Advantage Plans Get a Boost

[somarco]

Health insurers that sell Medicare Advantage plans are going to get about $30 billion more in taxpayer money next year.

President Trump's Medicare agency finalized a rule Monday that would raise benchmark payment rates to privatized Medicare plans by 5.1% for 2026. That was higher than the Biden administration's proposed payment increase of 2.2% — and well above what Wall Street investors had expected

Trump gives major lift to 2026 Medicare Advantage payments

Insurance companies will get billions of dollars more from the federal government in 2026.

www.statnews.com

I wonder how many carriers will take the money & run while cutting/eliminating commissions?

 

[annon123]

Health insurers that sell Medicare Advantage plans are going to get about $30 billion more in taxpayer money next year.

President Trump's Medicare agency finalized a rule Monday that would raise benchmark payment rates to privatized Medicare plans by 5.1% for 2026. That was higher than the Biden administration's proposed payment increase of 2.2% — and well above what Wall Street investors had expected

Trump gives major lift to 2026 Medicare Advantage payments

Insurance companies will get billions of dollars more from the federal government in 2026.

www.statnews.com

I wonder how many carriers will take the money & run while cutting/eliminating commissions?

Considering that the carriers already get paid more for "sicker" patients and do a lot of upcoding to get that, I'd imagine since they are already behaving in an unethical way, not much of this additional money will filter down to agents. I'd guess they figure that already agents get a higher commission to sign someone up to an MA plan rather than a supp so the already the deck is stacked in favor of MA plans and likely won't bother to stack it more unless they see the overall market of MA enrollment percents (vs OM) dropping. Well unless they figure, now that they have more money the way to get a higher percentage of clients inside the MA market is to pay agents who sign a client up for their plan a higher commission than other companies pay (although putting back some of the benefits they have cut will do it for many customers who choose based on who offers the most extras they want - well presuming their doctors are in network). And, of course, they are for profit companies and their stock prices will rise if their profits are higher and so will make decisions to keep more of that money so don't increase agent commissions (or client benefits). That gives the CEO/top management job security and more wealth. And of course what do some/many of those people care about most? Themselves.

 

[Chazm]

I'd say, I wonder how many plans come back into the market, and how many plans that stopped paying, start paying again? My guess is yes. A lot

 

[axeman462]

I'd say, I wonder how many plans come back into the market, and how many plans that stopped paying, start paying again? My guess is yes. A lot

that would be my guess. The only thing is by pulling commissions some plans have now damaged the broker/carrier relationship.

WellCare for example with the VS plan, I am less likely to recommend that plan if another plan is close to the same cost for the customer going forward; even if commissions come back.

 

[Chazm]

that would be my guess. The only thing is by pulling commissions some plans have now damaged the broker/carrier relationship.

WellCare for example with the VS plan, I am less likely to recommend that plan if another plan is close to the same cost for the customer going forward; even if commissions come back.

Florida blue is a great example. I think no matter what they were going to have commissions again next year. This just solidifies it.
That said, I do think companies will take the UHC cautious route and not go over board. UHC, at least in FL, is the epitome of consistency.

 

[bill3173]

that would be my guess. The only thing is by pulling commissions some plans have now damaged the broker/carrier relationship.

WellCare for example with the VS plan, I am less likely to recommend that plan if another plan is close to the same cost for the customer going forward; even if commissions come back.

Cigna's slimy ass commission cut was all I needed to never offer them again, and hang up on their reps. I wouldn't offer a carrier that cut commissions that way regardless of whether they did a U turn or not.

Sitting there offering bonuses and secret handshake leads, and then bam, Zero. The only thing I can say to that unconscienable BS is good bye.

 

[sman]

Cigna's slimy ass commission cut was all I needed to never offer them again, and hang up on their reps. I wouldn't offer a carrier that cut commissions that way regardless of whether they did a U turn or not.

Sitting there offering bonuses and secret handshake leads, and then bam, Zero. The only thing I can say to that unconscienable BS is good bye.

Only thing I will say is at least Cigna gave us a few days. Anthem in Georgia literally gave us a few hours. I had two Anthem cases where I mailed the client the app (they had no capability for electronic apps). I had to eat both of those (no commission). At least with the potential Cigna apps I had time to work around them. However, Cigna and the main hospital in my county and the next county ended their contract on March 31st which meant I had to move several and lose money. I will avoid both Anthem and Cigna (also WellCare) moving forward.

 

[axeman462]

Florida blue is a great example. I think no matter what they were going to have commissions again next year. This just solidifies it.
That said, I do think companies will take the UHC cautious route and not go over board. UHC, at least in FL, is the epitome of consistency.

i fully expect commissions to come back with Fl Blue as well. They at least did it correctly, and communicated the zero commission plans for several months, and gave several heads up about no commish.

My bigger curiosity is if this year they allow the broker community to offer their ACA plans. There is rumors that they are planning on it

 

[bill3173]

Only thing I will say is at least Cigna gave us a few days. Anthem in Georgia literally gave us a few hours. I had two Anthem cases where I mailed the client the app (they had no capability for electronic apps). I had to eat both of those (no commission). At least with the potential Cigna apps I had time to work around them. However, Cigna and the main hospital in my county and the next county ended their contract on March 31st which meant I had to move several and lose money. I will avoid both Anthem and Cigna (also WellCare) moving forward.

Of course you're right about giving a warning, but I didn't have the gut wrenching experience with Wellcare, because I never took them seriously. Cigna had been overpowering with all of the atta boys, leads, bonuses, and the "we're here for you and we're there for you" then... "okay, now you can get lost".

 

[EckoRomeo]

Cigna had been overpowering with all of the atta boys, leads, bonuses, and the "we're here for you and we're there for you" then... "okay, now you can get lost".

But the atta boys weren't coming from the people who decided to yank commissions. I'd bet many of the people giving you the atta boys lost their jobs.