Wellcare PDP Class Action Suit

[hockeyday]

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

Your going to be having a few conversations this year

 

[hockeyday]

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

So you look up no drugs at all

 

[Yagents]

Your going to be having a few conversations this year

About 80 more then last year. Book keeps growing. Repeat and rinse. I think it may be a simple year with only 1, maybe 2 cheap premium options. The 50% of clients just on generics will just move to lower cost plans.

All clients are given instruction to create a mc.gov account and be logged in at time of our call.

When client logs into their mc.gov account, 90% of drugs are already pre populated as it connects to Part D claims somehow. They adjust rx and move on to compare plans and to enroll. All personal data is also pre populated like mc# address name etc. Makes it easy for everyone.

If needed, I just duplicate rx on my end in public mc.gov site to view what they are seeing, especially expensive brand drugs. By Nov 1st I have the generics memorized.

Then I ask them how the grandkids are doing

 

[Chazm]

Please elaborate on "offer".

Can an agent that is not certified and does not sell, nor get paid commissions on pdp or mapd.....charge a fee for a pdp review?

If you sell any MAPD or pdp you can’t charge a fee. That’s what she told us. Not that I have any evidence to back it up.
A few of us brought it up to our personal meet with our FMO and we asked that question. We wanted to charge a fee.

 

[somarco]

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.

THIS ^^^^^

 

[somarco]

. Everyone thinks they will be paid on their MAPD book for life. I never understood why they felt that.

Perhaps because they don't read the agreement and addendums.

 

[LostDollar]

In reply to LostDollar:

- 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.

I bolded a portion of your quote above. It implies multiple carriers and that IS the industry standard definition of an "Independent Insurance Agent".

Also, In my quote below, I used the word "independent" to modify the word "review", not the word "agent".

caveat, not an agent.

I don't think sending them to the carriers to enroll gives the appearance of independent review when CMS has an all carrier enrollment platform available.

 

[LostDollar]

In reply to LostDollar:

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?

In various years, using CMS Plan Finder and my medications, I have found Silverscript, Cigna, and Wellcare PDP plans to be the "best" plans for my situation.

In person, and on the forum, agents have made it quite clear to me that asking them to sell me those plans is an "unwelcome advance". I have just started using plan finder and not even asking any more.

That is my business decision.

 

[LostDollar]

In reply to LostDollar:

- 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?"

I can't remember all the steps from one year to the next, but I have used CMS plan finder for enrollment for several years. I do not recall ever being sent off the CMS site to an agent for those enrollments.

 

[Newby]

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.

Agents think they will be paid on MAPD for life for two reasons.
1. They believe all the Sales pitches that huckster FMO‘s pitch to them.
2. They haven’t grabbed a calculator and figured out the age of the people they’re writing up are usually older than their own age. Therefore, when the agent thinks he’s gonna retire on those sweet sweet renewals, his customer base is all dying off. Surprise, surprise, surprise!!!

Smart agents don’t believe such things. But that leaves a whole lot that do.