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The Book of Business Download is Here!

You're busy each day meeting with clients and submitting business. The last thing you want to spend a lot of time on is figuring out what types of policies each of your clients have.

Fret no more. Mutual of Omaha's new Book of Business download is available now, and provides what've you've been wanting - a complete list of the in-force Mutual of Omaha policies* you've sold in one easy-to-sort file.

Why Use the Book of Business Download?

It makes finding information about your clients' in-force policies super easy, so you'll be more informed about your clients' coverages and be positioned to answer any questions about their policies.

Refer to the flyer for details on how to use the Book of Business download.

View the Book of Business Flyer

Note: If you currently have pop-ups blocked on your internet browser, you will need to change the setting to "Allow" to see Book of Business on SPA. Policies sold under a Special Agent contract are not accessible to the writing Special Agent.

As the 2023 Medicare Open Enrollment season winds to a close, and beneficiaries and enrollees finalize their decisions, nearly half, 48.7%, of people eligible for Medicare have decided on Medicare Advantage plans, up from 46.1% in March of 2022. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment data for March 1, 2023, total Medicare Advantage (MA), including Medicare Advantage with Prescription Drug Plan (MA-PD) membership, stood at 31,753,301 with a net gain of 2,276,490 members from March 1, 2022. Medicare stand-alone prescription drug plans (PDPs) covered 22,533,411 members as of March 1, 2023, a net decrease of 910,978 from the previous year. Surprisingly, nearly 80 percent of MA enrollees selected one of 10 insurers, out of the 294 offering plans in 2023. This brief assesses Medicare Advantage and PDP performance, market share and market penetration by state as of March 1, 2023.

Medicare Advantage (MA) Membership

Medicare Advantage (MA) market penetration remains strong; however, there is still abundant opportunity for growth with 48.7% of the nearly 65.2 million people eligible for Medicare enrolled in a MA plan. According to CMS Medicare Advantage enrollment reports aggregated by Mark Farrah Associates (MFA) in Medicare Business Online™, total Medicare Advantage plan enrollment, as of March 1, 2023, increased 9.8% from March 2022. The top ten companies, each with more than 300,000 members in this segment, collectively provided coverage for nearly 80% of the market. Most leading MA companies realized year-over-year growth with an overall net gain of 8.2%.

MA Leading Plan Performance

There are 294 insurers covering the MA marketplace in the United States, however nearly 80 percent of MA enrollees selected one of only 10 insurers.  As of March 2023, UnitedHealth continues to dominate in this highly competitive segment. With over 9 million enrolled, UnitedHealth commands 28.5% of the MA market. Humana ranks second with nearly 18% market share and over 5.6 million lives. CVS maintains the third position, enrolling approximately 3.37 million, and Elevance Health (formerly Anthem) follows, with over 2 million lives. Together the top three insurers cover 56.9% of the MA market.

Source: https://www.markfarrah.com/mfa-briefs/nearly-80-percent-of-medicare-advantage-enrollees-covered-by-10-insurers/ 

Today, we'll be discussing the expectation of agents during telephonic enrollments. Although what we'll discuss mainly pertains to agents working in call centers, this information is certainly beneficial for all agents if you have a few minutes to spare. Recently, a carrier conducted an audit and found that most agents missed five key elements during telephonic enrollments. It's crucial for agents to be aware of CMS and Carrier expectations when conducting these enrollments, not only to protect the client, but also to safeguard themselves from corrective action.

Summary of Benefits 

First, it's critical that agents review the Summary of Benefits before completing the enrollment process. This document contains important information about the plan and must be completed by agents in accordance with the approved script requirement. Agents must also ensure they accurately answer any additional questions asked by the applicant or their legal representative, and provide accurate information on plan details described in the SOB. This includes details such as benefits, costs, and coverage limitations. By doing so, agents can provide the applicant with a clear and comprehensive understanding of the plan, which ultimately leads to a successful enrollment process.

Required Disclosures

During telephonic enrollments, agents must read all required and relevant disclosures. as outlined in CMS approved scripts, for the specific plan that the applicant is interested in. Agents should collect agreement and understanding from the applicant regarding these disclosures to confirm that everyone is on the same page and that the applicant fully comprehends what they are signing up for. These disclosures may be presented in various formats such as pop-up boxes or required statements and must be presented to the applicant clearly and concisely to ensure transparency and compliance with CMS and Carrier expectations. 

Complete the Application

When completing the caller's application, the agent must ensure they accurately enter the applicant's contact information, payment options, language preference, and alternate format election.

Additionally, the agent must:

•    Provide the name of the plan that the applicant is enrolling in. 
•    Advise the applicant of the plan's effective date. 
•    Confirm with the applicant that they are ready to complete the enrollment process. 

Call Closing

It's important to provide a compliant call closing to wrap up the call. To do so, you must provide the caller with the carrier name and customer service phone number so they know who to contact for support in the future. Additionally, it's important to provide the TTY number for the benefit of those with hearing impairments. Finally, make sure to provide an application confirmation number for the caller's records, so they have a way to reference their enrollment in the future. 

Accessing MARx 

Before accessing MARX, the agent must obtain and document the beneficiary's permission. The agent should explain that they may collect information related to the beneficiary's current enrollment status, dates of Medicare Part A and B entitlement, eligibility information, and incarceration, if applicable. The beneficiary must be informed about the purpose of accessing this system and be given an opportunity to decline or approve the request. Lastly, the agent must document the beneficiary's response for future reference.

Updated Medicare Advantage and Part D policies ensure the overall Medicare program remains strong and stable for the 65 million beneficiaries today and future generations to come, payments to private insurance companies are accurate, and taxpayer dollars are well spent.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released the Calendar Year (CY) 2024 Medicare Advantage (MA) and Part D Rate Announcement that finalized payment policies for these programs. The final policies in the Rate Announcement improve payment accuracy and ensure taxpayer dollars are well spent. CMS will phase-in certain updates, and on average, CMS anticipates a payment increase for MA plans of 3.32% from 2023 to 2024, which is approximately a $13.8 billion increase in MA payments for next year.

Additional proposed policies to strengthen the MA managed care program that will hold health insurance companies to higher standards by:

• cracking down on abusive and confusing marketing schemes;
• addressing problematic prior authorization practices that prevent timely access to needed care;
• making it easier to access vital behavioral health care; and
• raising the bar on quality and driving toward more equitable care.

Taken together, these actions will make the overall Medicare program stronger.

Read the full article here.

PSM was a proud sponsor at this years NABIP Austin - Professional Development Day. We appreciate the local Austin agent community and time spent to engage with us.

AAHU The Austin Association of Health Underwriters is a local chapter of the National Association of Health Underwriters,(NAHU) and the Texas Association of Health Underwriters (TAHU) a volunteer member organization that represents nearly 20,000 licensed health insurance agents, brokers, consultants, and benefit professionals through more than 200 chapters across America. 

AAHU members help Central Texas consumers by guiding them through the complexities of Health, Dental, Disability, Medicare Supplements and Life insurance benefit decisions for  businesses and individuals.

Our organization is dedicated to providing professional development opportunities to our members so they can better serve their clients insurance needs.