In this lesson we will talk about the different major player companies you will run across. We suggest you find 2-3 companies that you want to use as your go-to companies. Be prepared to be able to tell a client why you are selecting the company you are recommending. Also know why you would not select a company if asked.
Gordon Marketing has a Medicare Quoting tool available to you for no charge. It will list out the different companies along with premiums based on the zip code, gender and age you select. There is an option for market analytics. This will show you the number of policies there are in the state and the company’s history of rate increases. We have used this to show a client why we would NOT recommend a company. You want to recommend companies that have a large number of clients in the state, have been doing business in the state for a while and have a good history of rate increases. You are in this for the long haul. You want to do the best job recommending something for your clients they will be happy with for years. As they get older their chance of changing plans and companies will diminish as their health declines. Don’t go with the lowest or newest company on the market. Premiums are based on claims history, so you want a company that has lots of policy holders to spread the risk over. Every company will have an annual rate increase. The timing of that may vary by company. Clients will ask why that is. It is because the deductibles go up with Medicare each year. When the company has to pay more, the client pays more. Also, the increase is based on claims history. The rate does not go up just because the client has had more claims than usual. The rate increase is the same for everyone in the state that has that policy with the carrier.
These are our opinions of the different companies. They are our opinions only. Your experience with a carrier may be different from ours.
Anthem
Anthem offers Medicare Supplements, Medicare Advantage plans and Prescription drug plans. We will focus on each of these segments.
Medicare Supplements Anthem typically has their annual rate increases in January. They are an attained age rated plans. That means that each year they get older up to age 78, they will get an increase because of their age increase. They also receive the annual increase at that time, so your client will see one bigger increase once a year vs two smaller ones with UHC. See our UHC section below for why that is. The age-related
increase caps out at age 78. That means that after that age, they will only see the annual increase. Anthem provides a 6 month rate for when you first sign up. Clients can choose to have their supplement taken from their bank account. A couple can have two separate accounts for their bank drafts. The husband can use his account and the wife can use hers. UHC is different. See their section below for information on bank drafts. Anthem offers a $2/month discount if the policy is on a bank draft and a $4/month discount for paying annually. The year is always
prorated to 12/31. Anthem’s annual year always starts on Jan 1. So, if the policy effective date is 7/1, then they would only pay for 6 months and would get a $24 discount (6 times $4). If they do not want to have it drafted from their bank account each month, they can choose to get a quarterly, semi-annual or annual bill. If they want to pay it monthly with a direct bill, the client needs to contact Anthem
customer support to get it changed.
Anthem also offers a 5% couples discount if 2 people living in the same household have a modernized (issued after 6/1/2010) Medicare supplement policy with Anthem. They do not need to be husband and wife, but can be partners or siblings. They just need to share the same address. If one client turns 65 and gets a supplement, when the other turns 65 and picks up a supplement, the first person will begin receiving the 5% discount. The two people are tied together on the application. Anthem’s select plans are very popular and well-priced. A Select plan means there is a network of hospitals for a non-emergency, in-patient hospital stay. All of the hospitals in Jefferson county, Oldham county, Shelby county and over the river in Indiana are in the network. If your client is outside the Louisville area, you MUST ask the person which hospital they would go to in a non-emergency to ensure it is in the network. I always caution people that the network is subject to change. A number of years ago, Norton Healthcare and Anthem got into a spitting match. All of the Norton hospitals went out of network for those 6 months. It meant that if you were planning surgery, you had to use a different hospital. In an emergency you can go to any hospital. Just make sure they know they would need to go in through the emergency room. The way you know if this is an option is to say, “In a non-emergency,
if you were going to be admitted to the hospital would you be in town? Do you live anywhere else part of the year? Do you have plans on moving in the next five years?” Depending on their answers to this, you will then feel comfortable recommending or not the select plan.
