Is the New 2025 CMS Rule for Agent compensation actually GREAT news for AGENTS and FMOs?

Carriers will be the ones that interept this rule.. they are the ones that have the most to risk….

Agents should watch this video below before they start spending that extra $100 watch the video below

Interesting take

Good video . This is exactly why the agent must have that extra $100. So what I’m saying in a is everyone suffers in this . Fmo’s on Facebook act like “ we’re still going to get our same admin fees . The carriers will disguise the reason for payment . But you little guys are losing marketing money , hra fees and you got to pay for Connecture/sunfire . Bs I say . Everyone suffers . I’m Will to take a $40 k hit if it ruins the call centers . In a nutshell medicare will not be as lucrative for agents or Fmo’s going forward . There will be much greater exp’s for the agents and much less overrides for Fmo’s and loa agency owners. Cms has basically drained liquidity from the system .
 
How much do you guys anticipate or think Medicare center/ sunfire/connecture will cost the agent? Will it be monthly or per app? any ideas, knowledge or thoughts?
 
Most likely a per app or volume based fee. Personally I just do not see how a monthly charge would work or be fair to someone that writes a couple apps per month versus someone that writes 10 apps per month.
 
Most likely a per app or volume based fee. Personally I just do not see how a monthly charge would work or be fair to someone that writes a couple apps per month versus someone that writes 10 apps per month.

So the guy who write one app is subsidized by the guy who does 10?

I really don't get it. why in the world is this getting unfunded

No FMO says if you write this many apps we will pay for these tools otherwise you don't

there is no steering involved, agents who have one contract and writes nothing have acess as much as the big producers
 
A major contention between insurers and CMS is the two groups could not agree that utilization increased in the fourth quarter. Major insurers like Humana and UnitedHealth Group reported higher-than-expected utilization for their MA plans but CMS chose to stick with its initial notice cut from January, an uncommon move from the feds.Toy reiterated that Clover did not see increased utilization.

"My view is that this corroborates our Clover view that other managed care orgs are seeing a challenge in managing care and cost on their PPO plans - an area they have pushed hard into in the last few years as they chased growth," explained Toy, adding that Clover has always been PPO-focused with tools like Clover Assistant.

This belief mirrors his fourth quarter earnings comments, where he said the landscape is shifting from from HMO plans to PPO plans rapidly.


I don't have a dog in this fight and could care less about petty fighting over nominal cuts in funding.

IMHO the Clover guy nails it by addressing the consumer costs and a desire for greater access to care. My rule is, if it is good for the consumer it is good for the agent.
 
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This is the main issue for a independent issue. What happens to all the apps we did in the past 3 plus yrs ? I know from a credible source that some integrity call centers take our client list and call them . Honestly that doesn’t bother me as our clients get massive calls daily . I’m assuming if the fmo does get paid directly from the carriers they can still help the agent with commission problems ,hung up apps etc . That’s one thing I’ll miss . I could dump those issues on the fmo . I can’t see Connecture being over$200 a month . It’d price agents out of mkt . Agents will start having to exam the economics of the business . Will an agent with a book of 30-50 pay $300 or more for Connecture . Will he spend $3000 a yr to buy leads to keep that 50 ? I personally think a book of business becomes more valuable now . Entry to selling Medicare as an independent agent wil be tough . You’ll have to pay all your own lead costs ( no more carriers paying for a booth , seminar or Walmart ) .Pay your own Connecture or Sunfire . Another area I probably got $5 k a yr of is swag ( company branded shit ) . I’m sitting on 20 boxes of branded stuff from United , Humana and Aetna. I grew my business from the client 1 to now for zero cost . That can never happen to a new agent going forward
 
This is the main issue for a independent issue. What happens to all the apps we did in the past 3 plus yrs ? I know from a credible source that some integrity call centers take our client list and call them . Honestly that doesn’t bother me as our clients get massive calls daily . I’m assuming if the fmo does get paid directly from the carriers they can still help the agent with commission problems ,hung up apps etc . That’s one thing I’ll miss . I could dump those issues on the fmo . I can’t see Connecture being over$200 a month . It’d price agents out of mkt . Agents will start having to exam the economics of the business . Will an agent with a book of 30-50 pay $300 or more for Connecture . Will he spend $3000 a yr to buy leads to keep that 50 ? I personally think a book of business becomes more valuable now . Entry to selling Medicare as an independent agent wil be tough . You’ll have to pay all your own lead costs ( no more carriers paying for a booth , seminar or Walmart ) .Pay your own Connecture or Sunfire . Another area I probably got $5 k a yr of is swag ( company branded shit ) . I’m sitting on 20 boxes of branded stuff from United , Humana and Aetna. I grew my business from the client 1 to now for zero cost . That can never happen to a new agent going forward
The problem is MAPD and Supp don't pay high enough commissions with the cost of acquisition being so high if you are working leads. Especially if its replacement instead of T65.

If Sunfire ends up costing $$ ill just start doing my scopes within my CRM, I already have it done I just need to finalize a few things. Can just use Medicare.Gov and Carrier sites for Dr's and Meds.
 
The problem is MAPD and Supp don't pay high enough commissions with the cost of acquisition being so high if you are working leads. Especially if its replacement instead of T65.

If Sunfire ends up costing $$ ill just start doing my scopes within my CRM, I already have it done I just need to finalize a few things. Can just use Medicare.Gov and Carrier sites for Dr's and Meds.

Scopes no big deal, I already have on CRM

Meds no big deal, I already use med.gov way more accurate
Not to say its highly acerate but just a lot more accurate then the tools

Docs are much easier on the tools, though, However if I compare and I know which plans I will really be looking at I can go to carrier sites for docs

so again this is not the biggest thing

Here is the big deal though the tools make it a 100% easier to compare benefits then medicare.gov which is a muddles mess with limited access to benefits on plan

And going to carrier sites is time consuming just to compare benefits and its not right there together to compare

And also to be able to enroll with on tool is priceless going to many different site and different platforms and so forth in the past (unless its got a lot better) was a pain


Some of them in the past at least was hard for the client to esign and some had cumbersome processes

besides that there are so many password issues I cant tell you how many times I got a client on the phone and UHC is requiring a password change and its a process especially to get it to stick in the password manager
 

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