ACA Begins Using Star Ratings for Plans

HealthCare.gov and the state ACA exchange websites will start publishing quality star ratings for insurance plans, CMS announced Thursday. Under the now-nationwide policy, set to start for the 2020 plan year, exchange insurers will be rated using a 5-star quality rating system similar to Medicare Advantage’s. The number of stars awarded depends on how enrollees rate in-network doctors, care received, customer service and overall experience with the insurer. HealthCare.gov will post the ratings.

ARTICLE based on CMS RELEASE

 

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Medicare Advantage: Double-Digit Growth

All but one of the five largest for-profit payers saw double-digit growth in their Medicare Advantage membership in Q2 2019. Insurers are listed in order of year-over-year M/A enrollment growth, as of June 30:

  1. Aetna: M/A membership – 2.3 million, 30.6% growth;
  2. Anthem: M/A membership – 1.2 million, 24.9% growth;
  3. Humana: M/A membership: 12.4 million, 19.2% growth;
  4. Cigna: M/A membership – 1.6 million, 10 % growth;
  5. UnitedHealthcare: M/A membership – 5.2 million, 8.4% growth.

 

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Medicare Advantage: ‘Tremendous Growth’

Cigna is planning to expand its Medicare Advantage footprint by 14% next year, according to Forbes.  The insurer plans to enter 37 new counties with individual HMO plans, and 43 new counties with individual PPO M/A plans in 2020. “We see tremendous growth opportunity in M/A, starting in 2020,” CEO David Cordani said. This comes on the heels of Centene announcing its plans to expand into 100 new counties and enter a new state – Nevada – to expand M/A to seniors in 2020. Cigna now joins a group of well-known health plans looking to capitalize on new rules that allow M/A plans to offer more benefits to seniors. Cigna’s M/A business had 440,000 members at the end of Q2, significantly fewer than rivals such as Humana, UnitedHealth and Aetna.

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Why Prospects Don’t Make Decisions

“Let me think about it … I’ll get back to you.” How many times have you gotten this answer when trying to close a sale? Too often, it never closes. You presented a good idea in the prospect’s best interests. You answered the questions. It seems like a square peg and a square hole. Many agents and marketers wonder why prospects hesitate. I wondered too. When doing research, I surveyed and interviewed scores of marketers and insurance agents, asking the question, “Why don’t prospects and clients make decisions?” There are logical reasons they don’t make decisions. Once you understand a prospects’ concerns, you can address them:

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Take Responsibility for Your Own Work

For some, responsibility is empowering. For some others, responsibility is frightening, even debilitating. When you get right down to it, when it comes to your work and your responsibilities, you are responsible for everything. So if everything is your responsibility, then you’re the one who must do something to change the outcome from negative to positive. Problems don’t age well. Tiny monsters grow up to be giant monsters. You’re better off dispatching them before they become entrenched, and before they wreak havoc on your results. Be bold; be daring; be resolved to make the hard calls before someone else has to do it for you. You can do this. COLUMN

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