Dear John, I have Good News & Bad News………….

dearjohn

In order to rebalance our existing and future book of business, we are increasing our  HMO new and renewal commission rates, and reducing the commission rates for all new and renewing  PPO health plans………..

A regional health insurer sends Dear John Letter to agents this morning: (Name redacted)

We are fully committed to the commercial business line and paying competitive commissions to our valued broker partners. We would like to inform you that our commission structure will change effective September 1, 2016. In order to rebalance our existing and future book of business, we are increasing our  HMO new and renewal commission rates, and reducing the commission rates for all new and renewing  PPO health plans as outlined below:

Brokers and Agents New Structure – Group
Policy Type Small Group Large Group
New/Renewal New/Renewal
HMO Health Plans 6.0% 6.0%
PPO Health Plans 4.0% 4.0%

 

Brokers and Agents New Structure – Individual
Policy Type Issue Age New/Renewal
HMO Health Plans Individual <64.5 6.0%
PPO Health Plans Individual <64.5 0%

 

This change will further align with our strategy to efficiently manage client costs while continuing to provide quality care to our members. We can do this much more effectively within our HMO framework. Our HMO plans deliver significant savings while providing comprehensive, quality care. Key benefits of our HMO plans include:

  • Our HMO plans are open access. This means you are not required to designate a PCP, and no referrals are needed to see specialists
  • All (Name of Insurance Company) hospital locations are in our network
  • Our HMO plans include (Name of Insurance Company) Care Clinics, HEB RediClinics and Walgreens Take Care Clinics
  • UT Physician groups are in our HMO network
  • National emergency coverage is included as an in-network benefit

The new commission rates are effective immediately for new business and for renewing groups with an effective date of September 1, 2016. Any groups already renewed as of July 29, 2016 for September 1, 2016 or earlier will be paid according to the previous commission structure.

This is part of our long term strategy to solidify our business in the best way possible. We value and appreciate your continued partnership with (Name of Insurance Company). Please see the attached revised commission schedule, and place it with your agent agreement.

 

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