Wellcare PDP Class Action Suit

[InsuranceGuy29]

It’s every insurance company’s, wet dream to be able to eliminate insurance agents and commissions entirely, and still sell the same volume of their products. With most things, they can’t pull that off because sales just shut down when they eliminate commissions.

But on a product that everyone has to sign up for and there is zero premium and zero underwriting they will eventually be able to sign up people directly if they make it easy enough for people to know how to do that. It will happen. We have always known that.

The only reason I think commission will never go away on MAPD is because people really don’t have to sign up for it.

Med supps are an option, and believe it or not, there is a sizable amount of people that just opt for original Medicare with a PDP. I wouldn’t advise it, but some people do.

That’s 2 points of competition for MAPD. Another is that all the companies compete with each other fiercely for business. So now that’s 3 points of competition.

In a scenario like this, you have to incentivize brokers to bring in sales to your company.

The only way to do that is commission. Even paying them a salary or hourly won’t do that. To me, Aetna has the right idea and setup.

No in-house agents (which keeps worker-related expenses MASSIVELY down), and they just pay brokers the commission and let them run wild and get business.

The broker is also happy because they don’t have to worry about competition from in-house agents. It’s a win/win.

And Aetna is able to keep costs down and has zero to lose and everything to gain. I also don’t think technology will affect us.

Most seniors are utterly clueless on anything insurance-related. Most barely even know how to get Part B. No amount of technological knowledge will ever fix that. You’re always gonna need brokers to guide them through.

Plus, we now live in a very information-heavy and overwhelming society. People are exhausted and don’t want to be bothered with handling it. Many don’t even have the energy.

Plus, this current crop of the population is also super entitled. They want everything done for them, anyway.

Also, don’t forget, the under-65 ACA marketplace already tried the no agents thing back in the day and it was total chaos and didn’t work.

Most companies paid zero commission for a few years. It backfired spectacularly. You always need local actual agents that people know and trust.

This is a personal, in-person, kind of business that's built on the foundation of building personal relations, trust, and rapport. People don't trust anyone they don't know. That's the bedrock of sales.

 

[rmhaire]

Any agent that has not been running his Med Advantage and Part D biz in a manner where he knows that ALL commissions and renewals can go poof in the stroke of a politician’s pen has his head in the sand.

Make all the money you can while it lasts. But never put all your eggs and income in that basket. That has been my opinion for 15-years. But I have been surprised that it has lasted this long.

It’s every insurance company’s, wet dream to be able to eliminate insurance agents and commissions entirely, and still sell the same volume of their products. With most things, they can’t pull that off because sales just shut down when they eliminate commissions.

But on a product that everyone has to sign up for and there is zero premium and zero underwriting they will eventually be able to sign up people directly if they make it easy enough for people to know how to do that. It will happen. We have always known that.

It still pays very well today so make all the extra cash you can with it. But especially if you’re a young agent, I would never build my entire empire off of this product. This is an additional sale product not your bread and butter. You better be selling a lot of Medicare supplements or Final Expense or annuities or something that is more of a long terms stability or you are going to be hugely disappointed one day.

Just my opinion. I could be wrong, but I doubt it.

Best advice I've seen yet. Especially for the younger guys.

With MA, you're working for the federal government. They make the rules so that makes them the boss.

I've always known that MA, in it's current form, was going to implode. Most other agents knew it too.

And as for baskets. I've got more baskets than the woman on a boat dock in the Bahamas.

 

[Yagents]

Dude. I'm old people. We go around with all kinds of stuff in our heads. Just don't ask us where we found it.

But I've been told that I've got 3 or 4 other people living in my head. I'll go ask one of them.

I'd suggest a google search. "Can an insurance agent charge a fee in AZ"

That will give you your answer.

I literally can't read or interpret legal jargon well. That's why I have you

 

[Dave G]

In reply to LostDollar:

