S.S.D.Y. – Same Stuff Different Year – Here’s Your 2019 AEP Checklist

S.S.D.Y. – Same Stuff Different Year

Getting Ready for 2019 AEP & OEP – Agent Success Checklist



RBI Senior Sales Coordinator/Independent Agent: James Gramp

With his signature common sense, quiet good humor, and brilliant customer service, Jim is the other half of the RBI phone answering dynamic duo! An Arizona native, Jim manages agent relationships for the East Coast and specializes in the RBI agent tools, especially the Agent Market Edge. Jim has been a licensed health insurance agent for over a year, and has worked at RBI for 3 years. An accomplished bassoonist, he is known around the office for his amazing musical skills. In addition to keeping busy around the office, Jim frequently contributes to our blog, bringing a new agent’s perspective to the RBI online presence.

Hooray, it’s that time of year again where agents spend hours blankly staring at their computers – Medicare Certification Season! Cue the collective groan from agents across the US. That’s why I’m here, to give you a handy 2019 AEP Checklist to get you ready for a successful Annual Enrollment Period!

It’s very important that you get your ducks in a row EARLY! Waiting until September to complete your AHIP and product certifications is a sure-fire way to increase stress levels this fall. The closer it gets to AEP, the more bogged down carriers get with processing new contracts, background checks, and product certifications.

Speaking from personal experience, I’ve seen it take as long as 4 weeks for agents to receive their “Ready to Sell” status after completing their product certifications. There’s nothing more frustrating than losing a sale just because you were still waiting to show up as “Ready to Sell.”

Without Further Ado, Here is Your 2019 AEP Checklist!


AHIP

That dirty four-letter word that spikes agent’s blood pressure far and wide. Unfortunately, it’s a necessary evil in our industry and is required to sell Medicare Advantage and Prescription Drug Plans. If you’re an agent that doesn’t sell MA, then I have news for you – You’re Leaving Money on The Table! Read my Blog Post from last year to learn why you should consider adding MA plans to your portfolio. Quick update, there are now over 21 million Medicare Advantage members compared to roughly 14 million Medicare supplement members nationwide.

Haven’t taken your AHIP yet? Follow this AHIP link to receive your $50 discount… But wait, there’s more!

Picking up Additional Products

Now is the time carriers are releasing first-look benefit information for the 2019 plan year. Head on over to our Events Calendar to register for our upcoming webinars. Curious to find out how these carriers stack up in your market? I’m just one phone call away!

Carrier Certifications

2019 Medicare AEP Certifications RBI

More online testing and certifications! Are you excited yet? No? Not sure when each of the carriers are launching their certifications, head on over to our 2019 Carrier Certification page. You’ll be able to see when all the 2019 Medicare Advantage Certifications are released.

Certainly don’t wait until the last week in September to do these! If you’re not marked as “Ready-to-Sell,” you will not be able to pick up any sales kits or marketing materials for the upcoming Annual Enrollment Period.

Evaluate your FMO Relationship

evaluate you FMO Medicare Advantage

If your FMO isn’t holding up their end of the bargain by providing you the support you need to grow your Medicare book of business, then now is the perfect time to re-evaluate that relationship. If your Field Marketing Organization doesn’t provide anything in the way of marketing support, they’re really just a Field Organization. The bottom line is, your FMO should work for You! These are things you should consider when choosing who to work with.

  • Sales training + coaching
  • Marketing support
  • Compliance support
  • Accessibility

“If you fail to plan, then you plan to fail.”

The most successful agents don’t go into AEP flying by the seat of their pants. At RBI, we develop marketing plans with our agents the M.A.P.S. way. Your marketing plan should be Measurable, Actionable, Profitable, and Scalable. Check out my blog post that I linked to above to learn more about the M.A.P.S. method for success.

A lot of agents I speak with only look for referrals from their existing book of business but are totally ignoring a HUGE opportunity, getting referrals within your community.  The easiest place you can start is your very own doctor’s office.  If you’ve ever wondered how an agent is able to be successful in this industry without breaking the bank by purchasing leads, here’s your answer: Community Marketing.  Not sure how, or where to start?  Check out my blog post, “Building Your Referral Network” and download the free white paper where I demonstrate how to get started!

