Word on the Street Newsletter 9/23/24

September 30, 2024

I’d like to welcome you to Agility’s Word on the Street Newsletter

Welcome to another edition of Agility – Word on the Street, our weekly newsletter designed specifically for you, our Key Partners. We’ll share critical weekly insights and trends as we move through the selling season. This time, we’re changing things up a bit! We’ll dive into five significant changes for this AEP, highlight some important Agility and ACA intel, and explore the riches in the niches with Medicare Supplements.

Commissions for PDP Plans: Wellcare has announced that it will no longer pay commissions for Part D plans—both new and renewal business. Aetna, meanwhile, will only pay renewal commissions on Part D plans but is discontinuing commissions on new PDP sales. Be sure to adjust your strategy accordingly.
Premium Stabilization M3P:Starting in 2025, Medicare Part D beneficiaries will have a $2,000 annual out-of-pocket limit for prescription drugs. Beneficiaries who reach this cap can opt for the “smoothing” feature, spreading their remaining payments annually. Agents must explain the full payment structure, including risks like potential deferred debts, and use clear scenarios when advising clients.
Cigna’s Hot Markets:Early looks show Cigna is feeling strong in the following markets for 2025: Texas (statewide) and Alabama (statewide), Tennessee – Nashville & Chattanooga, North Carolina – Charlotte & Asheville, South Carolina – Greenville, Spartanburg & Anderson, Pennsylvania – Philadelphia, Illinois – Chicago, Florida – Miami-Dade, and more.
Central Florida Bets to Make:In Central Florida, keep an eye on Freedom Health, Devoted, and Aetna. Devoted is maintaining its 5-star rating with a focus on integrated care. Aetna is leaning toward Part B givebacks and strong food card allowances for full duals, and Freedom stands out with its Part B giveback plus a food and OTC card.
Sonder Health in Georgia:With Humana exiting 31 counties and Aetna discontinuing its Signature Plan in Georgia for 2025, Sonder Health is stepping in, creating great enrollment opportunities amid this disruption.

Agility Launch Events: If you’ve attended any of our kickoff events recently, you know how different—and fun—they are! Our last event is coming up in Atlanta on 9/24. Don’t miss it!

Health Sherpa’s Consent Form: Compliance is key this year, and HealthSherpa now offers a consumer consent option. Be sure your agents are locked in for the upcoming plan year.

CMS and Social Security Numbers: Starting October 1, CMS will block applications without Social Security numbers, with an update for tax IDs in December. Be prepared!

Cigna Growth Markets for ACA: Look for growth in Colorado, Mississippi, Florida’s Treasure Coast, and Tennessee’s Tri-Cities.

Ambetter Plan Name Update: Ambetter’s Bronze, Silver, and Gold (Core) Network has been rebranded as the Premier Network.

ICHRA Updates: Ambetter is expanding its off-exchange network in Indianacalled Ambetter Health Solutions. Oscar is also focusing on ICHRA and may soon introduce off-exchange options.

Unlocking the Opportunity with DACA for ACA Agents

With recent changes, DACA recipients (Deferred Action for Childhood Arrivals) are now eligible for ACA health insurance plans. This creates a massive opportunity for agents, as over 580,000 individuals, many previously unable to access ACA coverage, are now in the market for affordable healthcare.

Why This Matters for Agents

Many DACA recipients are young, working, and navigating complex healthcare systems with little help. They now qualify for ACA subsidies, creating a new pool of consumers who need guidance. This group will be particularly interested in preventive care, maternity services, and chronic condition management, making them prime candidates for ACA plans.

How to Tap Into This Niche

Educate: Spread the word! Many DACA recipients don’t know they’re eligible. Use webinars, social media, or local community partnerships to inform them.
Targeted Marketing: Focus on states with large DACA populations, like Florida, Texas, Georgia, California, Illinois, and New York. Highlight affordability and subsidies.
Be Their Guide: Make the healthcare navigation process simple by positioning yourself as their trusted advisor.

The Big Takeaway

This is an underserved market with actual demand for ACA solutions. Agents who tap into this niche will find both personal and business rewards. The opportunity is there—now it’s time to act!

That’s it for this week! This information helps grow your business and provides value to your partnerships. We’ll see you next week with even more updates!