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Medicare Officials to Review Insurers' Commissions
By Kevin Frekin,
Yahoo News
October 25, 2008
Federal health officials said Friday they will soon address growing concerns about the lucrative commissions that some Medicare insurers plan to pay their agents and brokers this year.
In Medicare, the elderly and disabled can enroll in private insurance plans that assume responsibility for covering a participant's health benefits. Those plans get a generous government subsidy and now serve roughly 10 million people. The program is called Medicare Advantage.
Documents obtained from some companies participating in Medicare Advantage show that their agents stand to make $500 to $550 this year for enrolling a beneficiary into one of their plans. In subsequent years, the agents could make another $500 for every year the beneficiary stays with the plan. After five years, an agent could have made more than $2,500, which is quite a jump from previous years.
Such a financial reward is raising concerns that agents and brokers will work too aggressively to enroll people into plans that don't meet their health needs.
"Medicare Advantage plans that have nearly quadrupled agent commissions are putting profits before patients and that's wrong," Sen. Max Baucus, D-Mont., said in a news release Friday. "We can't let seniors remain at risk of being targeted by predatory sales agents looking to make a quick buck."
The Centers for Medicare and Medicaid Services recently issued regulations designed to curb abusive sales tactics in the Medicare Advantage program. The regulations went into effect Oct. 1, the start of the new marketing season. Plans can't begin enrolling new beneficiaries for their 2009 coverage until Nov. 15.
Rep. Pete Stark, D-Calif., urged CMS to consider capping commissions.
"This issue needs to be resolved immediately, before open enrollment begins," Stark said.
Kerry Weems, the acting administrator for CMS, said the agency plans to take action soon.
"We will address the concern and expect to take regulatory action next week," Weems said. "CMS is strongly suggesting that plans keep this in mind as they contemplate making any final arrangements regarding commission structures."
Weems did not elaborate on what regulatory changes will be make. The trade group representing insurers encouraged CMS to take some action.
"We support CMS acting in this area and believe clear and consistent standards are necessary," said Karen Ignagni, president and CEO of America's Health Insurance Plans.
Two of the major players in the program, Humana Corp. and UnitedHealth Group, both said Friday that they welcomed regulation of insurance agent commissions.
"Nine months ago, we called for capping commissions and total compensation paid to contracted agents and brokers. Consistent with our position, we support Chairman Stark's proposal," said Humana spokesman Tom Noland.
"We believe this payment method ensures that agents and brokers are rewarded only when seniors are satisfied with their choices, and penalizes agents and brokers who use marketing tactics that result in beneficiaries signing up for a product they do not fully understand."
"We would also welcome regulation that establishes reasonable industry-wide broker commission norms," said a statement issued by Ovations, a subsidiary of UnitedHealth Group.
Officials familiar with the Medicare Advantage program say the increases being seen in insurance agent commissions this year are a result of competition as well as regulatory changes that the government made.
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