If someone has a select plan, they can go anywhere in the US to see a doctor, receive treatment, get a second opinion or have outpatient surgery. The only restriction is for the non-emergency, in-patient hospital stay. If they move outside of the Select plan’s area (outside KY), they are guaranteed issue for a Medicare Supplement in the state they move to. We always tell people, if you are outside this area and someone tells you that you need to be admitted to the hospital, go in through the emergency room. If at any time it is an emergency, tell them to go to the closest place they need to get help. There are a lot of people in Kentucky that have the Anthem Select plan. It has a good history of
reasonable rate increases. For the most part you can’t go wrong with this plan as clients will talk to their friends and their friends probably have this plan. The Anthem plans also come with Silver Sneakers, which is a free gym membership to participating gyms. They can join as many gyms as they want. Any Anthem supplement effective after June 2010 now has the Silver Sneakers. The prefix of their ID number is VNG. All clients got a new card in December 2016 if they were eligible for the Silver Sneakers. You will typically NOT propose the Standard Anthem plans. These don’t have the hospital network like the select plans do, but the premiums on those are really high compared to UHC. Instead, you would do
the UHC plan. If you have a snow bird (someone who lives somewhere else part of the year) or if they would go to Mayo Clinic for something, then do NOT do the Anthem Select plan. In this case you would do the UHC plan. One exception to this is if they are planning on moving in the next 5 years or so. Depending on where they are moving, UHC may not be a better option. The reason is that after they change their address with UHC, they will get the rate for the state they move to. UHC rates in some states (like FL) are really high. You may want to do the Anthem standard plan instead as they will retain the KY rates when they move to a different state. If you are not sure if where they are moving has
higher rates, go to the Gordon Marketing Medicare tool to find a rate for that state and compare it to the KY rates.
Anthem will offer a limited selection of Medicare supplements to clients under 65. Only if they are coming off of employer coverage. Coming off of employer coverage has to be involuntary. That means they are losing through no fault of their own (ie. Loss of job, exhaustion of Cobra). You will receive no commission for these plans. They will take a third-party check for payment. This is typically seen for people on dialysis where the American Kidney Foundation is paying their Medicare Supplement premium.
For Medicare supplements commissions are a flat 21% for years 1-6. They are paid now with a 9-month advance. After that, they are paid monthly. In year 7 that drops to 4%. If you AOR an older plan, the commission percent may be different depending on the level the agent that wrote it was at and how old the policy is. If you write a new policy for a client who already has a Medicare Supplement and you are not the agent on that plan, you are not automatically made the agent by submitting the Medicare Supplement new application. You will need to get an AOR signed by the client when you write the new Med Sup.
With Anthem, you can “poach your way to prosperity”. Anthem will allow you to do an Agent of Record (AOR) change. When you have your client write and sign a letter stating that they would like you to be their agent, you will begin to get commissions on their plan. See our lesson on Getting an AOR. We encourage you to do this as it provides the client with one point of contact for their Medicare needs.
Please ensure that they don’t already have a relationship with another agent prior to doing this. If they do have a relationship with an agent, you do not want to sever that. Perhaps over time if you help them with their drug coverage, they will value you more and sign the AOR.
Enrollments are done online through your agent portal via MProducer. You can take the application and then enter it electronically later. The only exception to the online enrollment is for clients under 65 for whom you are submitting a Medicare Supplement. Those applications MUST be faxed to Anthem.
Medicare Advantage and Prescription Drug Plans
Anthem’s MAPD plans have been very consistent over the years. As of 2021, they offer an HMO, 2 PPOs, 1 RPPO, D-SNP and a no drug Medicare Advantage plan. See our MAPD comparison document for the details of all these plans. You cannot share this information with clients, but it is a good reference tool. Anthem has a D-SNP (Dual Special Needs Plan) if someone has Medicare and Medicaid. You should call agent support or use the D-SNP tool in MProducer to verify that they have the right level of Medicaid. Anthem will take some levels of Medicaid that other companies will not. To enter the application, you must have the D-SNP code. A benefit of their HMO plan is that referrals are recommended but not required. Some other carriers require a client to get a referral to see some specialists. Until 2019, their PDP plans were NOT competitive at all. Once they started using Ingenio as their pharmacy benefit manager, they became much more competitive. As of 2021, they are NOT paying
commissions on their Enhanced PDP plan. That means if you sell it, you will not get paid. See our PDP comparison document for details of the plans and copays. You cannot share this information with clients, but it is a good reference tool.
