Commissions FAQ's From Agents
Commissions Knowledge Quiz
Test your understanding of commissions and enrollment processes in the Medicare Advantage and Prescription Drug plan landscape. This quiz is designed for agents looking to enhance their knowledge and ensure they are up to date with the latest policies and payment structures.
Key areas covered:
- Payment structures for MAPD plans
- Impact of disenrollment on commissions
- Certification requirements for agents
- Commission rates and true-ups
“If my member stays enrolled in their current Anthem MAPD plan into 2023, how will I be paid in 2023?”
You’ll be paid a lump replacement in January.
You’ll be paid monthly renewals for each month the member is enrolled during 2023.
You’ll be paid a lump initial in January.
You’ll be paid a lump replacement once the member pays their premium.
“I enrolled my member this month and only got paid a small fraction of the full, why?”
The carrier has decided that is all they are willing to pay at this time.
The carrier just has to pay this way at first, they will issue you more money in the next few months.
At this time CMS has not reported the members prior plan history to the carrier yet to pay the full initial, this can take up to 90 days after the effective date. If during that time CMS reports the member as new, you will be issued a true up.
I’m not sure, I’ll reach out to the carrier to see why.
“I enrolled my member in a 11/1/2022 plan with Excellus and they disenrolled on 11/31/2022 because they didn’t like the plan, why did all of my commissions get taken from me?”
This is incorrect, we’ll work with the carrier to have these commissions paid back to you
Due to the timeframe your member was enrolled and the reason for disenrollment, this would be considered a Rapid Disenrollment. CMS states that if the member has a rapid disenrollment from their plan all commissions issued must be retracted.
Since your member is no longer enrolled, Excellus had to issue a chargeback for the time you member wasn’t enrolled.
Excellus was update that your member didn’t like their plans, so they took your money back as pay back.
“Can you tell me how much I’ll make if I write someone into a CBC MAPD plan in 2023?”
Yes, if you write someone who is new to Medicare into a CBC MAPD plan in 2023, you’ll be paid $678.
Yes, if you write someone who is new to Medicare into a CBC MAPD plan in 2023, you’ll be paid $339.
At this time I am unable to provide definite amounts as the payment will all depends on the information the carrier received from CMS pertaining to their commissions eligibility. I am able to provide you with an estimate of what the carrier might pay based on the effective date.
It’s the carrier discretion of how they will pay the policy, I won’t be able to provide you with an amount today. If you want to call back in once you receive the payment to confirm if that is the correct amount you can do so then.
“Do I need to complete my certifications in 2023 to continue to receive my renewals on my Anthem MS policies?”
Yes, in order to receive renewal commissions all agents must complete their yearly certifications.
No, yearly certifications are not required to receive compensation on Medicare Supplement commissions
I’m not sure, I’d double check with Anthem on their requirements. Every carrier is different.
Yes, you must also be licensed, appointed, and contracted with Anthem.
“My member only had a PDP before, why didn’t I get paid all of my money for the MAPD plan?”
At this time CMS has not reported the members prior plan history to the carrier yet to pay the full initial, this can take up to 90 days after the effective date. If during that time CMS reports the member as new, you will be issued a true up
I’ve seen this before with other policies, this is correct.
You should have been paid the full initial on this policy, I’ll work with the carrier to have this corrected.
A switch from a PDP to an MAPD is considered an unlike plan change, due to this it is stated by CMS that the carrier must only pay a pro-rated initial payment for the policy. The new plan would only pay the months the beneficiary is enrolled.
“My member just enrolled in an 11/1/2022 plan with Highmark but we found a better plan for them with Geisinger in 2023. If I enroll my member in a 1/1/2023 plan with Geisinger will I get a chargeback from Highmark since I was paid for the entire year?”
No, per CMS guidelines if a member is enrolled during the month 10/1-12/1 and subsequently enrolls during AEP into a new plan effective 1/1 the carrier is not allowed to issue a chargeback.
Yes, this would be concerned a disenrollment. Per the CMS guidelines, you will be charged back for any months the member was not enrolled so for this case you will receive a chargeback from 1/1/2023-10/31/2023.
Yes, per the CMS guidelines this would be concerned a rapid disenrollment. You will be charged back everything that was issued. In order to not have a chargeback the member will need to stay enrolled in their Highmark plan until the end of 2023 and will be eligible to switch plans during AEP for 2024.
There shouldn’t be one but the carriers system may get confused as see if as a disenrollment and issue a chargeback, if this occurs just let us know and we’ll work with the carrier to have it corrected.
“When will you guys pay me for me UPMC renewals in 2023?”
All Renewals will be paid in January 2023.
All renewals will be paid at the end of June 2023
We don’t pay commissions for UPMC, you’ll need to contact the carrier for that information
Renewals will be paid in the first quarter of the year, it can take the carrier up to two to three payment cycles to get caught up on all business that needs to be paid out.
“If I get a release from you guys, will you still pay me?”
Yes, we will still pay you on everything.
As long as you remain properly credentialed and the policy stays enrolled, any business you wrote while under us will continue to pay as it has. All new business will pay out to your new upline.
No, since you are no longer active under us we will not be able to pay you as we won’t be able to verify your enrollment or credentials.
No, all of your business will automatically move with you to your new upline
“I’m calling in for one of my downlines. They have their commissions paid to me for 2023. They said they enrolled someone for a 10/1/2022 effective date, but their client had a plan switch during AEP, I’m not sure of the effective date to be honest. Do you know who will get paid and what we’ll get paid? The previous policy was under Excellus, I think the new policy is for Anthem Empire. I should be getting overrides based on my level 7 contract with Anthem.”
Since the member would not be new to Medicare, you will be paid a prorated replacement based off a 10/1/ 2022 effective of $89.50 in broker portions and $100 in override. This will be paid by Anthem to Ritter and then we will pay you.
For the policy your agent wrote with the 10/1/2022 effective, you will not be eligible to receive override commissions on this policy due to it being effective prior to 2023 when your agent has assigned their commissions over to you. However, for the plan switch during AEP if this does have an effective date of 2023 you will be eligible to receive override on this policy. Due to it being a replacement policy you should be receiving $100 in override from Ritter.
I won’t be able to provide you with exact amounts until you are able to provide me with the specific carrier and effective date. If you can confirm that information with your downline, I’ll be more than happy to look into it to let you know how much you and your downline will be receiving!
At this time I am unable to provide definite amounts as the payment will all depends on the information the carrier received from CMS pertaining to their commissions eligibility. I am able to provide you with an estimate of what the carrier might pay based on the effective date.
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