Zero Premium & Broker Options For New Producer?

[Zoaty]

Hello Pros,

I'm curious if zero premium plans are helpful or hurtful to clients? From what I've read, it sounds like it depends on the health status of the client as the co-pays or deductibles may be high to make up for the zero premium?

Also, if zero premiums are good for a segment of the market, what is a good non-captive broker specializing in MA/MG/Zero Premium to work under which would sign a release if I would ever need to switch brokerages?

I don't mind if the broker isn't offering the highest paying commission split, but rather need one that has great support and training.

Any thoughts would be appreciated. Thanks!

 

[somarco]

Opinions are all over the board on this, but if someone has an expensive chronic condition, or impending surgery, as a general rule the MAPD approach will be more costly than original Medicare and a supplement.

 

[bluediamond]

somarco is right about opinion's being all over the board, my own personal experience: Been on a mapd for 1.5 years, have a few health problems and two chronic conditions, no hospitalization. I would have had to have 4 hospital stays at 5 days each time to hit max oop. A supplement and part d roughly would have cost me $2600 a year, zero premium plan last year and my total oop was around $600 and that included two mri's and an ultrasound and several doc visits. So far this year I have had one ct scan, one ultra sound and just a few doc visits and have spent $384 oop. Next year will be different because I will have a small premium and copays will probably go up some. I will probably remain on that plan. If I decide to up and go to another state for treatment then I have to find out who is a member of that states bluemedicare plan, if I had a supplement I'd just up and go.

The other day I had a client that wanted mapd but he had been in the hospital 5 times last year and most were longer than 5 days, I explained the difference and said with your track record you should purchase a supplement because it would potentially cost him less money over a year's time, well he opted for a zero premium mapd and told me he'd take his chances. In his case I think it was mistake. So it's up to the individual after your explanation. But you better have a good understanding of Medicare.

 

[JimmyUt]

Hello Pros,

I'm curious if zero premium plans are helpful or hurtful to clients? From what I've read, it sounds like it depends on the health status of the client as the co-pays or deductibles may be high to make up for the zero premium?

Also, if zero premiums are good for a segment of the market, what is a good non-captive broker specializing in MA/MG/Zero Premium to work under which would sign a release if I would ever need to switch brokerages?

I don't mind if the broker isn't offering the highest paying commission split, but rather need one that has great support and training.

Any thoughts would be appreciated. Thanks!

As long as you aren't assigning commissions, compensation on MA plans should be the same with every FMO/IMO. Todd King here on the forum can help you with a handful of companies, and there are others as well. I would refer you to my upline, but he probably wouldn't release you without a fight. I don't have any reason to move so I don't care on the MA side.

 

[kstein]

Just to play devils advocate, I'm pretty sure in the regs it says you can't suggest a plan based on health or tell an unhealthy person they would be better off on med sup. Its considered cherry picking against Medicare. Maybe the dumbest rule of them all.

Also Medicare Advantage plans are different commissions with different IMOs. Granted if your looking at the same level among imo/fmo they are probably the same but you would be ignorant to not think there is more wiggle room from an IMO depending on your negotiation skills.

 

[Chazm]

somarco is right about opinion's being all over the board, my own personal experience: Been on a mapd for 1.5 years, have a few health problems and two chronic conditions, no hospitalization. I would have had to have 4 hospital stays at 5 days each time to hit max oop. A supplement and part d roughly would have cost me $2600 a year, zero premium plan last year and my total oop was around $600 and that included two mri's and an ultrasound and several doc visits. So far this year I have had one ct scan, one ultra sound and just a few doc visits and have spent $384 oop. Next year will be different because I will have a small premium and copays will probably go up some. I will probably remain on that plan. If I decide to up and go to another state for treatment then I have to find out who is a member of that states bluemedicare plan, if I had a supplement I'd just up and go. The other day I had a client that wanted mapd but he had been in the hospital 5 times last year and most were longer than 5 days, I explained the difference and said with your track record you should purchase a supplement because it would potentially cost him less money over a year's time, well he opted for a zero premium mapd and told me he'd take his chances. In his case I think it was mistake. So it's up to the individual after your explanation. But you better have a good understanding of Medicare.

Off topic but do you know if FL Blue will have a ppo premium?

 

[JimmyUt]

Just to play devils advocate, I'm pretty sure in the regs it says you can't suggest a plan based on health or tell an unhealthy person they would be better off on med sup. Its considered cherry picking against Medicare. Maybe the dumbest rule of them all.

Also Medicare Advantage plans are different commissions with different IMOs. Granted if your looking at the same level among imo/fmo they are probably the same but you would be ignorant to not think there is more wiggle room from an IMO depending on your negotiation skills.

I realize there may be wiggle room, but that being said, unless you have agents under you, to get paid more than is outlined is a CMS violation. I have seen big IMOs termed over it by carriers.

 

[WCMason]

Just to play devils advocate, I'm pretty sure in the regs it says you can't suggest a plan based on health or tell an unhealthy person they would be better off on med sup. Its considered cherry picking against Medicare. Maybe the dumbest rule of them all.

This is a well-intentioned rule with unintended bad consequences (not uncommon with govt regs). I get how they don't want carriers--through their captive agents--steering unhealthy people away from their plan, and the rule serves that goal. But as an independent agent I don't care about putting a sick person in a plan, as I've got no loyalty to a particular carrier and can better serve the beneficiary WITH this information. They obviously didn't have the indy agent in mind when they created this "protection."

 

[policy doctor]

Usually the meds give away the condition(s) the client has. Ever notice how they volunteer what it's for?
I usually lead with the drug presentation first because it's so time consuming and it steers me to certain conversations.

 

[Zoaty]

Wow - a ton of great responses in just a short time away from the computer.

So it sounds like it's good to sign with an upline that offers both zero premium & MA / MG carriers based on this conversation.

Great real life examples by the way.

Thanks for the feedback.