AEP + OEP

With our selling season lasting almost three times as long than in previous years – OEP lasts from January 1st through March 31st, now is the time to start planning! You’re probably thinking, “wow, that’s a lot to think about.” That’s because it IS a lot to think about. But, if you really want to be successful in this business, then don’t let another Annual Enrollment Period pass you by without doing everything in your power to make it happen!

RB Insurance Group has the tools, marketing support, and most importantly, the expertise to turn you into a Medicare selling machine.

Give me a call today to learn all about how we do things differently than our competitors! (800)-997-3107 .



2020 ahip discount certification
OEP
Medicare cost-sharing

Save Big: Medico + USA Senior Care Network

Medicare SEP

About the Author: With his signature common sense, quiet good humor, and brilliant customer service, Jim is an integral part of the RBI team — we’d go so far as to say we’d be lost without him! An Arizona native, Jim manages agent relationships for the East Coast and specializes in the RBI agent tools, especially the Agent Market Edge. Jim has been a licensed health insurance agent for 2 years, and has worked at RBI for almost 3 years. An accomplished bassoonist, he is known around the office for his amazing musical skills. In addition to keeping busy around the office, Jim frequently contributes to our blog, bringing a new agent’s perspective to the RBI online presence.

Save Big with Medico + the USA Senior Care Network

Medico is introducing a brand new program that is designed to save your client’s money. This new program, the USA Senior Care Network program, is a completely voluntary program designed to help save you money when you obtain inpatient services at a USA Senior Care Network hospital. Best of all, this new program costs absolutely nothing!

About the Program

USA Senior Care Network has contracted with hospitals across the U.S. to waive all or a portion of your client’s Medicare Part A deductible if they’re admitted into a participating hospital. This allows them to pass some of those savings on to your clients in the form of a $100 premium credit on their next months Medicare supplement premium payment. For a list of participating hospitals in your area, click here!

USA Senior Care Network

How do You Receive the Premium Credit?

Beginning on June 22nd, 2018, when your clients are admitted into a hospital in the USA Senior Care Network, show your new insurance card with the USA Senior Care Network logo on the back (mailed on June 7, 2018). When Medicare applies a Part A deductible to their claim, the hospital will waive all or a portion of that deductible and will notify your client that an upcoming premium payment will be reduced by $100.

There are two groups of policyholders who will not be eligible for this program:

  1. Medicare Supplement Plan A policyholders are not included, because Plan A does not pay the Medicare Part A deductible.
  2. For legal reasons, this program is not available in the state of Missouri.

Current Coverage

Your clients Medicare supplement policy will remain unchanged by this program. They are not required to use a participating hospital, and you can still go to any hospital you choose. Your clients can now access their policy information on Medico’s secure customer portal at www.gomedico.com or they can call Customer Care Center at 1-800-228-6080.

Medico offers a whole suite of products that are designed to protect your clients from a multitude of situations! If you would like to get contracted, or learn more about their product offering, give me a call directly at 1-800-997-3107!

2020 ahip discount certification
OEP
Medicare cost-sharing

United Healthcare 2018 Certification

RBI Senior Sales Coordinator/Independent Agent: James Gramp

With his signature common sense, quiet good humor, and brilliant customer service, Jim is the other half of the RBI phone answering dynamic duo! An Arizona native, Jim manages agent relationships for the East Coast and specializes in the RBI agent tools, especially the Agent Market Edge. Jim has been a licensed health insurance agent for over a year, and has worked at RBI for 2 years. An accomplished bassoonist, he is known around the office for his amazing musical skills. In addition to keeping busy around the office, Jim frequently contributes to our blog, bringing a new agent’s perspective to the RBI online presence.

United Healthcare 2018 Certification

Last year we created a super handy master certifications page on our blog so that agents could easily access all of their certification portals from one spot.  Fear not!  As we draw closer to AEP and more carrier certifications become available we will update our 2017 certifications page for the 2018 certification season.  United Healthcare is the first Medicare Advantage carrier to announce the opening of their 2018 certification, which will be June 26th.  Click the button below to access the UHC certification once it has been released.




Five reasons to not procrastinate this certification season!

