World -- Health Care Reform Commission Calculations

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AHCP Newsletter: The Leading Edge



World -- Health Care Reform Commission Calculations




World's new PPACA-compliant major medical products are now available in all states.
As World communicated in previous articles, some benefits mandated by the PPACA do not qualify for commissions. Note: The current compensation schedules reflect these changes.
There are three pieces of premium that comprise the mandated benefits and do not qualify for commissions:
HCR PPACA Requirements - This is the premium for providing Guaranteed-Issue coverage as required to dependents under age 19, and removing any internal limits on essential benefits.
Lifetime Max - base - This is the required premium for providing an unlimited lifetime maximum benefit ($4 per covered person per month).
HCR Preventive Services - This rider adds the first dollar benefits for all required preventive services under PPACA and varies by age, gender and state.
Reviewing Your Commission

Your commission statement will show the total commissionable premium for issued business.
Itemized premium amounts do appear on the quoting and application software but not in ezHealthQuoter. World is working to incorporate this level of detail in ezHealthQuoter. At this time, they do not have a target date. In the meantime, you may contact Sales Support at 800.733.5454.

 

[669comche]

So basically no commission is paid on

1) Preventative
2) Life time max
3) Premium needed to make GI for dependents.

What is there left to be paid a commission on?

 

[Evan]

So World will out of the industry in three months, awesome.

 

[Crabcake Johnny]

In various sales fields I've worked in I've deal with non-commissionable parts of a sale which has always left be befuddled (trying to impress Arnguy.)

If the premiums are being raised to account for the mandated benefits, then why are they non-commissionable?

Assurant plays this game with age. Over 62 and you drop from 20% street to 10%. But wait - don't clients over 62 pay rates according to their age?

 

[HealthGuy]

What the hell is world trying to do here? Ridiculous. Third world carrier. No pun intended. If they are gone in three months nobody is going to care.

 

[AllenChicago]

I used to sell quite a bit of World Insurance until they started doing the 30% premium increase routine in 2003. After I didn't sell one for a year, they canceled my contract/renewals.

Since they've been in business since 1908 (as they're proud to say), World was probably once an honorable company. But as HealthGuy says, almost no agents will miss them when they fold, or get bought.

BTW.. In the World communique, they referred to the Preventive Care Benefits as a "Rider". This implies that the customer does not have to purchase preventive care with their World Major Med. Isn't it now illegal for major medical to NOT have preventive care?

-AC

 

[Crabcake Johnny]

I used to sell quite a bit of World Insurance until they started doing the 30% premium increase routine in 2003. After I didn't sell one for a year, they canceled my contract/renewals.

Since they've been in business since 1908 (as they're proud to say), World was probably once an honorable company. But as HealthGuy says, almost no agents will miss them when they fold, or get bought.

BTW.. In the World communique, they referred to the Preventive Care Benefits as a "Rider". This implies that the customer does not have to purchase preventive care with their World Major Med. Isn't it now illegal for major medical to NOT have preventive care?

-AC

Apparently not. Carefirst has a new plan - HealthyBlue Triple Option where people can choose not to have preventative covered. This is very confusing.

Preventive Care Coverage
Periodic Health ExamOption 1 & 2: No charge, no deductible
Option 3: Not Covered

Periodic OB-GYN ExamOption 1 & 2: No charge, no deductible
Option 3: Not Covered

Well Baby CareOption 1 & 2: No charge, no deductible
Option 3: Not Covered

 

[HealthGuy]

WTF...Now these guys can choose to not offer preventative? I thought no preventative was illegal as well. This confusion is insanity.

 

[Full Throttle]

In various sales fields I've worked in I've deal with non-commissionable parts of a sale which has always left be befuddled (trying to impress Arnguy.)

If the premiums are being raised to account for the mandated benefits, then why are they non-commissionable?

Assurant plays this game with age. Over 62 and you drop from 20% street to 10%. But wait - don't clients over 62 pay rates according to their age?

The profitability to the carrier depends on the length of time the policy stays on the books. If you have a 63 year old hopping on, they will be gone at age 65, not as much time to be profitable. I think the real reason for the reduced commission, Assurant doesn't care 62+ year olds and wants to discourage that business. Other carriers that offer Med Supps, probably want the first in for their business when they hit age 65.

 

[dgoldenz]

Apparently not. Carefirst has a new plan - HealthyBlue Triple Option where people can choose not to have preventative covered. This is very confusing.

Preventive Care Coverage
Periodic Health ExamOption 1 & 2: No charge, no deductible
Option 3: Not Covered

Periodic OB-GYN ExamOption 1 & 2: No charge, no deductible
Option 3: Not Covered

Well Baby CareOption 1 & 2: No charge, no deductible
Option 3: Not Covered

Option 3 is out of network, therefore doesn't have to be covered. HealthyBlue is a good plan for younger people who want maternity benefits, but ridiculously priced for just about anyone over age 45.