Regarding health insurance plans, one of the most important things for your customers to understand is the difference between high and low deductibles. Understanding this difference between high and low deductibles can help your clients make an informed decision when selecting a health insurance plan. Here are 8 things for your customers to consider when comparing high vs low deductibles:

Cost: 

High deductibles generally mean lower monthly premiums, while low deductibles typically mean higher monthly premiums. Depending on your budget and healthcare needs, customers need to weigh the pros and cons of higher and lower deductibles to determine what’s best for their situation.

Coverage: 

High deductible plans tend to have higher out-of-pocket costs and fewer covered services, while low deductible plans may have more comprehensive coverage but with higher monthly premiums.

Maximum out-of-pocket expenses: 

High deductible plans tend to have higher maximum out-of-pocket expenses, while low deductible plans tend to have lower maximum out-of-pocket expenses. This is an essential factor for clients to consider when selecting a plan.

Tax benefits: 

Some high-deductible plans are eligible for tax benefits. Depending on the situation, these tax benefits could make a high-deductible plan more attractive to customers than a low-deductible plan.

What services are covered: 

Be sure to look closely at what services are covered under a high-deductible plan vs a low-deductible plan. Make sure you understand how the plan works and what services are covered before enrolling.

Copayments and coinsurance: 

Copayments and coinsurance vary among plans and can affect how much clients pay out-of-pocket. In a high deductible plan, customers may pay more out-of-pocket than in a low deductible plan.

Network coverage: 

Network coverage is important to consider when selecting a plan. High deductible plans may have more limited network coverage, so make sure your customers look closely at the provider networks available under each plan.

Prescription drug coverage: 

Many high-deductible plans have limited prescription drug coverage and may require clients to pay more out-of-pocket for their medications. Make sure to remind clients to look closely at prescription drug coverage before enrolling in a plan

When selecting a health insurance plan, it is crucial for shoppers to understand the differences between high and low deductibles. Remind your customers that high-deductible plans can be more cost-effective but may have higher out-of-pocket expenses and more limited coverage. Meanwhile, shoppers should remember that low deductible plans often have higher premiums but more comprehensive coverage. Understanding the benefits and limitations of each option can help consumers make an informed decision that best fits their healthcare needs and budgets.

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Agility Producer Support
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FAQs on Agent and Broker Compensation for Special Enrollment Periods

 

 

 

 

 

 

 

 

 

The Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) regarding compensation paid by issuers to agents and brokers who assist consumers with enrollment during a Special Enrollment Period (SEP) or during Open Enrollment Periods (OEPs). It has been made a priority by the Biden-Harris Administration to provide those who are uninsured and underinsured with quality, affordable health care coverage and recognizes that agents and brokers play a vital role in helping consumers enroll in coverage that best fits their needs and budget.

 

CMS has become aware that some issuers in the individual market, who commonly use agents and brokers as part of their marketing and sales distribution channels, have reduced or eliminated commissions and other forms of compensation to agents and brokers for enrollments during an SEP. Today’s FAQs provide guidance that paying differential compensation to agents and brokers for coverage in the same benefit year based on whether the enrollment is completed during an SEP or during the OEP is prohibited under federal law. These practices violate the guaranteed availability protections afforded to these individuals under the Affordable Care Act.

The Centers for Medicare & Medicaid Services (CMS) has become aware that some health insurance issuers offering individual market health insurance coverage, including issuers of qualified health plans offered through the Marketplaces, have reduced or eliminated commissions and other forms of compensation for agents and brokers who assist consumers with enrollments in individual market coverage during a special enrollment period (SEP). 

Is it permissible for an issuer to differentially compensate agents or brokers who assist consumers with enrollments in individual market coverage in the same benefit year based on whether the enrollment is completed during an SEP or during the applicable benefit year’s Open Enrollment period (OEP)? 

No. Arrangements that pay reduced or no commissions and other forms of compensation to agents and brokers who assist consumers with enrollment in individual market coverage during an SEP and pay higher amounts for OEP enrollments for the same benefit year violate the guaranteed availability provisions of the Affordable Care Act. Issuers’ normal conduits for receiving applications and offering coverage must also be open to individual market consumers for OEP and SEP enrollments, as applicable. An arrangement that reduces or eliminates the commission or other compensation an agent or broker receives for SEP enrollments compared to the commission or other compensation received for OEP enrollments in the same benefit year discourages agents and brokers from marketing to and enrolling individuals eligible for an SEP. These practices therefore violate the guaranteed issue protections afforded to these individuals under the statute. Exceptions may be made for cases in which state regulators make specific recommendations for issuers to address solvency concerns or financial capacity limitations.



