DC

The SNP Alliance requests that CMS exempt from Medicare Advantage agent compensation requirements employed agents of SNPs. Many SNP Alliance members have evolved out of demonstration programs that use employed staff to carry out plan functions. Many use employed agents who have an exclusive relationship with and work full time for a single SNP, unlike brokers who may be selling multiple products for various companies. In addition, employed agents’ compensation is not based on a traditional commission structure, but based on a salary structure. Employed agents with exclusive relationships do not have the incentive to “churn” and move clients from plan to plan to increase their compensation. Employed agents with exclusive contracts have the incentive to maintain current clients. In addition, plans have a much greater influence on employed agents than brokers and a greater capacity to provide oversight than for broker relationships. Because employed agents are selling a single company, plans also have a greater incentive to provide additional training to their employees to ensure that they fully understand the product, how to ascertain its value for prospective enrollees and how to communicate the product benefits and requirements to prospective beneficiaries and others that may be involved in decision making about enrollment. This is especially important for Special Needs Plans as Special Needs Individuals often do not respond to standard marketing strategies and require additional support through the enrollment process. For example, low-literacy and ethnicity complicate communications and make it more challenging to explain products. Because special needs plans are targeted to a defined population group and have a different benefit structure and sometimes different cost-sharing from standard MA plans, these differences further complicate the marketing and communications process. Multiple people often are involved in decision- making about plan enrollment and employed agents often work with family members, health care advisors and other advocates help them understand the benefits of the special needs plans. Since employed agents of SNPs work for a single plan and receive the bulk of their compensation from salary as opposed to commissions, they do not have the incentive to churn, which is a key reason for the agent compensation rules. We also believe that beneficiaries are further protected from marketing abuses in these cases based on additional training and oversight employed agents receive from plans and the interaction of agents with family members and advocates in decision making about plan enrollment. For these reasons, we believe employed agents should be exempt from the agent compensation requirements.