The Conservative Party Principles

The Conservative Party Principles

Tuesday, June 23, 2009

The truth about Medicare RIGHT NOW!

So you want the government running health care?
Then you need to know something very important. I sell insurance and I sell Medicare Advantage which is HEAVILY monitored and controlled by the Center for Medicare and Medicaid services. They determine who I can and can't sell to, how much I get paid and when I get paid, how I ENROLL members into benefits including all sales materials , language and presentation of the material and I AM NOT ALLOWED TO TALK ABOUT ANYTHING OTHER THAN THAT PLAN FOR 48 HOURS EVEN IF THEY WANT TO! They control whether or not the enrollee is accepted and when the coverage begins and what the plans cover. This is a nightmare for everyone especially the enrollees.

In the past 6 months this office has dropped several of my clients, (BY MISTAKE) missed applications and disenrolled one of my clients out of Medicare altogether because they confused her eligibility by trying to assess her benefit account to her first husband instead of her second husband. It took an act of GOD and Social Security and myself 41/2 months to get her coverage back.
They now have, for 13 weeks screwed up all the records for payment for EVERY LICENSED AGENT IN AMERICA and kept us all from getting paid our DUE COMMISSIONS for everyone of our clients and new enrollees. I just spent the last 120 minutes trying to get an answer from someone at CMS and finally gave up and called 2 of my companies to get some information. I got the same answer that they have been e-mailing me for weeks. Below are copies of some of those e-mails from two companies:

Important Update: CMS Error in Release of First Year Commissions
We recently informed you that on April 29, 2009, the Centers for Medicare & Medicaid Services (CMS) announced the release of the first report that identifies initial Medicare Advantage enrollments (ICEP) and Part D Prescription Drug Plan enrollments (IEP) with a January 1, 2009 effective date. This also included beneficiaries who were previously enrolled in Original Medicare and elected to enroll in a Coventry Health Care Medicare Advantage plan.
In keeping with our commitment to you, our valued brokers and agents, Coventry acted promptly on those files and released commission payments via Electronic Funds Transfer (EFT) on Monday, May 25, 2009.
However, we have learned from CMS that there were issues with the data files that were provided to us. Because of this news from CMS, Coventry held the mailing of the paper commission checks due to the CMS error. That means that some of you have not yet received any initial year commission payments if you elected to receive commissions by paper checks. For those of you who received an EFT, we may need to make adjustments accordingly, either through charge-backs or further payments.
The extent of the issue is not currently known, nor do we have a timeframe from CMS as to when they will provide further direction. However, once we receive the information, rest assured that we will act in a timely fashion to adjust the payments, to notify you of any charge-backs, and to distribute correct paper checks (to those who do not receive EFTs). We will also share with you updates related to the issue as we receive them.

Update: Centers for Medicare & Medicaid Services (CMS) Renewal Rate Determination
First and foremost, thank you for your support and patience throughout the CMS initial-year commission process. We recognize the inconvenience that has been caused, along with the critical importance of the timely and accurate payment of commissions. We remain committed to paying commissions appropriately, accurately and as quickly as possible based on the data received from CMS.
Along with the rest of the industry our valued agents in particular, we at UnitedHealthcare have been closely following the updates from CMS regarding initial-year commission payments. Representatives from UnitedHealthcare continue to have dialogue with CMS regarding this information and we will provide updates as they are made available to us. We have processed the data received thus far and have conducted commission adjustments for January 1, February 1 and March 1, 2009 effective dates accordingly. We have the data for enrollments with April and May 1, 2009 effective dates and are processing payments this week/weekend. Going forward, our understanding is that CMS plans to provide the remainder of the reports for January through June effective dates by the end of June. CMS has further stated that beginning in July, reports will be released monthly during the third week of the month.
Most recently, we have been made aware of the CMS interpretation that consumers enrolled in Original Medicare with a stand-alone PDP who are then enrolled in an MA or MAPD plan in 2009 are considered "renewals". On Friday, June 19, 2009, CMS confirmed the following information regarding qualification for initial-year commission payments. CMS 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:
1. When someone is new to Medicare (e.g. an age-in) or
2. 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 should be paid the renewal amount.
Please note that UnitedHealthcare cannot interpret the data or in any way make judgment calls on which enrollees do or do not qualify as initial enrollees according to CMS. The published reports stand as-is.
Although CMS has not provided an appeal or escalation process for this situation, we are accepting and compiling information from agents and providing it to CMS.
Thank you for your continued support and dedication to our members.
Sincerely,

June 22, 2009

These communications are internal and I could lose my contract for publishing these but you know what? Right is always the thing to do!

If ANYONE thinks Obama and the rest of those bureaucratic SCREW-UPS in Washington are capable of running something 8 times larger then they are as stupid AS THEY ARE INCOMPETENT!

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