Urgent Update on Non-Commissionable Medicare Plans and How You Can Help Protect Our Role

The recent rapid changes in Medicare commissionable plans have left many agents across the country unsettled. Major carriers, including Wellcare, Aetna, Anthem, Cigna, and more to come next week, have shifted plans to non-commissionable status right in the middle of the Annual Enrollment Period (AEP). With fewer than 24 hours’ notice, this has significantly impacted our industry and the clients we serve.

Understanding the Shift

Several factors have led to these changes:

1. Increased Healthcare Costs: Since the pandemic, hospital costs have surged due to staff shortages and higher operating costs. Hospitals have leveraged their influence with carriers, leading to increased demands for reimbursement—costs which now affect plan structures and agent commissions.
2. Higher Utilization of Medical Benefits: More people are seeking treatment, including those newly eligible for Medicare. This spike in medical use has placed additional financial strain on carriers.
3. Reduced Reimbursements for Carriers: Congress recently reduced Medicare Advantage reimbursements, hitting carriers hard financially and directly impacting plan features and commissions.
4. Dwindling 5-Star Plans: Medicare’s STAR ratings, which help drive carrier funding, have taken a significant dip. We’ve gone from over 70 plans with 5-star ratings to just 7 in the last three years. Fewer high-rated plans mean lower incentives, affecting plan quality and financial resources.
5. Inflation Reduction Act: Uncontrolled medication costs and increased prescription drug use have led to higher expenses for carriers, which are now partially subsidized by Medicare—but at a cost that may ultimately fall to taxpayers.
6. Negative Perceptions of Agents: Faulty studies and media coverage often paint agents as profit-driven, which has triggered increased scrutiny from legislators. Organizations like NABIP, NAIFA, and HAFA are working to correct this image, but the need for clear advocacy has never been greater.

What This Means for You

While this environment is challenging, it doesn’t mean the end of our role. Commissions will continue for any plans enrolled before November 1, 2024, and for renewals of existing clients. Many of the plans affected by these changes are smaller regional ones, although some high-impact plans, like the Ohio Anthem HMO, are included.

How You Can Make an Impact

We need your help to safeguard our industry and our clients. Here’s how:

1. Voice Your Concerns – Share your experiences by filling out the Agent Survey on Medicare Market to document the challenges agents face. This feedback is critical to advocating for fair policies.
2. Encourage Clients to Support Us – Invite your clients to take this 5-question Client Survey to highlight the value agents bring. Many agents are handing out postcards with the survey link or having clients complete it during appointments.
3. Spread the Word – Please forward this message to your colleagues. There’s strength in numbers, and we need every voice in this fight to protect our role and the clients we serve.
4. Contact Local Legislators or the Press – Encourage clients and fellow agents to reach out to local legislators or media to voice concerns about how these changes will impact healthcare access for all. Let’s amplify our message to ensure that community leaders understand what’s at stake.

Let’s keep pushing forward to protect our role in guiding clients through their healthcare choices. Your resilience is invaluable—thank you for standing strong in these challenging times.

Look out for emails on a townhall meeting we will be setting up shortly.