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Agility Producer Support
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The Centers for Medicare & Medicaid Services
(CMS) report that over 528,000 Americans signed up for health insurance
from the start of the 2021 Marketplace Special Enrollment Period (SEP)
for consumers in HealthCare.gov States through March 31st, including
approximately 322,000 signups from March 1st to March 31st. 

February 15th – March 31st, 2021

The Centers for Medicare & Medicaid
Services (CMS) report that over 528,000 Americans signed up for health
insurance from the start of the 2021 Marketplace Special Enrollment
Period (SEP) for consumers in HealthCare.gov States through March 31st,
including approximately 322,000 signups from March 1st to March 31st.

The number of people signing up for health
insurance from the start of the SEP opportunity on February 15th through
March 31st represents a substantial increase from 2020 and 2019, when
209,000 and 171,000 consumers signed up for health insurance
respectively.[1]
In previous years, SEPs were available only for qualifying life events,
whereas this year the Biden Administration opened a SEP to all
Americans in response to the COVID-19 Public Health Emergency.

Data suggest a more diverse set of American
consumers are enrolling in health insurance coverage through the SEP. Of
enrollees who identified a race from February 15th through March 31th, 17%
identified as Black, compared to about 11% during the same period in
both 2020 and 2019. In addition, lower income Americans represent a
larger percentage of new plan selections so far during the SEP compared
to prior years. Among consumers requesting financial assistance, 41%
have a household income between 100% and 138% of the federal poverty
level, compared to 38% in 2020 and 33% in 2019.

Definitions and details on the data are included in the glossary at the end of the report.

READ FULL REPORT > 

 

If your looking to expand your book of business and client reach as a professional life and health insurance agent, you are in the right place. 

Check out enrollinsurance.com now.

 

 

Agility Producer Support
(866) 590-9771
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Don’t miss the chance to enroll new and existing clients in more affordable coverage!

Learn how much your clients in Texas can save with the recent expansion of APTC subsidy eligibility. See below for an example of how the subsidy changes would impact a 40-year-old at 150% of the FPL on a Bronze Classic Next 2 Plan in each county of Texas.

 Click here to download the PDF with Full Details >

 

Get Contracted To Sell Oscar Today >


Agility Producer Support
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 President Biden announced that the Centers for Medicare & Medicaid
Services (CMS) is extending access to the Special Enrollment Period
(SEP) until August 15 – giving consumers additional time to take
advantage of new savings through the American Rescue
Plan. 

This action provides new and current enrollees an additional
three months to enroll or re-evaluate their coverage needs with
increased tax credits available to reduce premiums.

“Every American deserves access to quality, affordable health care –
especially as we fight back against the COVID-19 pandemic,” said HHS
Secretary Xavier Becerra. “Through this Special Enrollment Period, the
Biden Administration is giving the American people
the chance they need to find an affordable health care plan that works
for them. The American Rescue Plan will bring costs down for millions of
Americans, and I encourage consumers to visit HealthCare.gov and sign
up for a plan before August 15.”
 

As a result of the American Rescue Plan, additional savings will be
available for consumers through HealthCare.gov starting April 1. These
savings will decrease premiums for many, on average, by $50 per person
per month and $85 per policy per month. On average,
one out of four enrollees on HeathCare.gov will be able to upgrade to a
higher plan category that offers better out of pocket costs at the same
or lower premium compared to what they’re paying today. 
 

Consumers who want to access the SEP to enroll in coverage and see if
they qualify for financial help to reduce the cost of monthly premiums,
can visit

HealthCare.gov
or
CuidadoDeSalud.gov
to view 2021 plans and prices and enroll in a plan that best meets their needs. Additionally, consumers can call the

Marketplace Call Center
at 1-800-318-2596, which provides assistance
in over 150 languages. TTY users should call 1-855-889-4325.  Consumers
can also find a local assister or agent/broker in their area:

https://localhelp.healthcare.gov

 

Consumers who are eligible and enroll under the SEP will be able to
select a plan with coverage that could start as soon as the first month
after plan selection. Current enrollees will be able to change to any
plan available to them in their area. To take
advantage of the SEP, current enrollees should review their application
and make changes, if needed, to their current information and submit
their application in order to receive an updated eligibility result.
 

