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Great find . Incredible detailed on the inner workings of what's going on . I read the whole 88 pages and it shows the mass corruption and steering using massive overrides and marketing money to sways app's . Huge changes coming in payments structures no question.Some of my takes in this just by memoryI found it. This is the complaint that also mentions WellCare, brokers' favorite carrier. And there are other numbers and quotes in this one.
Seems that Georgetown's law school tracker has lots of cases available for the public to read.
1. WellCare was giving $500 an app admin fee to ehealth ( this combined overrides and marketing money to). What's fascinating they were also giving $125 bonus in month 13 and month 25 In addition to the $10-$12 a month in renewal overrides . This is eye popping . Justice dept mentioned the renewal override bonus payments steered ehealth to leave the plan in force causing them not to shop for better plans .
2. In 2020 ehealth made $67 million in marketing money alone . Thats was 64% of their profit
3. Justice dept said " These marketing payments took away benefits from Medicare beneficiaries "
. This has peeled the onion layers back and now we know were the $1000-$1300 total per app Comes from . Overrides (admin fees )are included in all this because each fmo negotiates there own deals ( One might get $175 and another gets $250-$300 an app admin fee) . This also causes steering . All this comes down to sweetheart deals and different carriers making different deals with fmo's to drive vol . This investigation started in 2021 and i believe it was the basis for the 2024 cms lawsuit to ax admin and marketing money . What these lawsuits are saying is the govt wants all carriers to be on the same playing field with set commissions and no volume based overrides to steer Medicare beneficiaries