Medicare Advantage plan issuers might have increased policy sales during the annual enrollment period that ended Sunday — in spite of efforts to reduce sales.
Many issuers designed and priced their plans in their spring, before they understood what 2025 medical claims would look like.
Once the issuers saw more 2025 claims, and they decided that they had put underpriced products on the shelves for 2026, they took steps such as eliminating sales commissions and pulling plans off of electronic sales systems to keep hordes of potentially costly enrollees from surging onto their customer lists.
The annual enrollment period for 2026 coverage started Oct. 15.
UnitedHealth executives, for example, said Oct. 28, when the company released its earnings for the third quarter, that it was trying to cut Medicare plan enrollment by about 1 million, to 7.4 million, and that early sales figures were in line with expectations.
But there is one early sign that the issuers might have increased the number of policies sold: Spark Advisors, a Medicare plan sales platform provider, reported in mid-November that the top 10% of its brokers using its system had sold an average of 166 applications each, up 45% from their average for the comparable period in 2024.
What it means: Any clients who have Medicare may have had to scramble to find coverage that will meet their needs, or may still be struggling to cope with all of the disruption.
If they have a plan, the issuer of that plan may not be thrilled to have their business.
If you help clients with Medicare plans, you are probably very tired.
If you do not help clients with their Medicare coverage, but you have friends or associates who do: Those people may need a hug.
The backdrop: "Original Medicare" coverage exposes enrollees to many big deductibles, coinsurance payments and copayment bills.
The Medicare+Choice program once gave private insurers a chance to sell Medicare enrollees plans that filled the holes.
Congress tried to cut federal spending on that program in the late 1990s. Issuers ended up fleeing that program, and it died around 2001.
The replacement for the Medicare+Choice program, the Medicare Advantage program, came to life in 2003 with generous congressional support.
Medicare Advantage once looked like a strong, steady lifeboat program. It kept going through the 2007-2009 financial crisis and through the COVID-19 pandemic. It now serves about 35 million of the 69 million Medicare enrollees.
But the Centers for Medicare and Medicaid Services, the agency that oversees the program, has tried to tighten oversight of the program in recent years, and the decrease in use of medical care that occurred during the COVID pandemic suddenly reversed, with a vengeance, in 2024.
The result was that many issuers decided early in 2025 to thin out Medicare plan menus and increase rates for 2026 coverage.
After the issuers with the remaining plans analyzed the impact changes, they concluded that all of the changes, and the underlying increase in medical claims, could lead to big increases in spending for the plans still on the market.
Because of the difficulty of pulling plans off the market, they took steps to minimize sales of the unwanted plans.
Agents' and brokers' perspective: For agents and brokers, the annual enrollment period was the most brutal since the modern Medicare Advantage program came to life.
At least 10 states have objected to some issuers' decisions to zero out agents' and brokers' sales commissions in the middle of the annual enrollment period, and the Idaho Department of Insurance called mid-AEP commission cuts an unfair trade practice.
The National Association of Business and Insurance Professionals welcomed Idaho's unfair trade practice bulletin.
"When carriers remove or reduce commissions, they undermine not only the livelihoods of professionals but also the accessibility of quality guidance that consumers depend on," said Jessica Brooks-Woods, the chief executive officer of NABIP.
Amanda Brewton, a Medicare plan broker who is active at NABIP, has named the webinar she will be holding Dec. 18 to discuss what happened "The AEP Autopsy."
Her teaser for the webinar is "You Made It Out Alive... Now Let's Fix Everything."
Calvin Bagley, a Medicare broker, posted on LinkedIn that carriers should not be able to hide plans from consumers and brokers to cope with possible product pricing or benefit design problems.
"If a carrier faces financial pressure, the solution is to use actuarial expertise to design a sustainable value proposition," Bagley wrote. "It is not to remove enrollment channels, alter compensation mid-season, or cut off advisor access with only 24 hours' notice."
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