As of 3/1/21, MAPD and PDP plans can no longer be AOR-ed without a plan change. You would need to write the client on a new policy in order to be the agent of record. Enrollments are done online through your agent portal via MProducer. You can take the application and then enter it electronically later. All products can be done this way. If you are doing an MAPD or PDP, you MUST upload the Scope of Sales Appointment Form. You can take the application and then enter it electronically later. We highly recommend you submit your applications this way as it is more accurate and you have better tracking.
United Healthcare (UHC) (AARP)
United Healthcare offers Medicare Supplements, Medicare Advantage plans and Prescription drug plans. We will focus on each of these segments. One thing to note with UHC is that you need to sell at least one policy of any kind each year from July 1 to April 1. Failure to do so may result in a “non-production” fee from UHC. This can run $150 to $250/year. There is no longer a production requirement to continue to be appointed with UHC. It used to be that you had to sell at least 5 Medicare supplements per year to continue to be appointed. This is no longer the case, but you need to sell at least 1 policy to avoid the non-production fee. This can be just a PDP. United Healthcare is commonly known as UHC or AARP. The two companies have a relationship where UHC is the underwriting company for the AARP Medicare products. You can either use AARP or UHC when talking to clients. We encourage you to ensure they know the insurance company is United Healthcare, for that reason, we tend to only use AARP to define a plan when it is a PDP. Those are branded as the AARP plans.
Medicare Supplements As of July 2017, the pricing on this plan is very attractive compared to where it was because they moved to gender rating. They have a very reasonable history of rate increases. Typically, the annual increase comes in June of each year. This is a community rated plan. That means that the premium does not go up because of their age. Clients will see their rate go up a couple of times a year. The reason is for a number of reasons
1. Usually in June is the annual rate increase
2. There is a 36% early enrollment discount when you turn 65. That decreases the older you get. On your anniversary, you lose 3% of that discount each year. This means that most clients will see 2 increases per year depending on their anniversary.
3. There is a 12-month rate guarantee. That means if they sign up in April, they will not see the June increase until April of the following year. It will be combined with the loss of the 3% early enrollment discount. Then in June of the following year, they will get the annual increase.
What this means is that if someone has an effective date of Feb 1 and their rate is $140/month, they will stay at $140/month until August. On Aug 1 st , the rate will go to whatever the annual increase was in June (for example $144/month) because the 6-month rate guarantee will expire. From Aug to Feb, they will pay $144/month. On their anniversary in Feb, the 3% discount will come off and their rate will go to $148.32/month. Then in June they’ll get the annual increase. It is not necessary to get to this level of information with the client. This is what I usually say. “You have an early enrollment discount that will decrease by 3%/year on your anniversary. Typically, UHC has their annual increase in June. So, you will see a couple of small increases each year. You will get a letter at the beginning of each year telling you what your premium will be each month.” One thing to note is that if you have a couple, and they have different anniversaries, they may have 3 rate increases a year as each one will lose the 3% discount on their anniversary.
They do need to be a member of AARP to get the UHC Medicare Supplement. They do NOT need to be a ember to get the UHC-AARP Drug plan. They do not need to renew it to keep their Medicare Supplement, but they might like the benefits they get. If they are not a member when you enroll them, you can sign them up for a membership. You will need to get a credit card number to do that. DO NOT get a check that you will have to mail. That will totally slow down the application approval process. The membership fee is $16 for one year and will cover someone else living in the household with them for free. The AARP membership is done via your MyAARPConnection web portal. Additionally, you get a free
3-year AARP membership as an agent regardless of your age. You do have to sign up for it on the MyAARPConnection portal.
If you have 2 people in the household who have UHC Medicare Supplements, you only need one AARP membership because of the +1 membership. The only exception to that is if they want their Medicare Supplements to come out of 2 different checking accounts. In that case, you will have to do 2 separate AARP memberships. Each person will need their own membership. UHC will not allow 2 members to use
different bank account with only one AARP Membership. UHC offers a $2 discount for bank draft. There is no additional discount for annual payment. If there are two people on the AARP membership, they will only get one $2 monthly EFT discount. The UHC premiums for both people are lumped together into one payment. Since there is only one payment, there is only one $2 discount.
