Attention Insurance Agents, we understand you may be experiencing a delay in receiving New to Medicare Advantage payments for the month of November due to a data file issue with CMS. We empathize with the inconvenience this may be causing and we want to provide you with key information and strategies for navigating the delayed payment situation. We appreciate your patience and understanding as we work to resolve this issue as quickly as possible.
Understanding True-Ups
First and foremost, let’s address what the New to Medicare Advantage True-Up payments are. They are an additional payment that represents the difference in commission payments from a “renewal” to “new to Medicare”. An example of this would be an agent writing a Medicare Advantage plan to a client turning 65. The agent will receive payment from the carrier in the amount of what is the current ‘renewal’ payment (which is the same amount if you were to switch someone during AEP from one Medicare Advantage plan to a different Medicare Advantage plan. After the plan has gone into effect and is validated as being for someone who truly is new to Medicare Advantage, then an additional payment is sent to the agent. This additional amount is the True-up payment that is basically the other half of the agent’s total commission. These payments are incentives provided to insurance agents by CMS for every new Medicare Advantage enrollee they sign up who is new to Medicare Advantage plans.
What’s Causing The Problem?
Right now there is a bit of conflicting information that is swirling around out there. Some carriers are stating that they have not received the November file and that is causing the delay. Other information is pointing towards that a file was indeed sent out by CMS in early November, but the file was incorrect. The estimated time to correct the file and send to carriers is being estimated to be completed on November 20, 2023.
Conclusion:
In conclusion, we understand the frustration and inconvenience that comes with delayed payments, particularly in the case of the New to Medicare Advantage True-Up payments. However, by staying focused on the annual enrollment period and building your book of business, you can overcome the frustration of the delays by knowing you will reap the financial rewards of writing more business. Keep in mind that this is a delay and not an announcement that agents will be losing those payments. As we get more updated information, we will pass that along to you, our valued partners.