CMS Increases Estimate of Change in Medicare Advantage Plans

A couple of months after CMS had proposed using a 1.9 decrease in projected plan per-person costs for 2015, it looks the news will be slightly better. Actuaries are now expecting the cost of care for plan enrollees will drop by 3.4 percent. The change comes after CMS altered the way it calibrates one particular […]

Kathleen Sebelius to Resign


Department of Health and Human Services Secretary Kathleen Sebelius is slated to resign her post today, just as the ACA exchange plan has exceeded its first year enrollment goal. Sebelius has served as HHS secretary since 2009. A White House source has said that President Obama plans to nominate Sylvia Matthews Burwell, who currently serves […]

After Open Enrollment: Health Care Law Picture Begins to Emerge


Now that the rush to the March 31 Open Enrollment deadline has passed, we should begin to see how the health care law is working and how it’s not. All the talk and speculation of the past four years will be replaced by actual information based on enrollments, but expect for debate to continue as […]

Action Alert – Please Support Senate Bill 2175 and Senate Bill 2173!

The National Association of Health Underwriters has been vocal in its support of several key fixes to the exchange enrollment process since the beginning of open enrollment. The organization has been in constant contact with the Department of Health and Human Services (HHS) and, in December, NAHU worked with Senator Jeanne Shaheen (D-NH) on a […]

Tips for Passing a Sales Event Secret Shop

Just because we are nearing the start of the lock-in period does not mean agents are safe from secret shoppers. CMS and plans conduct secret shops throughout the course of the year to ensure agents are conducting compliant sales events. We took a look back on the secret shop results received over the past several […]

Avoid Sales Allegations this OEP

Most agents that work in the Medicare Advantage or Part D Prescription Drug space are aware of the dreaded sales allegation. Hopefully you have never experienced one but if you work in this market long enough, you most likely will at some point.  While some allegations are found to be due to some sort of […]

Carrier Verification of the Federally Facilitated Marketplace and/or State-Based Exchange Certifications

Many carriers are requesting verification that the required training has been completed before letting agents assist clients with enrollment on the Federally Facilitated Marketplace and/or State-Based Exchanges. Each carrier has a different process so make sure you pay close attention to the steps below and confirm that each carrier you are appointed with has everything […]

CMS Guidance on Marketing MA Plans between October 1st and October 14th

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CMS recently released updated guidelines regarding what agents may and may not do between October 1st and October 14th.  It is important to understand that the pre-enrollment period is an opportunity for agents to reach out to beneficiaries and review their options prior to October 15th. It is not an opportunity to collect enrollment applications. […]

Carilion Clinic Medicare Health Plan Announces they are not Renewing their Plans for 2014

Carilion Clinic Medicare Health Plan announced today they will not be renewing their current Medicare Advantage plan offerings in Virginia for 2014. Current members will have the option to switch to another Medicare Advantage plan available in their area or return to Original Medicare.  They will also be able to move to a Medicare Supplement […]

CMS Announces More, Higher Quality Options for Seniors in Medicare Advantage


According to a recent CMS press release, more beneficiaries are choosing higher quality Medicare Advantage plans. Over half of Medicare Advantage enrollees are currently enrolled in plans with four or more stars. Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that the average number of plan choices will remain about the same in […]