UHC Medicare Supplements do not come with the Silver Sneakers, but they do come with Renew Active. It is similar to Silver Sneakers. The networks of gyms are not exactly the same but very similar. They can join as many gyms as they want.
UHC Medicare Supplements are unique in that they will allow a client to switch their plan to any other plan as of the first of the next month with no underwriting. For example, if they want to do the Plan G when they first get the policy because they go to the doctor frequently, they can do that. Then once they don’t have the need to go to the doctor as much, they can move down to the Plan N and pay less in
premium and have the $20 copay when they go to the doctor. Likewise, if they did the Plan K and then knew they were going into the hospital, they could move up to the Plan N and not have to pay the hospital deductible. The exception to this is that if later they want to go back up to the Plan G, they will have to go through underwriting. The plan change is made as of the first of the next month. All the client needs to do it call customer service to make the change. You will remain the agent of record. There is a CMS rule that if within the first year of having an MAPD for the first time, if the client doesn’t like it and they dropped a Medicare Supplement to get it, they can get a Medicare Supplement again
with no underwriting. This is called the trial right. We have a lesson on trial rights. UHC is the only company who extends this to 2 years.
UHC’s underwriting is also the most lenient of all the companies. There are a few knock out questions. If they answer yes to anything in number 6 on the application, they are not denied a plan but are charged the Level 2 rates. They will take people with Parkinson’s and Alzheimer’s where most companies will not. UHC will do a medication pull when they do the underwriting. You will receive an email if your client is rated to a Level 2. There is an appeal process that you and your client can follow. They will receive a letter stating why they were rated at Level 2. The client can call the underwriting number in the letter to get more clarification. You cannot call underwriting without them on the phone.
We encourage you to call the underwriting with the client as you will understand more about what underwriting says than they will.
UHC does not offer Medicare Supplements to people under 65 on disability in Kentucky. Commissions are paid as a 9-month advance and then monthly after that. The Plan F/G are commissioned higher than the Plan N. Plan K commissions are ½ of the Plan N commission. Commission
amount is determined by the first plan written. If you write someone on a Plan N or K and then they upgrade to the Plan F, you are only paid at the Plan N or K rate for the life of the policy. Roughly, commissions are less than what you might get paid from Anthem or Medico. Look at the difference in premium and have the client do a Plan G if they are going to the doctor frequently, then they can switch down to the Plan N if they want. This way you are locked into the higher commission amount. Having said that, you ALWAYS do what is in the best interest of the client.
There are no Agent of Record (AOR) changes with UHC. The original agent is always the agent of record even if the client switches plans and if you take the application. The only exception to this is if there is a 30-day gap in UHC Medicare Supplement coverage. For example, if the client does an MAPD for January and then during OEP (1/1 to 3/31) and then goes back to a UHC Medicare Supplement. You would then
be the agent on the new plan. You might want to use this strategy to move them to one of the new plans that came out July 2017 to get them a lower rate and to get paid on it. See us for more information on this strategy. We call it the “Two Step”. Refer to our lesson on trial rights. Remember, even with this, they are not guarantee issue for the Plan G unless they had the Plan G with UHC when they did the trial right.
Enrollments can be done electronically via the LEAN application. You must have a signature pad, signing capability on your laptop or iPad or an email them for an electronic signature to do the enrollment. You must also be connected to the internet to do the enrollment. This is the fastest and most accurate way of submitting applications. If you don’t submit it via LEAN, you will need to fax the application to UHC.
We have process documents on all the submission processes. Medicare Advantage and Prescription Drug Plans
UHC also offers MAPD and PDP plans. As of 2021, one of their PDP plans (AARP Preferred) offers the insulin savings. They offer 2 HMOs, PPO, D-SNP and a no RX Medicare Advantage plan. Some of their MAPD plans also offer the insulin savings. As of 2021, they have only been in the MAPD arena in KY for a few years. They are still working on developing their network of doctors. They are also not in every county in KY. See our MADP comparison document for more information on the plan benefits. You cannot share this information with clients, but it is a good reference tool. On Jarvis (UHC agent portal), in the LEAN application) there are tools to look up doctors or medications.
