ACA INDIVIDUAL MARKET COMMISSION CHANGES
As we near the beginning of the 2019 Open Enrollment Period (OEP), we’re excited to make the following announcement for our ACA Individual Market members and our producer community.
Highmark is renewing its 2018 WPA portfolio and expanding the on-Marketplace offering into Armstrong, Clarion, Forest and Warren Counties. In Erie County, a new product is being introduced: my Direct Blue Erie HMO. This new product connects members to high-quality care from local doctors and community hospitals, allowing us to keep premium costs even lower.
Our 2019 products will offer:
- Lower deductibles on most plans (including a $0 deductible plan!) – over 2/3 of renewing members will see their deductible go down in 2019
- More copay-based benefits
- More care at little or no cost sharing
- Benefits that encourage appropriate, cost-effective-site-of service utilization
- Plans designed to encourage primary care and preventive benefit utilization
Effective January 1, 2019, for renewals and new sales, Highmark will pay commissions only on Highmark Blue Cross Blue Shield and Highmark Choice Company (HCC) renewals. There will be zero commission for new Highmark Health Insurance Company (HHIC) business, however, renewal business will be compensated as shown below.
The new 2019 commission structure for on- and off-Marketplace will be as follows:
All Counties Except Erie
|
Highmark BCBS & HCC
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HHIC
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New contracts with issue date in 2019
|
$15 PMPM
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$0 PMPM
|
Renewal contracts with issue date in 2018 or earlier
|
$5 PMPM
|
$5 PMPM
|
Erie County Only
|
Highmark BCBS & HCC
|
HHIC
|
New contracts with issue date in 2019
|
$20 PMPM
|
$0 PMPM
|
Renewal contracts with issue date in 2018 or earlier
|
$5 PMPM
|
$5 PMPM
|
- PMPM = per member per month
- Commissions for renewing contracts during the 2019 calendar year will adjust on the anniversary of the issue date
- Commissions are applicable only to contracts renewed during the Open Enrollment Period (OEP) (Nov. 1 – Dec. 15)
- Zero ($0) commission will be paid on contracts written outside of the OEP
- There remains a maximum of five members per contract
- Renewal commissions are paid on terminated policies only if there is less than 6 months lapse in coverage from termination date to Jan. 1, 2019
Product Training is being released today under a separate announcement. Please do not hesitate to contact U65TrainingCertification@highmark.com with any questions. We appreciate your business and presence in our communities.
Best regards,
Mark Nave
Senior Vice President, Government Markets |
