MA Commission Controversy Mounts
A lot of agents are unhappy about the latest CMS ruling on first-year MA commissions, which says that consumers who were enrolled in Original Medicare with a stand-alone PDP and then switched to an MA or MAPD plan in 2009 are considered “renewals” and therefore do not qualify for the full initial year compensation.
CMS has stated that the November revisions to the compensation policy indicate that in 2009 there are only two situations in which an initial compensation amount should be paid:
- When someone is new to Medicare (e.g. an age-in) or
- When someone enrolls from Original Medicare (i.e. they were not previously enrolled in an MA, Program for All Inclusive Care for the Elderly (PACE), cost or Part D plan).
All other enrollments will only be paid the renewal amount.
Please note that neither SMS nor the carriers can interpret the data or in any way make judgment calls on which enrollees do or do not qualify as initial enrollees according to CMS. However, Senior Market Sales continues to closely follow the appeals process for all our carriers and their communication with CMS regarding the definition of initial compensation eligibility. It is our hope that CMS will revisit this issue and come to a more favorable resolution for the agents in the field.
If you’d like to make your feelings heard on this issue, we encourage you to contact your elected representatives.
Write Your Congressional Representative
If you have questions, please feel free to contact an SMS Medicare Expert at 1-877-645-0147.