Under the Enrollment tab is a place where you can verify their Medicaid eligibility for a D-SNP plan. Enrollments can be done electronically via the LEAN application. You must have a signature pad, signing capability on your laptop or iPad or an email for an electronic signature to do the enrollment. You must also be connected to the internet to do the enrollment. This is the fastest and most accurate way of submitting applications. If you don’t submit it via LEAN, you will need to fax the application to UHC. We have process documents on all the submission processes. Immediately after completing the enrollment you can do the HRA to earn a fee. If you send the client the email link to sign the application, the HRA is not available to you.
Humana
Humana offers Medicare Supplements, Medicare Advantage plans and Prescription drug plans. We will focus on each of these segments.
Medicare Supplement
Humana’s Medicare supplements are not their bread and butter. Their plan can be attractive for a couple as they offer a 12% couple’s discount. Their history of rate increases is not as good as Anthem’s or UHC’s. We do not recommend their Medicare supplements for this reason. Commissions are ???
Medicare Advantage and Prescription Drug Plans
Historically their Medicare Advantage plans have been pretty good. They tend to have a LOT of difference Medicare advantage plans which can make it really confusing. Refer to our MAPD comparison document for the differences between them. You cannot share this information with
clients, but it is a good reference tool. They have multiple HMO plans. They are based on two different networks. The networks are very
different. The Community HMO only has Jencare and some Norton doctors in the network. The only hospitals in the network are Norton. The Gold Plus HMO has a much better network. This network is really pretty good. Their Community and Gold Plus plans offer the insulin savings plan. Humana requires that clients get a referral from their Primary Care Provider (PCP) to see some specialists.
Humana has multiple PPO plans. The network is pretty good in the Louisville area. You really need to understand the differences between all the PPO plans as the differences can be subtle. It is important to understand the differences between the plans so that you make a good recommendation for your client. Humana has multiple Special Needs Plans (SNP). They have a D-SNP for people with Medicare and
Medicaid, one for people with chronic diseases (Heart and Diabetes). Within the D-SNP, there are is the Community Network and the Gold Network like the HMO above. The Chronic SNP (C-SNP) only uses the Community Network. You need to be aware of this as the network is much more narrow than the Gold network. The C-SNP requires that the doctor fill out a form confirming they have a Heart of Diabetes problem. If it is not submitted within the correct timeframe, the plan will be cancelled. Make sure this is done by the doctor and submitted to Humana on time. Enrollments are done via faxing the application or doing an electronic enrollment on the enrollment hub. With enrollment hub you can either take their signature with a signature pad or mouse/finger signature or email them a link where they can click on it and electronically sign it. NOTE: If you are doing and email signature and the client wants to logon to your computer to get to their email, you will get a violation. Humana tracks the IP addresses of where the link was sent from and from where it was signed. You cannot have the client’s signature come from your machine. It has to be done on a separate computer. If you do this a lot, you may want to have a spare laptop or iPad for them to logon to. They can also do it on their phone if they get their email there. We recommend having them logon to sign it while you are there so you can assist them with the process.
After you have done the enrollment for the MAPD, you can do the HRA. You can send the questions to the client ahead of time to enter them later. The HRA must be done within 2 days of enrolling the client to get the fee. See the process document on this for more information.
Wellcare Wellcare offers Medicare Advantage plans and Prescription drug plans. We will focus on each of these segments. In 2019 they were purchased by Centene. Over the next few years, this should help them improve some of the areas where they have issues.
Medicare Advantage Plans
The network is pretty good. It has gotten better over the years as they also have Medicaid plans. They have a number of different HMO plans, a PPO plan and DSNP plans. The copays on their MAPD plans are very reasonable especially when it comes to the diagnostic tests. The extra stuff they provide is very generous compared to the other companies. The complaint we have about Wellcare is that their customer service doesn’t always speak English very well. The customer support is in the Philippines. You can ask to be transferred to a US based agent and they will transfer you. Enrollments are done via the Ascend application. We have a process document on that walking you through the process. If you are doing a D-SNP, you will need to do an additional Special Populations (SPOP) call to get a code. If you don’t do the SPOP call, the SNP plan will not show up as an option when you enroll. Immediately after the enrollment you can do a HRA (Health Risk Assessment). If you are not
doing the enrollment with the client there, then provide them the HRA questions and have them answer them. Then when you enter the application, you can immediately do the HRA. If you send an electronic link to the client to sign the application, you will not be able to do the HRA and will not receive the fee for it.
