Wellcare a Harbinger of the Future? Good video

[Duaine]

As you are probably aware, Wellcare announced that in 2025, they will not pay commissions on over 3 million Medicare Prescription Drug Plans for both new enrollments and renewals.

I believe this to be unprecedented in our industry. We have seen carriers in Medicare insurance stop paying commissions before, but it has always been on future business and not past business.

But, canceling commissions on an existing book of business is something we have never seen from a national carrier and it has wide implications for the long-term viability of our profession.

It appears that Wellcare had provisions in their contract that allowed them to do this, so it may be legal. However, it is clearly an unethical and immoral act. The contracts also stated that agents would be paid for the life of each policy.

 

[InsuranceGuy29]

From what I understand, there is language in the contract that they have to pay us for the life of the client's policy. I believe there's also language in there that they can alter terms at any time, and blah, blah.

This is conflicting rhetoric, and a judge REALLY should be ruling in our favor on this. Then what needs to happen is we need to go to CMS and lobby to make sure that out renewals are guaranteed for the life of a client's policy.....period. End of story.

After this clown show, I'm not trusting ANY of these companies with this. We need this IN WRITING, and guaranteed by CMS.

This is a federal program with tax dollars. We are providing a service to our client's and need to be paid for that service. There is no other way to be paid for service because CMS doesn't allow for us to charge a separate fee to a client, nor would I want to do that anyway.

Therefore, we are legally not allowed to earn any money in this situation. This has to violate some sort of labor law. Slave labor was outlawed long ago. CMS has to step in here and get these companies in line, and tell them this practice needs to stop immediately and that it won't be tolerated.

It's a federal program, and if they want to participate, then paying agents their VERY SMALL commission is a part of that. Absolutely RIDICULOUS that this even needs to be explained to supposed adults at this WellCare company.

 

[DonP]

What’s not being said is they could have simply made the plan non commissionable for 2025 and still paid no renewals . I’ve seen this happen with mapd . Or they could have simply cross walked the plans to a non commissionable plan . Believe me they studied this long and hard with lawyers knowing the backlash amd possible litigation. Big agency’s could give 2 shits about the $2 a month override . They’re worried about what comes after this . Will United and Humana try to ax or drastically cut overrides in 2025 ? Is this the start of a trend for agency’s and agents . I saw what’s happening now 3 yrs ago . The utter millions being made by so many agency’s in overrides . The 100’s of thousands of agents who have rushed into Medicare the last 5 yrs for their pot of gold .

 

[MedicareWAA]

If you sued, fraudulent inducement is probably the only viable allegation to put in a complaint, and it would be far fetched. You’d be suing mostly for the annoyance and expense, assuming you could make it all the way to discovery in the first place.

Use the power of your client relationships to send a message. Our future has always been protected by a natural tension and it goes away when agents roll over and take it up the butt. There are plenty of great drug plan choices in most markets and sometimes clients will change just because they want to support your business. None of this needs to be underhanded or at odds with the interests of our clients.

If I can find ANY honest reason to justify a switch and if I have the time to do it, I’m gonna make the switch. Not for the money but to help stop this from spreading. Alternative plan saves you $3 total in out of pocket costs? Switch. WellCare has slightly better benefits? Explain circumstances and lots of my clients will switch.

WellCare is far and away the best plan fit? I’ll still try to make time to explain what’s happening to my clients but I’m not going to switch them in that case. I might encourage them to file a grievance with the plan because they’re tracked by CMS and have at least a little impact on star ratings.

 

[FourOaks]

Not sure I have seen this posted....

Here is the contract language we all signed with Centene/Wellcare - Section 5. This says they basically can do anything they want with our commissions and we have to just shut up about it. I am sure all of our contracts have this type of provision. The surprise is that Centene would use this provision as part of their business acquisition strategy.

2. Termination without Cause. Either party may terminate this Agreement without cause upon thirty (30) days priorwritten notice to the other party. The termination of this Agreement shall not affect the obligations of either party tothe other with respect to any continuing obligations arising prior to termination of this Agreement.

4. Compensation Payments Following Termination.

a. In the event that Company terminates this Agreement in accordance with Section 5(1) (2) or (3),Company’s obligation to pay any compensation hereunder shall cease as of the effective date of suchtermination....

b. Communications Following Termination. In the event of termination or notice of termination of thisAgreement, the parties agree that they will not thereafter make any written or oral statement orcommunication to any Medicare Enrollee that disparages or criticizes the other party, or the quality ofservices provided thereby

 

[sshafran]

Not sure I have seen this posted....

Here is the contract language we all signed with Centene/Wellcare - Section 5. This says they basically can do anything they want with our commissions and we have to just shut up about it. I am sure all of our contracts have this type of provision. The surprise is that Centene would use this provision as part of their business acquisition strategy.

