If you’ve ever lost out on a commission you earned, you know it can be frustrating.
Fortunately, the WAP team is here to help. Today, Nic LeClair, our accounts payable and accounts receivable manager, and Damon Rose, our commission specialist are sharing valuable insights to help you understand you commissions and resolve discrepancies.
Q: How do You Know What You Are Owed?
A: Commission rates for 2025 have been revised. Previously, CMS had released fair market values for 2025 that included administrative fees. Those have now been removed, but there’s still a nice percentage bump.
For 2025 plans, you’ll receive the following commissions:
- MAPD Initial Year: $626
- MAPD Renewal Year: $313 or $26.08 PMPM
- PDP Initial Year: $109
- PDP Renewal Year: $55 or $4.58 PMPM
Q: How Do Commissions Change By Enrollment Type?
A: The enrollment type impacts how much you will receive. The difference between a like-plan change commission and an unlike-plan change commission is significant!
- A like-plan change occurs when you enroll a member who was already on an MAPD plan to an MAPD plan. The commission is made in one payment and is equal to the renewal commission.
- An unlike-plan change occurs when you enroll a member who was previously on a PDP plan, either with original Medicare or a Medicare Supplement, in an MAPD plan. The commission amount is the initial year commission, and it’s split into two payments.
- A T65 or ICEP enrollment occurs when you enroll a member who has never had an MAPD or PDP in the past to an MAPD plan. The commission amount is the initial year commission, and it’s split into two payments.
Q: When Do You Get Paid?
A: Exactly when you receive your commissions can depend on both the carrier and the type of enrollment. However, most larger carriers will issue the first commission within one to two weeks of when you submit the enrollment.
The second payment takes longer because the carrier needs to communicate with CMS. However, you should receive the second payment within five weeks of the first payment – if you don’t, something could be wrong, and you may need to follow-up.
Q: How Can I Keep My Commissions Organized?
A: There are three things you can do to stay on top of commissions so you always receive what you’re owed.
- Build a spreadsheet to track commissions. Record all pertinent information so you know which payments should be arriving. The image below shows the fields you may want to include. Here’s a sample Excel Sheet you can use to get started.
- Record all payments received. Mark the date of any payments received in your spreadsheet and reconcile your spreadsheet with carrier statements. Promptly reach out to troubleshoot any missing payments.
- Save carrier commission statements in organized folders. Create a folder for each carrier with sub-folders inside for each state, and subfolders inside each state for each month. You can also create a cumulative all-statement file for each year and for each carrier. This way, if you ever need to check a commission, it will be easy to find.
Q: How Do Discrepancies Occur?
A: In some cases, an enrollment is lost. For example, in some cases, agents think they have faxed a submission in, but for some reason, the carrier never receives the fax.
In other cases, the amount is less than expected. For example, you may think that you’re going to receive a full unlike-plan change commission, but the second check never comes. A situation like this requires follow-up. In some cases, the mistake may be on the carrier’s end, and you’ll end up getting the money you’re owed. However, it’s also possible that the carrier has correctly determined that no second check is owed. This can happen when, unknown to you, the client actually had an MAPD plan previously. Enrollees don’t always understand the difference between Medicare Advantage and Medicare Supplements, and they may say they had one type when they actually had the other.
Most discrepancies can be quickly resolved with prompt investigation and communication.
Q: How Should I Deal with Discrepancies?
A: If there’s a discrepancy, you should:
- Reach out to the organization that pays your commissions. For example, if the commission is paid by WAP, reach out to us at commissions@westernassetprotection.com. If the commission is paid by the carrier, you’ll need to reach out to the appropriate department at the carrier – use the Medicare Engine and Commission FAQ to find this information.
- When you reach out, be polite but direct. State the problem clearly. Have you not been paid at all, or were you paid less than you expected? Also securely supply all the relevant member information outlined in point 3.
- When you share beneficiary information, keep in mind that this is sensitive information. To keep your client’s information safe, you need to send the member information securely, providing the following:
- The client’s name
- The client’s date of birth
- The client’s Medicare Beneficiary Identifier
- The carrier
- The policy type (MA, PDP, Medicare Supplement)
- The policy effective date
Q: What If I Need Additional Help?
A: Most of the time, you should receive your commissions without any problems, and carriers are responsive to any inquiries. However, if you’re unable to resolve a commission issue, WAP is here to help. Contact us at commissions@westernassetprotection.com.