Prescription Drug Plans
They have a number of PDP plans. That is because in 2019 they acquired Aetna’s drug plan business. This created a number of duplicate plans. Some are the legacy Aetna and some are the legacy Wellcare. They have 3 drug plans that offer the insulin savings plan. Their drug plans are very competitive. You need to know which plans have which preferred pharmacies because they differ by plan. Refer to our PDP Reference for more information. You cannot share this information with clients, but it is very helpful.
Aetna
Aetna offers Medicare Supplements, Medicare Advantage plans and Prescription drug plans. We will focus on each of these segments. Their PDP plans are branded as Silverscript which they acquired in 2019. Over the next year or so, they will be branded as Aetna.
Medicare Supplements Medico – Until July 2017, Medico was a company that we liked. They started a new company in KY and are now putting Medicare Supplements out under the new company. This has resulted in some rate
increases that we have not been too pleased with, but they are not so bad that we will still sell them. Medico will give you a 7% household discount if you live with someone over the age of 18. So, if they have a spouse or child or grandchild that lives with them, they will get a discount. That person does NOT need to have a Medico med sup for the household discount.
Medico does not have MAPD or PDP plans. They have a very good Hospital Indemnity plan that you can add to an MAPD. The household discount on the Hospital Indemnity plan only applies if BOTH members of the household have a Medico Hospital Indemnity plan.
Medico’s rates for people in their 70’s are VERY competitive compared to Anthem or UHC. With the 7% household discount, they can be significantly lower. Medico does offer a High Deductible Plan F which might be an option for your client and they are one of
the 2 companies that we like that offers HDF. Medico is the only company that will pay you on under 65 Medicare supplements. You only get 4% but it is better than 0%. Under 65 people are only GI for the Medicare supplement if they are INVOLUNTARILY losing employer coverage. That means through no fault of their own. For example, termination of employment or exhaustion of COBRA benefits. They will require a letter with the application or shortly after before they will approve the application. Under 65 Medicare supplements cannot be submitted through My Enroller. You must fax them in. Medico will NOT accept third party checks for payment of Medicare Supplements. In the case where the American Kidney Foundation is paying, the AKF will send the money to the client and the client will send the money to Medico.
Enrollments are done electronically via the My Enroller Application. It does not require a signature pad by the client. You can take the application and then enter it electronically later. The My Enroller also serves as a quoting tool for their products. It can be put on your desktop or accessed via their agent portal. We have process documents on this as well.
Commissions are pretty good with Medico. You get 19% (KY) for years 1-6 and then 2% until year 10.
Anthem and UHC will pay you beyond year 10.
Omaha Insurance Company (or whatever the Omaha name it is this year) – Mutual of Omaha, United of Omaha, Omaha Insurance Company, are all the same. Typically, Mutual of Omaha (the parent company) every 3-4 years will introduce a new company (usually with Omaha in the name). When this happens, they close the book of business on the old company. That means they are not adding new clients to the old company. This is called “Blocking the Business”. What we have seen happen is that the premiums on the old book of business start to increase greatly over time. Clients will see 2 rate increases per year to the tune of about $20/month. Premiums are based on claims history, so if you
aren’t adding those new, younger, healthier clients to the pool, then as the pool of clients age and have more claims, the premiums go up more. This is the Omaha company strategy. They also have rates for new people that are lower than what your attained age rate is. For example, a client who is 68 will pay more than a 68-year-old just getting a policy.
Because of this strategy with the company and what we have seen with our own clients, we encourage you to steer clear of the Omaha companies. Outside of Louisville, there are a number of agents who push these plans. The premiums are based on zip code and out in the country can be very affordable.