Additionally, beginning in early July on HealthCare.gov, consumers
who have received or have been determined eligible to receive
unemployment compensation for any week during 2021 may be able to get
another increase in savings when enrolling in new Marketplace
coverage or updating their existing Marketplace application and
enrollment. These savings to be made available starting in early July
for eligible consumers are in addition to the increased savings
available to consumers on HealthCare.gov starting April 1.
 

The SEP is currently available to consumers in the 36 states that use the
HealthCare.gov
platform. Consumers served by State-based
Marketplaces that use their own platform can check their state’s website
to find out more information on Special Enrollment Periods in their
state.
 

To see how the American Rescue Plan will bring down health care costs and expand on the Affordable Care Act, visit:

https://www.hhs.gov/about/news/2021/03/12/fact-sheet-american-rescue-plan-reduces-health-care-costs-expands-access-insurance-coverage.html
.

Still looking to get contracted with top carriers to expand your book of business?  Get ACA Contracting Here.

 

 

 

Agility Producer Support
(866) 590-9771
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Many of the approximately 8.9 million people who qualify for financial help* know
the value of health insurance but may not know they qualify for the
financial support available. With your help, we can reach the uninsured
and bring them the protection and peace-of-mind an Ambetter health plan
can provide.

 


Contracted brokers earn a one-time, per member bonus for eligible members enrolled from February 15th, 2021 through
May 15th, 2021.
 

This new SEP gives us the opportunity to help more of the uninsured and get them the health coverage they need.
 
 
The post provides the
highlights of the 2021 SEP Bonus Program. It is not a contract. Complete
and prevailing terms and conditions are set forth in the
2021 SEP Bonus Program Agreement, which is required. 

Read more

 

Earn your Teepee Builder Badge and Earn More Money too! 


 

Molina Healthcare is excited to announce an Agent Bonus for New 2021 SEP Members.

TOTAL # OF NEW MEMBERS: 25+ 

ONE TIME BONUS AMOUNT PER MEMBER: $50

Check out the details and terms and conditions below…. 


 

Agility Producer Support
(866) 590-9771
support@enrollinsurance.com

 Earn an additional $50 per customer!

We’re
excited to announce our 2021 Special Enrollment Period (SEP) Broker
Bonus. All Cigna Individual and Family Plans appointed brokers are
eligible to earn an additional $50 for each new medical customer
submitted February 15th to March 15th, 2021 and February 8th to March 15th, 2021 in Colorado, once seven new SEP customers have been submitted.

The
SEP Broker Bonus is in addition to the competitive commissions we pay
on both Open Enrollment and Special Enrollment sales. You can access the
2021 commission schedule for both medical and dental plans in the Broker
Resource Center
on CignaforBrokers.com.


Broker Bonus requirements:

Bonus is based on new sales submitted, February 15th to March 15th and February 8th to March 15th in Colorado. Customers must pay initial payment and be in active status to qualify.
Must
submit a minimum of seven new SEP customers. At that time, any new
medical sales bonus due will be paid, starting from the first 2021 SEP
application. Customer plan changes do not qualify.
Bonus
program is based on number of customers submitted at the agent level.
Customer counts will be capped at six customers per policy.
Eligible products include all IFP medical products in all markets.
Cigna
reserves the right to charge back bonuses if brokers have over 15% of
their membership leave the plan or not maintain continuous coverage for
the first four months of their policy contract.
Cigna will offset any overpayment against other compensation due and payable to producer.
Cigna pays commissions to producers licensed under state insurance laws, and if required by law, appointed with Cigna.  

Get Contracted with Cigna Today:  Cigna Contracting >>

Questions?
Contact Broker Support at 877.244.6215. The Broker Support team is ready to help and is available Monday – Friday 8:00 am – 8:00 pm (EST).

 


 

Agility Producer Support
(866) 590-9771
support@enrollinsurance.com

Individual Health Plans Commission: New Members: $40 per member.


Effective February 15th, 2021

Read more

Oscar Health extended your Florida broker bonus eligibility AGAIN! We’re extending your Florida broker bonus eligibility through June 1st, 2021 to align with the federal SEP time frame, so there’s even more time to hit the next tier of your Oscar bonus!

Every individual and family member, you’ve enrolled through a 6/1
effective date whose premiums have been paid through June, will
contribute to a potential uncapped bonus on top of your commission. See below for our bonus rates and click to learn more about our updated bonus program. 

 

Get Contracted with Oscar Today:  OSCAR CONTRACTING >>

Learn more

2021 Florida Bonus Structure

Agility Producer Support
(866) 590-9771
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