Medicare Advantage: 2018 Trends for Carriers, Agents, and Agencies


2018: the year of External Sales Agencies and Agents. In previous years, many Medicare carriers invested in growing internal call centers and internal sales teams. With the time and resources spent building complex team structures and internal hierarchies, carriers who had not planned well diverted attention from valuable agencies and agents. At a recent conference forum, a representative of a top national agency stood and said, “Yes, as a health plan, member experience is first. But your agent experience better be a close second.”

Agents are the evangelists of carriers in the field and play a huge role when prospective members choose a plan. Often, the only person a prospective member will meet while choosing a Medicare Advantage plan is an external agent. Many carriers who invested in internal sales are now realizing that external agencies cannot be ignored. Carriers are asking themselves, “How do we attract new external producers while supporting current ones?” The answer is technology.

Better Technology to Attract Power Agencies in a Competitive Landscape

Medicare Advantage competition is fierce. Health Plans find themselves in a war on two fronts: attracting members on one side and recruiting the right producers on the other. With commission rates so heavily regulated by CMS, carriers are instead battling over delivering the best agent experience. Meanwhile, External Producers are recognizing their worth and are asking carriers, “What’s in it for me?”

Timely and Accurate Commission Payments

The surest way to ruin the Agent Experience is to pay commissions late, incorrectly, or worse, both! No one wants a pay check to be late or wrong, and the same goes for commission checks. Time and again, carriers ignore this most basic principle. Unable to understand why fewer agencies and agents seem to recommend their products, many Health Plans watch as External Producers flock to carriers using the best and most accurate incentive-management tools. It’s simple: the choice between selling for a carrier that pays accurately and on-time or a carrier that pays wrong and late is a no-brainer.

Transparency—Self-Service Portals and Tools that Improve the Selling Experience

The key to transparency for agencies and agents is self-service portals. Self-Service portals with any-time access to commission statements, licensing, and training status, and easy tools to recertify make for happy producers. Offering a self-service portal is no longer enough. Anything short of best-in-class can be worse than having nothing at all, especially if the user experience leaves Producers unsatisfied.
Better Tools for Agencies

Agencies also require better tools to manage an increasingly complex Producer landscape.

Field Marketing Organizations managing traditional GA, MGA, and SGA frameworks are being acquired or are consolidating, sometimes adding an additional layer such as national marketing organizations. Agencies are now shopping for carriers with tools that quickly and easily manage complex hierarchy changes. As external agents hop from agency-to-agency, tools to manage book of business moves and agent of record changes become increasingly important. Carriers and Distributors who can provide quick self-service tools for these adjustments are winning.
For many carriers, additional internal support has been brought to bear to improve the producer experience. In many cases, multiple internal managers help support the same agencies or regions and share complex bonus structures. As carriers work out these new structures, internal hierarchies and teams change more rapidly than ever. Carriers without the tools to meet the needs of growing sales-support teams are falling behind.

Rapid Onboarding

Every Annual Election Period (AEP), as Producers scramble to ramp up their sales forces, more agencies look for carriers providing tools to rapidly onboard new agents. Carriers that provide automated, web-based producer onboarding are quickly dominating the market.

What’s Next?

In 2018 we will see a continuing trend toward a hypercompetitve Medicare Advantage market. Agencies and carriers will continue to consolidate, with many upstart health plans and agencies trying to tackle giants. In short, 2018 will be fought over recruiting the best Agencies and Agents, attracting the producers who can grow the member base. Carriers and distributors who bring the best technology to bear will win in 2018 and beyond. As the 2019 annual election period rapidly approaches, smart sales leaders are not resting on their laurels; they are seeking and implementing the best tools and software to improve the External and Internal Producer experiences, and will grow their business as a result.


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