If you’re like me, you are going to get your AHIP out of the way as soon as possible.  For me, that’s the day it comes out, June 19th.  I know what you’re thinking, “it’s your job to get it done ASAP,” and you wouldn’t be wrong.  So here are the top 5 reasons to knock out AHIP and carrier certifications as they become available.

  1. The closer you get to AEP to do your certifications, the longer it takes carriers to process paperwork and background checks.  I’ve seen it take up to 6 weeks before agents got their “Ready to Sell” status.

    2018 - Ace the AHIP Live Workshop

    Get ‘er done!

  2. The sooner you get your certifications done, the sooner you can start crafting your marketing plan for AEP (sending ANOC letters, calling all clients, scheduling events and so on).
  3. If you plan on doing any kind of events during AEP, the sooner you have your certifications done, the less likely the locations you have picked out will be booked.
  4. You will not be able to order or pick up any Sales Materials until you are marked as “Ready to Sell” with that particular carrier.
  5. And finally, the last reason you shouldn’t procrastinate when it comes to Medicare certifications: PEACE OF MIND.

That moment an agent tells me they finished AHIP before August

Webinar Wednesday – June 14th

Join RBI Director of Marketing, Justin Bever, on June 14th at 12pm ET to see how RBI Eliminates the Stress, Fear, and Anxiety of Certification and AEP Planning to learn how we’re going to approach the 2018 certification season.

If you don’t want to be frantically running around before the Annual Enrollment Period, then do yourself a favor and don’t procrastinate.  Just get it done, start planning for your AEP, and let RB Insurance Group make this your most successful Annual Enrollment Period yet!


Want to learn how RBI can take your Medicare business to the next level?  Get contracted today, or give us a call at 1-800-997-3107!



2020 ahip discount certification
Medicare cost-sharing
Aetna certification

Video: RBI Carrier Hall of Fame Week 3

Video: RBI Carrier Hall of Fame Week 3 (ICYMI)

Hey, you! We’re back again! As you know, this whole month we’re bringing you the scoop on our RBI Carrier-Partners with “Carrier Spring Training” month! It’s been a great month so far (we’ve definitely learned new things every day!) and we cannot believe that next week is our last week! The time certainly has flown by. If you missed the webinars this week and don’t have time to re-watch them, here’s the RBI sales team to break down the highlights of each carrier, and what they do for your portfolio. Watch the videos below: RBI Carrier Hall of Fame Week 3!

To start things off this week, we heard from Mutual of Omaha, on Monday! Then Tuesday, we had a webinar from GTL or Guarantee Trust Life, followed by RBI’s own Quoting Tool on Wednesday, and wrapped up the week with a presentation on SilverScript on Thursday! Our presenters this week — thanks a million: you guys are the best! — were Ken Colvard (Mutual of Omaha and SilverScript), Greg Esposito (GTL) and Brien Welch (RBI Quoting Tool). We watched these webinars and were so impressed with the knowledge base that they bring to the table, as well as some of the great new plans available to agents and members. There was a lot to go over, so here’s the four highlight videos from this week!

RBI Carrier Training Highlights Team:

  • Mutual of Omaha by Charlie Ferrell
  • Guarantee Trust Life by James Gramp
  • RBI’s Quoting Tool by Justin Bever
  • SilverScript by Rebecca Howard


Monday, April 17, 2017 at 9 AM


Tuesday, April 18, 2017 at 9 AM


Wednesday, April 19, 2017 at 9 AM


Thursday, April 20, 2017 at 9 AM

Video: RBI Carrier Hall of Fame Week 3

Look for this symbol on all our new “Carrier Hall of Fame” videos!

When you think about these three carriers, it’s important to understand how each brings something different into your portfolio. Whether you focus on Medicare Supplements, Hospital Indemnity or PDP plans, it’s important to have products that fit well together. And not just each other, but products that will serve the needs of your clients. In addition, this week you may have noticed a bit of a technology theme developing. Each carrier this week has a focus on making your life as an agent easier with online enrollments. And RBI’s quoting tool fits right into this theme. If you aren’t taking advantage of the technology and tools available to you at RBI, now is the time!