Make sure your clients know how the Omaha companies work and encourage them to look at a more stable company.
Their underwriting can be a little more lenient as they have multiple underwriting categories. The categories are based on the height/weight ratio, so if you have someone who is too short for their height (nice way of saying overweight), you might be able to get them a policy with Mutual of Omaha or whatever Omaha they are now. Mutual of Omaha also offers PDP plans. As of 2021, one of the PDP plans offers insulin savings. Enrollments can be done via your agent portal. Commission percentages are around 18%.
Cigna – Cigna is another company like Mutual of Omaha which comes out with different companies every few years. They are the only company who will give a person under 65 who is first getting Medicare a Medicare supplement with no underwriting. In this case, the American Retirement Life company under Cigna has the best rates. They will not accept third party checks so if the person is on dialysis and AKF is
paying, then AFK will need to pay the client and the client will need to send in a check. If they don’t have a checking account and pay with a money order, the client must include a note saying they purchased the money order themselves. Under 65 Medicare supplements pay $0 commission. Do not get contracted with Cigna just to sell their under 65 Medicare supplements. If that is the only business you write with them, they will terminate your contract and it is many years before they will allow you to recontract. Instead, you will send the client to the customer service line to get the supplement.
Cigna does offer PDP plans, but they do not contract or pay agents to sell them. Their plans can be competitive for insulin. One of their plans offers the insulin savings program. United American – The biggest benefit of this company is their High Deductible Plan F/G. They have a
very competitively priced plan. Commissions are good at 16%, but 16% of $43/month premium nets you about $6.88/month in commission. If you aren’t adding the ancillary products to the mix, you just shot yourself in the foot on commissions. On the second anniversary of a High Deductible Plan F/G, United American will allow a client to get a Plan F/G with no underwriting. Premiums are higher than they could get elsewhere, but if they can’t pass underwriting, it might be something they want to consider. We don’t really consider this a player in our market. You will want to see our Imagine University module on the United American strategy.
Newest Companies – There is always a new player coming into the market. Currently, there is Trivent, Combined, Central States, etc. Our feeling about these companies is that while they might have a lower rate (usually not by much), they don’t have a proven track record of reasonable rate increases since they are new. They also don’t have a robust book of policyholders, which means their income isn’t as solid as a well-established carrier. We like to stay with companies that we know are continually adding new, healthy clients to their book of business. A client can change their Medicare Supplement at any time, but they have to go through underwriting. This may mean they are stuck with the company they have now if they can’t pass. Our recommendation is that you do not run out and start offering the newest kid on the block until you have seen their history of rate increases. Our job it to provide the client with the best long-term solution as we want to be there for them now and in the future. Use the Gordon Marketing Medicare supplement tool to get the market analytics on these companies.
When you get a call from a marketer, and you will touting the newest lowest Medicare supplement in the state, ask them how long the company has been offering it in KY and what their last rate increase was. Have them send you the summary of benefits and check the rates against Anthem, UHC or Medico. You should not need to get contracted to get this info. If they pressure you to get contracted, disengage
from the call as quickly as you can. You can always check with us to get our feedback.
Medico typically has their annual rate increase in October. Attained age??? Until July 2017, Medico was a company that we liked. They started a new company in KY and are now putting Medicare Supplements out under the new company. This has resulted in some rate increases that we have not been too pleased with, but they are not so bad that we will still sell them. Medico will give you a 7% household discount if you live with someone over the age of 18. So, if they have a spouse or child or grandchild that lives with them, they will get a discount. That person does NOT need to have a Medico med sup for the household discount.
Medico does not have MAPD or PDP plans. They have a very good Hospital Indemnity plan that you can add to an MAPD. The household discount on the Hospital Indemnity plan only applies if BOTH members of the household have a Medico Hospital Indemnity plan.
