Agents are reporting they aren’t being paid commissions on enrollments through Covered California.
Through casual conversation and on various Internet forums numerous agents and brokers have mentioned they arent getting paid commissions for business they submitted through Covered California. Is there a crisis of commissions not being paid to Certified Insurance Agents? Without reliable data from the agent community it is hard to tell if the missing commissions are limited to a handful of agents or if the problem is widespread throughout the industry.
Who tracks agent commissions that don’t get paid?
It is hard to gather accurate data on lost commissions because Covered California is fractured between twelve different health plans and the small group entity of SHOP. The only people who really know if they are not being paid for their work are the agents and brokers themselves. Absent any meaningful reporting of the unpaid commissions, there is no way to present the magnitude of the problem and possible causes to either the carriers or Covered California.
What causes commissions not to be paid?
Some of the potential causes that have been cited for commissions not being paid have been-
- Problems with, or lack of, agent delegation through Covered California
- Paper applications not properly entered by Covered California when submitted by agents
- Failure of Covered California to transmit broker of agent information to the carrier
- Failure of the carrier to receive or integrate broker of record into their system
No data, no action
In an effort to gauge the magnitude of the problem we are asking for your assistance in reporting to us which carriers have not paid commissions on business submitted through Covered California. If we have enough responses we can publish the aggregate data on lost commissions and possibly identify trends and problem areas. If the data pool is large enough we can also present the information to Covered California for their review and hopefully assist them in figuring out which systems need improvement.
Gathering data
Below is a simple spreadsheet for reporting the number of applications by carrier for which you have received no commission. You can report anonymously if you wish. No names will be used in any report that might be generated from the data. You can also call me, Kevin Knauss, directly at 916-521-7216 and I can populate the information in a spreadsheet on your behalf.
Download the Unpaid Commissions Report Excel spread sheet below. Fill it out, save it to your hard disk and then email it to calguild@insuremekevin.com/calhabg.
- Applications: number of individual or family applications submitted to Covered California with the indicated carrier.
- Members: number of household members the applications represented.
- Medi-Cal Kids: the number of children on the applications that were placed in Medi-Cal.
- Covered CA: the number unpaid commissions that were a result of a Covered California error.
- Carrier: the number of unpaid commissions that were a result of a carrier error.
For example, you may have placed three applications with Anthem Blue Cross representing 6 household members. Three of the individuals qualified for Medi-Cal kids. You have not been paid commissions on three adult members from Anthem Blue Cross. Of those unpaid commissions you have been able to trace the problem to one instance of a Covered California error and two that have resulted from a carrier error.
SHOP and Medi-Cal
SHOP is problematic because they havent paid any commissions and wont until the end of May. Even though Medi-Cal doesnt pay commissions, weve included an optional Medi-Cal entry for the reporting of entire families that you enrolled that were not APTC eligible. Medi-Cal enrollment can be used as another benchmark for illustrating the value of agents and brokers in reaching all segments of California residents that needed assistance with enrolling in an ACA health plan.
Feel free to contact us with any questions or suggestions.