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Broker News | March 2017 | Vol. 12 No. 3
Broker News | March 2017 | Vol. 12 No. 3

New Business Broker Bonus Program

Updated 05/08/17

Update: Broker Bonus Program Includes New Lifetime Benefit Solutions Business  

Bonus programs are for new business effective July 2017 through January 2018. New Lifetime Benefit Solutions (LBS) medical TPA business counts toward the override. Transfers from Lifetime Benefit Solutions do not apply.

 

DFS Approved

New Experience Rated Business Incentive*

Potential Earnings:

  • New Experience Rated contracts with an effective date between 7/1/17 and 1/31/18 will be paid a $10.00 Per Contract Per Month incentive in a one-time total payment based on the total number of contracts in effect as of the effective date.
  • Payment will be issued in the month following the effective date.

EXAMPLE: 

New Group Effective 7/1/2016  
Contracts 250
Incentive Per Contract Per Month x $10.00
Month x 12
Bonus paid in August = $30,000
  • For groups retained in year 2, a $5.00 Per Contract Per Month incentive will be paid in a one-time total payment based on the total number of contracts in effect as of the second renewal date.
  • For groups retained in year 3, a $2.50 Per Contract Per Month incentive will be paid in a one-time total payment based on the total number of contracts in effect as of the third renewal date.

Qualifications for Earning Agent Incentive:

  • Only contracts from newly sold experience rated groups qualify toward the calculation of the incentive. Growth on existing clients is not eligible.
  • If a qualified group is terminated before the renewal date, the Health Plan has the right to recoup any previously payments made under this program.

 

New Experience Rated and Self-Funded Business Agency Incentive*

  • Experience Rated and Self-Funded Business Agency Incentive*
  • Payments will be made based upon the total number of contracts in effect as of 1/31/18 for any new groups effective between 7/1/17 and 1/31/18.

New ER & SF Medical Contracts

Payment
 500-999 Contracts  $50,000.00
 1000-1999 Contracts  $100,000.00
 2000 or More Contracts  $150,000.00
  • The agency with the highest volume of new experience rated and self-funded contracts with an effective date between 7/1/17 and1/31/18 will receive an additional $100,000
  • Only brand new experience rated and self-funded groups qualify toward the calculation of incentive. Growth on existing clients is not eligible.

*Transfers from Lifetime Benefit Solutions do not apply.

 

Claim Based Business Pharmacy Broker Commission Program

 

Existing Claim Based Business Accounts

Commission Structure:

  • On or after January 1, 2017, existing Claim Based Business (CBB) medical groups that have their pharmacy coverage with the Health Plan are eligible for a commission payment of $.60 per script. To be eligible for this program the broker agency must be appointed with the Health Plan and have met a required 95% pharmacy retention qualification on their 2016 CBB pharmacy book of business or any subsequent year after 2016. Once the 95% qualification is met, the payment will continue as long as the broker holds the Broker of Record with the applicable group. Re-qualification is not required annually.
  • An additional $.10 per script will be paid if the broker agency maintains a 95% pharmacy retention rate on their CBB pharmacy book of business. Book of business retention measurement will be calculated on a calendar year basis for each year following the initial qualification year for the commission payment. Broker agencies will need to requalify for this additional payment annually.

 

New Pharmacy Claim Based Business

Commission Structure:

  • Broker agencies appointed with the Health Plan will be eligible for commission of $.85 per script effective January 1, 2017 for any new pharmacy CBB placed with the Health Plan on or after January 1, 2017.
  • An additional $.10 per script will be paid if the broker agency maintains a 95% pharmacy retention rate on their CBB pharmacy book of business. Book of business retention measurement will be calculated on a calendar year basis for each year following the initial qualification year for the commission payment. Broker agencies would need to requalify for this additional payment annually.


 

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