2. Termination without Cause. Either party may terminate this Agreement without cause upon thirty (30) days priorwritten notice to the other party. The termination of this Agreement shall not affect the obligations of either party tothe other with respect to any continuing obligations arising prior to termination of this Agreement.

4. Compensation Payments Following Termination.

a. In the event that Company terminates this Agreement in accordance with Section 5(1) (2) or (3),Company’s obligation to pay any compensation hereunder shall cease as of the effective date of suchtermination....

b. Communications Following Termination. In the event of termination or notice of termination of thisAgreement, the parties agree that they will not thereafter make any written or oral statement orcommunication to any Medicare Enrollee that disparages or criticizes the other party, or the quality ofservices provided thereby

Is that available for us to download somewhere in pingone?

 

[FourOaks]

Yes, go into the Centene Portal where you BOB is and look under "Documents and Resources" tab and then go to "My Documents"....

 

[GoPokes]

CMS clearly wanted to shorten the conflict of interest in, between mapd and pdp, when they attempted to increase the initial PDP commissions. We all know that didn’t not get rolled out.

That being said, I would think CMS would be interested in supporting agents getting paid on existing PDP, and FYC.

Obviously the conflict of interest gap in 2025 will be wider than it ever has been. MAPD commissions will be higher than they ever have been, with just normal inflationary adjustments, and the PDP commissions from wellcare and Aetna will be lower than they ever have been.

 

[InsuranceGuy29]

CMS clearly wanted to shorten the conflict of interest in, between mapd and pdp, when they attempted to increase the initial PDP commissions. We all know that didn’t not get rolled out.

That being said, I would think CMS would be interested in supporting agents getting paid on existing PDP, and FYC.

Obviously the conflict of interest gap in 2025 will be wider than it ever has been. MAPD commissions will be higher than they ever have been, with just normal inflationary adjustments, and the PDP commissions from wellcare and Aetna will be lower than they ever have been.

No better way to do that then to ensure that every insurance carrier is actually paying the CMS-dictated rate for each and every plan offered. No more of this "Plan A is non-commissionable bs." If they offer plans, then commissions should be offered on all of them.

 

[WiscBroker]

Not sure I have seen this posted....

Here is the contract language we all signed with Centene/Wellcare - Section 5. This says they basically can do anything they want with our commissions and we have to just shut up about it. I am sure all of our contracts have this type of provision. The surprise is that Centene would use this provision as part of their business acquisition strategy.

2. Termination without Cause. Either party may terminate this Agreement without cause upon thirty (30) days priorwritten notice to the other party. The termination of this Agreement shall not affect the obligations of either party tothe other with respect to any continuing obligations arising prior to termination of this Agreement.

4. Compensation Payments Following Termination.

a. In the event that Company terminates this Agreement in accordance with Section 5(1) (2) or (3),Company’s obligation to pay any compensation hereunder shall cease as of the effective date of suchtermination....

b. Communications Following Termination. In the event of termination or notice of termination of thisAgreement, the parties agree that they will not thereafter make any written or oral statement orcommunication to any Medicare Enrollee that disparages or criticizes the other party, or the quality ofservices provided thereby

In the 2024 contract that I have on file:
4. COMPENSATION
7. Termination of Relationship with Agent. In the event of termination of the relationship between TPME and an Agent, Company shall continue to pay compensation in accordance with the applicable provisions of Exhibit B, except as otherwise expressly set forth in this Agreement. TPME agrees that a termination of relationship with Agent due to Agent's death shall result in payment of compensation in accordance to the Company Book of Business Transfer Policy: Inheritor Delegation if the requirements are met.

BUT THEN, it also says this next:

5. TERM AND TERMINATION.

1. Term. This Agreement shall commence on the Effective Date and shall continue in full force and effect from the Effective Date for a period of one year. Thereafter, this Agreement shall automatically renew for successive terms of one year each, unless either party provides the other with thirty (30) days prior written notice of non-renewal or otherwise terminates this Agreement as set forth in this Section 5. Notwithstanding, the forgoing, Company and TPME may agree to an immediate termination in writing, if both parties agree that it is within their best interest to terminate immediately.

HOWEVER.....
IN THE EMAIL TO AGENTS ON AUG 23, 2024 IT SAYS:

To continue providing access to high-quality healthcare and Part D coverage that helps families and individuals, we have made a difficult decision – effective Jan. 1, 2025 – to cease new and renewal commissions for PDP beginning with the 2025 plan year.

How are we to interpret the part that says "beginning with the 2025 plan year" ??? Does that mean RENEWALS will not be paid on new business written in 2025?
Perhaps this does not mean RENEWALS are canceled for prior plan years. Simply put, ceasing renewals beginning with the 2025 plan year might be interpreted as anything written as of 2025 will not have new or renewal commissions.
Yet, everyone is convinced it's all renewals including existing policies.