Watch the recording: Mutual of Omaha. Watch the recording: Guarantee Trust Life. Watch the recording: RBI Quote Tool. Watch the recording: SilverScript.

Click here to get contracted. Click here to see all our contracted carriers.

Sign up for the next webinars today! Click here to see the full calendar.

  • Monday, April 24 at 9 AM MST/12 PM EDT – “Hit a Fastball with Molina” Register
  • Tuesday, April 25 at 9 AM MST/12 PM EDT – “Be a Power Hitter with Cigna” Register
  • Wednesday, April 26 at 9 AM MST/12 PM EDT – “Be a Clean-up Hitter with Gateway” Register
  • Wednesday, April 26 at 10:30 AM MST/12:30 PM CDT – “Pitch a Shut-Out with Blue Cross Blue Shield of Texas” Register
  • Thursday, April 27 at 9 AM MST/12 PM MST – “Be a Hometown Slugger with Harbor Health Plan” Register
  • Thursday, April 27 at 10 AM MST/12 PM CDT – “Load the Bases with Allegian” Register

Subscribe to the RBI Agent’s Advantage Blog today!

Did you miss last week’s webinars? Watch the full recording: Aetna. Watch the full recording: United Healthcare. Watch the full recording: Humana.


All videos are for agent use only.



USA Senior Care Network
AEP
New Agent

Video: RBI Carrier Hall of Fame Week 2

Video: RBI Carrier Hall of Fame Week 2 (ICYMI)

So if you’ve been following along this week on all our emails and event calendar, you know that April is “Carrier Spring Training” month! We are so excited for this new initiative, and just finished up our second week of webinars! But if you missed these webinars and don’t have time to re-watch them, here’s the RBI sales team to break down the highlights of each carrier, and what they do for your portfolio. Watch the video below: RBI Carrier Hall of Fame Week 2!

This week, we collaborated with Aetna, Humana, and United Healthcare. A huge shout-out to our presenters, Daniel Santos (Aetna), Kirk Sanich (Humana), and our own Charlie Ferrell stepping in for Ken Colvard (United Healthcare), who did a fantastic job showcasing their products and what makes them compelling for members.

RBI Carrier Training Highlights:

  • Aetna by Rebecca Howard
  • Humana by James Gramp
  • United Healthcare by Charlie Ferrell
Video: RBI Carrier Hall of Fame Week 2

Look for this symbol on all our new “Carrier Hall of Fame” videos!

The RBI bottom line is that all three of these carriers offer something different and that they work together nicely to fill out your portfolio as a senior insurance advisor. We recommend that you contract with all three today because everyone is different and it’s important to have the products that fit the needs of your clients.

Watch the recording: Aetna Webinar. Watch the recording: Humana Webinar. Watch the recording: United Healthcare Webinar.

Click here to get contracted. Click here to see all our contracted carriers.

Sign up for next week’s webinars today!

  • Monday, April 17 at 9 AM MST/12 PM EDT“Hit a Homer with Mutual of Omaha” Register.
  • Tuesday, April 18 at 9 AM MST/12 PM EDT“Steal Second with GTL” Register.
  • Wednesday, April 19 at 9 AM MST/12 PM EDT“Bat 1.000 with RBI’s Quoting Tool” Register.
  • Thursday, April 20 at 9 AM MST/12 PM EDT“Out of the Ballpark with SilverScript” Register.

Subscribe to the the RBI Agent’s Advantage Blog today

Did you miss last week’s webinars? Watch the full recording: American Continental Webinar. Watch the full recording: Equitable webinar. Watch the full recording: Medico webinar.


All videos are for agent use only.




2020 ahip discount certification
OEP
Medicare cost-sharing

Video: RBI Carrier Hall of Fame Week 1

Video: RBI Carrier Hall of Fame Week 1 (ICYMI)

So if you’ve been following along this week on all our emails and event calendar, you know that April is “Carrier Spring Training” month! We are so excited for this new initiative, and just finished up our first week of webinars! But if you missed these webinars and don’t have time to re-watch them, here’s the RBI sales team to break down the highlights of each carrier, and what they do for your portfolio. Watch the videos below: RBI Carrier Hall of Fame Week 1!