Medico’s rates for people in their 70’s are VERY competitive compared to Anthem or UHC. With the 7% household discount, they can be significantly lower. Medico does offer a High Deductible Plan F which might be an option for your client and they are one of the 2 companies that we like that offers HDF. Medico is the only company that will pay you on under 65 Medicare supplements. You only get 4% but it is better than 0%. Under 65 people are only GI for the Medicare supplement if they are INVOLUNTARILY losing employer coverage. That means through no fault of their own. For example, termination of employment or exhaustion of COBRA benefits. They will require a letter with the application or shortly after before they will approve the application. Under 65 Medicare supplements cannot be submitted through My Enroller. You must fax them in. Medico will NOT accept third party checks for payment of Medicare Supplements. In the case where the American Kidney Foundation is paying, the AKF will send the money to the client and the client will send the money to Medico. Enrollments are done electronically via the My Enroller Application. it does not require a signature pad by the client. You can take the application and then enter it electronically later. The My Enroller also serves as a quoting tool for their products. It can be put on your desktop or accessed via their agent portal. We have process documents on this as well. Commissions are pretty good with Medico. You get 19% (KY) for years 1-6 and then 2% until
year 10. Anthem and UHC will pay you beyond year 10. Mutual of Omaha – Mutual of Omaha, United of Omaha, Omaha Insurance Company, are all the same. Typically, Mutual of Omaha (the parent company) every 3-4 years will introduce a new company (usually with Omaha in the name). When this happens, they close the book of business on the old company. That means they are not adding new clients to the old company. This is called “Blocking the Business”. What we have seen happen is that the premiums on the old book of business start to increase greatly over time. Clients will see 2 rate increases per year to the tune of about $20/month. Premiums are based on claims history, so if you aren’t adding those new, younger, healthier clients to the pool, then as the pool of clients age and have more claims, the premiums go up more. This is the Omaha company strategy. They also have rates for new people that are lower than what your attained age rate is. For example, a client who is 68 will pay more than a 68 year old just getting a policy.
Because of this strategy with the company and what we have seen with our own clients, we encourage you to steer clear of the Omaha companies. Outside of Louisville, there are a number of agents who push these plans. The premiums are based on zip code and out in the
country can be very affordable. Make sure your clients know how the Omaha companies work and encourage them to look at a more stable company. Their underwriting can be a little more lenient as they have multiple underwriting categories. The categories are based on the height/weight ratio, so if you have someone who is too short for their height (nice way of saying overweight), you might be able to get them a policy with Mutual of Omaha or whatever Omaha they are now. Enrollments can be done via your agent portal. Commission percentages are around 18%. Cigna – Cigna is another company like Mutual of Omaha who comes out with different companies every few years. They are the only company who will give a person under 65 who is first getting Medicare a Medicare supplement with no underwriting. In this case, the
American Retirement Life company under Cigna has the best rates. They will not accept third party checks so if the person is on dialysis and AKF is paying, then AFK will need to pay the client and the client will need to send in a check. If they don’t have a checking account
and pay with a money order, the client must include a note saying they purchased the money order themselves. Under 65 Medicare supplements pay $0 commission. Do not get contracted with Cigna just to sell their under 65 Medicare supplements. If that is the
only business you write with them, they will terminate your contract and it is many years before they will allow you to recontract. Instead, you will send the client to the customer service line to get the supplement.
Newest Companies – There is always a new player coming into the market. Currently, there is Trivent, Combined, Central States, etc. Our feeling about these companies is that while they might have a lower rate (usually not by much), they don’t have a proven track record of
reasonable rate increases since they are new. They also don’t have a robust book of policyholders, which means their income isn’t as solid as a well-established carrier. We like to stay with companies that we know are continually adding new, healthy clients to their book of business. A client can change their Medicare Supplement at any time, but they have to go through underwriting. This may mean they are stuck with the company they have now if they can’t pass. Our recommendation is that you do not run out and start offering the newest kid on the block until you have seen their history of rate increases. Our job it to provide the client with the best long-term solution as we want to be there for them now and in the future. Use the Gordon Marketing Medicare supplement tool to get the market analytics on these companies.
When you get a call from a marketer, and you will touting the newest lowest Medicare supplement in the state, ask them how long the company has been offering it in KY and what their last rate increase was. Have them send you the summary of benefits and check the rates
against Anthem, UHC or Medico. You should not need to get contracted to get this info. If they pressure you to get contracted, disengage from the call as quickly as you can. You can always check with us to get our feedback.