- How is there conflict of interest if the agent forgoes commissions to simply discuss PDP drug coverages with a consumer? Consumer is given info and choices to then enroll with whomever/wherever they wish.
- I use the CMS platform primarily for drug plan reviews. If you click the "enroll" tab there, guess where it takes you to enroll? To a licensed agent contracted with that plan. By your logic, why isn't that also a "conflict?"
- Agents aren't actually "independent" since they must be contracted with each company and certified for each plan represented. They are required to give unbiased information and answers, but ultimately represent the plan, not the consumer. Makes a difference.
- Agents don't risk their license telling a consumer they don't represent every plan, in fact it is required "disclosure" to everyone you speak with. Agents don't have to be all things to all people, even if it were possible.
- From start to finish, including gathering client data and preferences, obtaining the required Scope of Appointment (needed to even discuss a drug plan), sending the plan info to the client, setting up and doing a recorded plan review (also required), submitting the enrollment, then following up to be sure it was approved....takes 2 hours or more of agent time, plus multiple emails back and forth.
- PDP plans are effectively "loss leaders" for agents. Yes, the marketplace has changed since 2016-2017. The administrative rules, govt. requirements, consumer expectations and yes, risk to the agent already make it a challenge to market. Throw in cutting off agent compensation from the carriers, and what do you expect to happen?

So....are you saying that isn't worth compensating agents for? Insurance is a business, not a charity. Do you expect agents to work for free? Are you one of those people who expect something for nothing?

 

[rmhaire]

I literally can't read or interpret legal jargon well. That's why I have you

I probably should have been a lawyer. I'd have been a damn good one.

I was married to the same woman for 51 years. And I've done four divorces. One for my son and three for my brother.

When my brother's 2nd wife filed she hired one of my golfing buddies as her lawyer.

He called me one day saying "Mary wants half of this and half of that". I stopped and said "Didn't my brother pay for Mary's boob job".

"We're going to want one of those titties back."

We never got it. But we did get everything else we asked for.

 

[Wayne Daniel]

All MAPD and PDP are one-year contracts. There are no renewals, just a renewal rate for that one year. That is why we sign an amendment to our contracts for the increase in MAPD each year. They could decide in 2026 not to pay anything for MAPD or PDP, and the carriers use their call centers, and they don't have to pay anyone anything contractually. Don't put all your eggs in the Medicare Advantage basket. This does not include Med Supps. those renewals are guaranteed contractually. Everyone thinks they will be paid on their MAPD book for life. I never understood why they felt that.

 

[InsuranceGuy29]

All MAPD and PDP are one-year contracts. There are no renewals, just a renewal rate for that one year. That is why we sign an amendment to our contracts for the increase in MAPD each year. They could decide in 2026 not to pay anything for MAPD or PDP, and the carriers use their call centers, and they don't have to pay anyone anything contractually. Don't put all your eggs in the Medicare Advantage basket. This does not include Med Supps. those renewals are guaranteed contractually. Everyone thinks they will be paid on their MAPD book for life. I never understood why they felt that.

You're not wrong, but this is what needs to change. We do have a good bit of leverage as independent brokers with large swath of clients/followings.

As a broker, I want to put my clients with companies that I know are doing the right thing overall. Not some slime bag company with a psychopathic CEO, like Michael Carson of WellCare, who just decided to make an unethical decision and steal our money.

But even in regards to Med Supps, they can and will screw with those, too. Government cancelled Plan F. They alter those plans, too. Companies have slashed commission on some of those too, change them at will, and can even cancel some of them, if they seek fit.

Hell, they even made it illegal to sell short-term insurance plans, which is insane, when you think about. How are you gonna tell a private business what plans they can offer when it's not even a Federal program?

Like it or not, our job is politics. It's embedded, and we need to wake up to that fact and adjust tactics accordingly.

Whether med supplements or Medicare Advantage, a TON of our job relies on politics. That's just the facts. We need to start making friends in much higher places to ensure this doesn't happen, or become a trend.

We need to do it both inside the insurance companies and in CMS and the government overall.

 

[Yagents]

All MAPD and PDP are one-year contracts. There are no renewals, just a renewal rate for that one year. That is why we sign an amendment to our contracts for the increase in MAPD each year. They could decide in 2026 not to pay anything for MAPD or PDP, and the carriers use their call centers, and they don't have to pay anyone anything contractually. Don't put all your eggs in the Medicare Advantage basket. This does not include Med Supps. those renewals are guaranteed contractually. Everyone thinks they will be paid on their MAPD book for life. I never understood why they felt that.

I never knew that, thanks for sharing. Made my day, loving my 100% med supp book right now given the chaos

 

[hockeyday]

I never knew that, thanks for sharing. Made my day, loving my 100% med supp book right now given the chaos

So you do no pdp

 

[Yagents]

I guide my clients on how to shop for pdp plans for free. They enroll in their own mc.gov acct. The yearly conversations generates a lot of referrals to offset lost pdp income