This week, we heard from three tremendous carriers: Aetna/American Continental, Equitable and Medico. A big thank you to our presenters, William Davis (American Continental), Bill Ellsworth (Equitable), and Carrie Haubensak (Medico) who did a really amazing job introducing their products and telling us why members like their plans!  We have three videos below so you can get all the highlights on what makes each carrier a perfect fit for your portfolio!

Video: RBI Carrier Hall of Fame Week 1

Look for this symbol on all our new “Carrier Hall of Fame” videos!

When you think about these three carriers, each has something a little different to offer. And at RBI, we like having all three carriers in our portfolio so that we can speak to any client’s individual needs.

Watch the recording: American Continental. Watch the recording: Equitable. Watch the recording: Medico.

Click here to get contracted. Click here to see all our contracted carriers.

Sign up for the next webinars today! Click here to see the full calendar.

Subscribe to the RBI Agent’s Advantage Blog today!


All videos are for agent use only.



USA Senior Care Network
AEP
New Agent

Medicare Supplements 201 Revisited for 2017

If you read our Medicare Supplements 101 Revisited article last week, you know that we are all about understanding supplements. This week it’s time to go deeper: Medicare Supplements 201 covers more about the unusual or specialized plans you might need. This article has also been revisited for 2017, so you’re getting the latest of fresh updates.

Part 1 of our series went over what the different Medicare Supplements cover and how they work with Original Medicare.

Medicare Supplements 201 coverage A-N chart

In Part 2 of our series we are going to discuss the different enrollment periods for Medicare supplements as well as some of the underwriting criteria major carriers use in pricing their plans. Remember, in order to enroll into a Medicare Supplement policy, beneficiaries must have Medicare Parts A and B.

Open enrollment for Medicare Supplements is the 6 months following a beneficiaries Part B effective date. No health questions asked. Full commission paid according to contracted rates.

Guaranteed issue. According to federal guidelines, carriers must issue a Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in the state under the following conditions;

  • During a Medicare Advantage members 12 month trial period
  • A beneficiaries’ current Medicare Advantage plan is leaving the area either due to financial reasons or is no longer going to offer that plan.
  • Beneficiaries’ employer group plan that pays after Medicare is ending. This includes retiree and COBRA coverage
  • Beneficiaries leave a Medigap or Medicare Advantage plan because the company hasn’t followed the rules

Underwritten policies can be issued at any time after the open enrollment period and beneficiaries are able to pass underwriting questions. Some policies have relaxed underwriting for a higher premium. Full commissions paid according to contracted rates.

Underwriting guidelines vary from carrier to carrier. Some carriers allow diabetics with no issues and other carriers will not issue policies at all for diabetics. Almost all Medicare Supplement carriers have a “prohibited prescriptions” list that tells you the application will be declined if a member takes the medication on the list for a specific condition. Some carriers include this list in every kit they send out.

Medicare Supplements for Beneficiaries under age 65. Not all states require Medigap plans to cover beneficiaries under age 65. In some cases states may only require carriers to offer certain plans for those under age 65 or cover certain conditions such as ESRD. In all cases, under 65 policies are more expensive than a regular Medigap policy since carriers know the beneficiaries will be using more benefits than those over 65 on original Medicare.

This is just brief overview of Medicare Supplements. For an in depth explanation and more, click the button below for the recording of Part 2 of our webinar series on Medicare Supplements: “Medicare Supplements 201.”

Contact us today to get contracted with the highest rated carriers in your area. Many plans are only competitive in certain zip codes so don’t be fooled by all their hype. Call us at 1-800-997-3107 and let us help you with all of your Medicare Supplement contracting needs.

Updated 3/13/2017; Originally Published 5/16/2016

Medicare Supplements 101 Revisited for 2017

If you’re not an expert in Medicare Supplements, it’s time to get educated! Our Medicare Supplements 101 article and webinar is here to help! Newly updated for 2017, this article will help you get started now!

A Brief History

Medicare Supplement (Medigap) plans have been around almost as long as Medicare, and just like Medicare, have transformed over the years. It began as a variety of different coverages state by state, and was ultimately standardized by Medicare in 1992. The Omnibus Budget Reconciliation Act of 1990 replaced many voluntary guidelines with new Federal standards. Nearly all states adhere to these standards with a few exceptions. Massachusetts, Minnesota, and Wisconsin are three states complying with Federal guidelines without using the standardized A through N plans.

