 1 effective. He put her on a Chronic CIP plan. How would he not know that he could submit for Nov 1? His loss anyway.

 

[Iwillpay]

The benefit to him is the 12-month true-up for a January 1 instead of the piddly 2-month true-up for the Nov 1 effective. He put her on a Chronic CIP plan. How would he not know that he could submit for Nov 1? His loss anyway.

I had one recently but played it right by using 1/11/2016.
Got my $35.83 on Friday. Looking for the other $35.83 for the true up.
These medicare beneficiaries, anything can happen. So I insist on getting coverage asap instead of waiting until 1/1/17.

 

[wehotex]

I had one recently but played it right by using 1/11/2016.
Got my $35.83 on Friday. Looking for the other $35.83 for the true up.
These medicare beneficiaries, anything can happen. So I insist on getting coverage asap instead of waiting until 1/1/17.

LOL. Well, that it was happening here! The guy snuck in 1 day before my in-home, which had already been scheduled a week out. You might recall that before, we would get paid the $35.83 ( your example) PLUS a second check for $393.17 (in your example) which would total $429- thus "making us whole". Now, we only get paid by your example (pro-rated amount x 2) when they ALREADY carry a Part D plan.

 

[Iwillpay]

LOL. Well, that it was happening here! The guy snuck in 1 day before my in-home, which had already been scheduled a week out. You might recall that before, we would get paid the $35.83 ( your example) PLUS a second check for $393.17 (in your example) which would total $429- thus "making us whole". Now, we only get paid by your example (pro-rated amount x 2) when they ALREADY carry a Part D plan.

Yes that's true. It really sucks now, however in 2015 I got some nice checks.
Maybe we have to start rolling the books each AEP to get lump sum payments in January.

 

[wehotex]

Yes that's true. It really sucks now, however in 2015 I got some nice checks.
Maybe we have to start rolling the books each AEP to get lump sum payments in January.

Well yes, but it could only be done in the situation where the prospect is coming off a PDP situation (Medicare ONLY, MEDICARE + MEDICAID (with PDP) or MEDICARE WITH SUPPLEMENT (with PDP).