Medicare Market Turmoil Boosts Shopping

News November 08, 2024 at 08:40 AM
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What You Need To Know

  • GoHealth is seeing more consumer shopping.
  • SelectQuote believes use of more experienced agents is helping to increase its closing rates.
  • The CEO of eHealth hopes regulators will extend the enrollment period past Dec. 7.
A 2025 Medicare & You booklet on a table

Turmoil has scared some distributors out of the Medicare plan market, but three companies that are still in it say the upheaval could help annual enrollment period sales.

"These shifts are driving increased shopping for new plan options," Vijay Kotte, the chief executive officer of GoHealth, told securities analysts Thursday during a conference call.

Worries about the market and cash-flow problems have also slashed some distributors' spending on Medicare sales leads. One market player, Primerica, was so concerned that it gave GoHealth e-TeleQuote, a Medicare plan distribution business with 400 agents, $90.5 million in contract assets and $22.5 million in cash, according to Brendan Shanahan, GoHealth's CFO.

Overall applications have been up 3%, but application volume through GoHealth's own career agents has jumped 46%, company executives said.

Executives at eHealth and SelectQuote also told securities analysts about seeing less distributor competition and strong consumer interest.

EHealth, a pioneer in web-based insurance sales, entered the Medicare annual enrollment period for 2025 coverage with many more sales appointments than it had scheduled a year earlier; plus, its call volume and website visits have been much higher during the first weeks of the current enrollment period, according to Francis Soistman, eHealth's CEO.

"The early indicators also point to increased effectiveness of our telesales organization, as we are converting demand at greater rates compared to a year ago," Soistman said during a conference call eHealth held Wednesdays.

Tim Danker, the CEO of SelectQuote, also reported seeing strong call volume.

The sales closing rates for the agents handling the calls have been very good, Danker said.

"It's certainly a different environment this year, and that was predicted," Danker said.

What it means: The market disruption making life difficult for clients enrolled in Medicare may improve the performance of the remaining Medicare plan distributors.

The history: The Centers for Medicare and Medicaid Services, the agency that oversees Medicare, runs the annual enrollment period to serve Medicare enrollees who want to buy Medicare Advantage plans or Medicare drug plans, or to return to Original Medicare from Medicare Advantage plans.

Medicare Advantage plans serve about 34 million of the 68 million enrollees, and about 23 million enrollees have stand-alone Medicare drug plans.

The annual enrollment period for Medicare Advantage plans and Medicare Part D prescription drug plans started Oct. 15 and is set to run to Dec. 7.

A federal court order kept the Centers for Medicare and Medicaid Services from implementing a controversial proposal that could have kept insurers from paying field marketing organizations or other distributors overrides for support services.

But CMS went ahead with tightening then funding for Medicare Advantage plan issuers and implementing Inflation Reduction Act changes that put a $2,000 cap on insured patients' annual out-of-pocket spending on covered drugs.

Health insurers have responded by increasing coverage prices, pulling products off the shelves and many states, and, in some cases, making last-minute moves to limit sales by zeroing out sales and renewal commissions.

What the survivors are seeing: Executives at GoHealth, eHealth and SelectQuote did not give details about the impact of the commission changes on their operations. But they said their companies are trying to cope with the turmoil by using new technology tools and new strategies to offer consumers more support.

At eHealth, the company has come up with ways to get marketing messages to consumers in the communities suffering through the worst Medicare plan menu turmoil.

In the third quarter, which ended before the new annual enrollment period started, Medicare Advantage submitted applications were 26% higher than in the third quarter of 2023, Soistman said.

At SelectQuote, Bob Grant, the company's chief operating officer, noted that the company hired fewer newer agents and is relying more on more experienced agents.

The agents are spending more time on calls but ending up with higher closing rates, Grant said.

"Those tenured folks really know how to deal with the complex environment that's out there," Grant said.

Soistman is hoping CMS will respond to the complexity of the current Medicare plan shopping environment by extending the enrollment period past Dec. 7.

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