Medicare Parts A and B cover most medically-necessary inpatient and outpatient services. Unfortunately for consumers, Medicare does not cover all medical costs, leaving beneficiaries responsible for a portion of the costs. Let’s take a quick look at Medicare Part A and B, and then take a look at Medicare Supplements 101!

Medicare Part A

The two largest costs associated with Part A are the Hospital Deductible ($1316 in 2017) and days 21-100 ($164.50 co-pay per day) of the Skilled Nursing Benefit. There are also some costs associated with Hospice care which Medicare does not cover. Medicare DOES NOT cover the cost of room and board if someone is using a private hospice facility. While the Hospice benefit does cover the doctors and additional care needed, it does not cover the facilities charge of around $300 per day in a nursing home or skilled nursing facility. As you can imagine, the bills pile up quickly!

Medicare Part B

Part B has a yearly deductible ($183 in 2017) and 20% coinsurance for all Part B-covered services, including chemotherapy. There is no cap on how much a beneficiary is responsible for under traditional Medicare Parts A and B so chemotherapy treatments for example, could be financially crippling.

Medicare Supplements 101 to the Rescue!

 Medicare Supplements 101 coverage A-N chart

Depending on the plan, Medicare Supplement A through N policies cover all or a portion of the gaps in Medicare coverage. Because of the Federal standardization, the included benefits for each plan type is identical across all insurance carriers. The only difference is the premium. It is no coincidence that 57% of all Medicare Supplements have enrolled on Plan F policies- the benefits are generous and the added coverage provides financial protection.

  • National Guaranteed Issue rights only apply to Medigap Plans A, B, C, F, K, or L . Some states have their own Guarantee Issue periods. With Plans D, G, M and N, the beneficiary will likely be subject to medical underwriting.
  • Excess charges can occur when a doctor does not accept Medicare assignment. The beneficiary can be charged up to an additional 15% of the Medicare allowable rates.
  • Plans C, D, F, M and N all include a Foreign Travel benefit.  Beneficiaries pay a $250 deductible and their Medigap policy will pay 80% of the remaining charges, up to $50,000.
  • HD-F, K and L all have deductibles and maximum out of pocket expenses which are set by CMS every year.
  • Plans C and F cover the Part B deductible. For those of you familiar with the Medicare Access and CHIP Re-authorization of 2015 (MACRA for short), Medicare Supplement plans C and F will not be available for sale to new Medicare beneficiaries after Jan 1, 2020.
  • Plan N has a $20 co=pay at a doctors office and a $50 co-pay at the Emergency Room

Keep an eye out for more information on Medicare Supplements 201, Open Enrollment, Underwriting and Guaranteed issue situations.

This is a just brief overview of Medicare Supplements. For an in depth explanation and more, click the button below for the recording of Part 1 of our webinar series on Medicare Supplements.



Contact us today to get contracted with the highest rated carriers in your area. Many plans are only competitive in certain zip codes so don’t be fooled by all their hype. Call 1-800-997-3107 and let us help you with all of your Medicare Supplement contracting needs.

Updated 3/6/2017; Originally Published 5/16/2016

Mergers and Acquisitions

2019 United Healthcare

(Updated on February 9, 2017. ) I’m sure you have all heard the news that the Federal government is suing to stop 2 healthcare mergers and acquisitions from happening. The latest news has both Aetna/Humana and Anthem/Cigna at odds with the Justice department. Both cases should be wrapped up soon.

Aetna would potentially owe Humana a “break-up” fee of $1 billion if their deal is not closed by February 15th, 2017 while Anthem would owe Cigna a $1.8 billion fee if that deal is not done by April 30, 2017. Aetna and Humana are vigorously defending their position to allow the sale to proceed. The Anthem/Cigna merger has had several setbacks and is in question.

