Agents fight for Part D commissions

Duaine

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Medicare agents are fighting back against the recent decision by some health plans to discontinue paying commissions on Medicare Part D plans.

More than 600 agents signed a petition on Change.org, demanding that WellCare pay agents their commissions they earned from the sale of the carrier’s Part D plans. Health Agents for America posted the petition and circulated it among its members. HAFA is asking WellCare “to rescind its decision and to ensure that agents are compensated fairly for their work.

“HAFA argues that fair compensation is not just a matter of equity for agents—it’s a necessity for protecting the seniors who depend on them,” the association said in its petition. “HAFA’s message is clear: Without fair compensation, the system fails everyone—most of all, the seniors who need it the most.”

Meanwhile, the National Association of Benefits and Insurance Professionals issued a statement this week condemning the decision made by some health plans to stop paying Part D commissions.

“These decisions by health plans threaten not only the livelihoods of Medicare agents but also the communities they serve and the seniors who rely on their expert guidance to navigate the complex Medicare system,” said NABIP CEO Jessica Brooks-Woods in a statement.

An agent gives his perspective

Mark A. Squires is president of Wise Choices Financial in Independence, Mo., and has worked in the Medicare market for more than 20 years. He told InsuranceNewsNet that most agents in the Medicare space are self-employed, or salaried with commissions paid to the agency.

"With Part D Coverage being a vital part of the Medicare puzzle, and arguably the most complex piece, Medicare beneficiaries need assistance in making sense of the maze of choices of coverage," he said. "Agents should not be expected to work without being paid. This leaves the Medicare population with few options other than doing their own research, contacting Medicare directly or contacting their SHIP. Neither Medicare personnel nor SHIP volunteers are permitted to make specific recommendations."

A huge part of the value agents and agencies provide to Medicare beneficiaries is ongoing service throughout the plan year, Squires said.

"In our organization, we refer to that proposition as 'lifetime claims support.' We document the service we provide and track the time used in servicing our clients, divided by product line. We invest more time per member on prescription drug plan questions and support than any other product line in our arsenal.

"Since we will not be paid, we cannot support the Medicare community."

Squires said his agency will continue to conduct prescription drug plan reviews for clients who have Medicare Supplements with a prescription drug plan.

"If the most appropriate PDP option based strictly on dollars and cents is one where we will not be paid, the agent will offer an A-B option. Option A is the plan the is most appropriate based on the dollars and cents with the caveat that we do not get paid, thus we cannot facilitate the enrollment. Nor can we provide any ongoing service in the plan year. Option B is a plan where we get paid and can offer a high level of service. If the member chooses Option A we will provide them with contact instructions for the carrier. If the member chooses Option B we will proceed as normal.

"This is not going to be good for the Medicare population."

Brooks-Woods said NABIP leadership reached out to WellCare/Centene senior leadership about the precedent they are setting in discontinuing commissions.

[EXTERNAL LINK] - Agents fight for Part D commissions
 
Whatever happens, this is something that CMS needs to address and change. It's now become a trend for many of these carriers to also not pay for enrollment into their exiting PDP plans, like Aetna, Humana, United, etc. And renewals need to be protected with ironclad written agreements. That goes without saying.

I know I'm a broken record here with this message, but lurkers need to understand what is really going on, and how this will affect them and the service they receive, as well.

We are essentially left with almost no options except a few high-cost plans. That is extremely unethical to make us work for free, and obviously puts agents in a HUGE moral dilemma.

I know agents aren't gonna just throw people on high cost plans, but at the same time we aren't gonna work for free. So we basically have no choice but to work for free or to not service seniors.

As much as I would like to help, PDP's are a HUGE time-suck and point of migraines. They were already well underpaid for the work involved. I'll now need that time to try and make up the revenue somehow.

Prior to this, CMS was on their crusade to make sure seniors get a fair and unbiased view of all their options, in regard to plans.....

Ummmmmmm... unless that was forgotten about, then something needs to change here and you need to make sure that if carriers want to be a part of this program, then they need to pay the peanuts wages to us. That just comes with the deal. Adjust accordingly.

These insurance companies and CMS preach about ethics and morals, well here's your time to practice what you preach. At the end of the day, CMS says what goes.

This is a federal program with federal dollars. There is no reason they can't make mandatory pay and renewal protection ironclad.

People also need to understand that all of this chaos is due to the Biden/Harris administration, and the supposed "Inflation Reduction Act." All this has caused is mass chaos, many less plans, services, and options, and ironically a LOT of inflation for Medicare beneficiaries in other areas.

Seniors definitely needed help on prescription costs....no doubt. But you cannot go from a $8,000 catastrophic limit with no MOOP to a flat $2,000 MOOP in one year.

That is an insanely drastic change for such a short period of time and causes chaos in a market. There were many other easier ways to ease the burden of this.

As a result, you are now seeing way less PDP plans, way higher monthly premiums (in both PDP plans and Medicare supplements), and no help from agents when you need it. Because, again.... small mom and pop small businesses like us cannot work for free.

And this doesn't even begin to get into the problems on the MAPD side, by the government tightening the purse strings there. Again....same problems that I just mentioned last paragraph. Only with added higher copays, deductibles, and less extra benefits.

This government administration is clueless with how to actually help seniors.
 
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