Chargebacks
When does a chargeback occur?
When the member is not enrolled through the end of the calendar year based on the policy’s effective date.
When do monthly renewals start for MA/PDP plans?
The 3rd weekend of January in the following calendar year (not matter the effective date of the policy)
How long is the statute of limitations on commission payments?
The current year and the prior calendar year.
If a client has never signed up for a Medicare Advantage or PDP plan - What type of sale is this?
New to Medicare - Full Initial Rate
When can a Rapid Disenrollment occur?
EE is disenrolled between months 1-3 of the enrollment (Does not go active on month 4)
When does an agent have be credentialed by to receive the monthly renewal?
The 1st of the month when the plan renews (Renewal Date)
Does the statute of limitations apply to research inquiries?
NO, the PHD can still research and advise on commission payments outside of the statute of limitation timeframe.
The client had a PDP plan before, but is now signing up for a Medicare Advantage for the first time - what kind of sale is this?
Unlike Plan Change
It will be a Prorated Initial Rate Commission
What are some exceptions to the rapid disenrollment?
Death
Q4 enrollment
1st Enrolling into a regular MA and then enrolling into a DSNP within the first 3 months.
Where can you/Agents find out more about renewal payments dates?
Commission Schedule in Jarvis
Who does not receive renewals from UHC? (Or any commissions directly from UHC)
Solicitor agents because their contract is with their direct upline.
The client had a Medicare Advantage plan before but is now signing up for a PDP for the first time - what kind of Sale is this?
Unlike Plan Change
It will be a Prorated Initial Rate Commission
What and when can a Prorate Chargeback occur?
EE is disenrolled between months 4 and the end of the year. This causes the chargeback to be prorated.
If an agent is Termed for Cause, will they continue to receive Renewals?
No
What makes an agent Properly Credentialed?
-Active Contract
-Licensed
-Appointed
-Certified
The client has been on a Medicare Advantage plan for years, but wants to switch to a New Medicare Advantage plan that offers better benefits for them. What kind of sale is this?
Like Plan Change
It will be paid out at the Renewal Rate
Do renewals chargeback?
Typically Renewals will just stop paying out once the client is inactive.
Renewals will only chargeback if the termination date was backdated or the commissions paid out incorrectly when client was already inactive/agent not credentialed by renewal date
Looking at the Commission Schedule, what else processed on the same date as MAPD/PDP Renewals?
Health Assessments
(They will pay the month after the effective date)
When does the agent need to be properly credentialed by for a new enrollment?
The Application Signature Date
The client has only been on a Medicare Supplement plan for years. They did not have a PDP or Medicare Advantage before, but are now signing up for a DSNP. What kind of sale is this?
New to Medicare
Initial Rate full year commission