On the Aetna/Humana merger: (Blocked January 23, 2017)

  • Aetna/Humana released a statement announcing a sale of some of their Medicare Assets to Molina Healthcare. You can see the press release here. The asset sale is contingent upon the sale of Humana to Aetna being completed.
  • The DOJ called Molina a junk-bond-rated company and Molina responded they could easily shoulder the additional 290,000 members in addition to their current membership of roughly 4.3 million lives, and restated their position as the 10th largest health insurer in the country hardly qualifies it as “junk status.”
  • In its final argument, Aetna said, “The government has rested its case upon theory and speculation from beginning to end.”

On the Cigna/Anthem merger: (Blocked February 8, 2017 )

  • Attorneys for the federal government have said that the deal would harm competition in the national insurance market. Anthem countered they are only a regional player licensed in 14 states.
  • The merger would make the combined carrier number 2 nationally in overall lives insured second only to United Healthcare.
  • In some markets, the combined carrier would reduce the number of insures down to 3. The federal government says the competition between Cigna and Anthem in these markets is leading to innovation, while keeping prices down. Anthem and Cigna contend that the merger will decrease prices due to better bargaining power with large provider groups, lowering costs to the consumers even more.

Both of these were bench trials and final arguments have been made.  The Anthem/Cigna merger is expected to be blocked but there is no time frame for the ruling. The outcome of the Aetna/Humana merger was blocked today on Antitrust grounds. Aetna has said it plans to appeal the DOJ ruling.

We are continuing to follow these carrier mergers and acquisitions, and will bring you up-to-date information on our blog.  Click here to subscribe!   

2019 Humana certification
Short Term Home Health Care
2019 United Healthcare
2019 Medicare Broker Compensation

Medigap 102: Revisited for 2017

Part 1 of our series went over what the different Medicare Supplements (Medigap plans) cover and how they work with Original Medicare.

In Part 2 of our series we are going to discuss the different enrollment periods for Medicare supplements as well as some of the underwriting criteria major carriers use in pricing their plans. Remember, in order to enroll into a Medicare Supplement policy, beneficiaries must have Medicare Parts A and B.medigapxplanxcoveragexpicturexa-n

Open enrollment for Medicare Supplements is the 6 months following a beneficiaries Part B effective date and they are 65 or older. No health questions asked. Full commission paid according to contracted rates.

Underwritten policies can be issued at any time after the open enrollment period and beneficiaries are able to pass underwriting questions. Some policies have relaxed underwriting for a higher premium. Full commissions paid according to contracted rates.

Underwriting guidelines vary from carrier to carrier. Some carriers allow diabetics with no issues and other carriers will not issue policies at all for diabetics. Almost all Medicare Supplement carriers have a “prohibited prescriptions” list that tells you the application will be declined if a member takes the medication on the list for a specific condition. Some carriers include this list in every kit they send out.

Guaranteed issue. According to federal guidelines, carriers must issue a Medigap Plan A, B, C, F, K, or L that’s sold by any insurance company in the state under the following conditions;

  • A beneficiaries’ current Medicare Advantage plan is leaving the area either due to financial reasons or is no longer going to offer that plan.
  • During a Medicare Advantage members 12-month trial period
  • Beneficiaries’ employer group plan that pays after Medicare is ending. This includes retiree and COBRA coverage
  • Beneficiaries leave a Medigap or Medicare Advantage plan because the company hasn’t followed the rules
  • Most states allow new move-ins a guarantee issue period for the first 63 days they are in a new service area.

Remember that some carriers will pay reduced or no commission on Guarantee issue business. Always do the right thing for your client but do it knowingly. Sometimes a client can still pass underwriting which allows you to get paid your full commission. Also, remember the plan letters listed above have Guarantee issue according to Federal guidelines (A, B, C, F, K and L). United Health Care also has guaranteed issue into the Plan N in many states. (At a reduced commission of course)

Medicare Supplements for Beneficiaries under age 65. Not all states require Medigap plans to cover beneficiaries under age 65. In some cases states may only require carriers to offer certain plans for those under age 65 or cover certain conditions such as ESRD. In all cases, under 65 policies are more expensive than a regular Medigap policy since carriers know the beneficiaries will be using more benefits than those over 65 on original Medicare.

Contact us today to get contracted with the highest rated carriers in your area. Many plans are only competitive in certain zip codes so don’t be fooled by all their hype. Let us help you with all of your Medicare Supplement contracting needs.