Compensation for selling Aetna medical, dental and group insurance products

Transcription

1 Compensation for selling Aetna medical, dental and group insurance products 2009 Producer Compensation Plans For agents, brokers and consultants selling to employer groups with 51+ employees G (11/08)

2 We share the same goal to provide our customers with the employee benefits products and services that meet their needs. Table of Contents Medical products 2 Dental products 4 Group insurance products 6 Aetna Affordable Health Choices 8 Aetna Global Benefits 8 Cross-Sell Bonus programs 9 Medicare products 10 Bonus guidelines and information Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).

3 Highlights of our 2009 program n The Group Insurance New Business Bonus per coverage maximum payments increased to $6,000/$10,000/$15,000, depending on number of products sold. n The continuation of eligibility for cases over 3,000 employees to the bonus programs. n The continuation of our Medical Super Cross-Sell Bonus program that pays you for the new sale of a medical plan to a new or existing Aetna dental and life and/or disability product customer. n The continuation of incentive bonuses for selling dental with one of our medical plans and selling a life or disability benefits plan with one of our medical or dental plans. n The continuation of our Group Insurance Retention Bonus program. n These programs may not be available in all geographic regions. Please check with your Aetna representative for details. Base commissions n All commission schedules apply to full-risk, new business only, unless otherwise noted. n Medical, dental, life and disability commission schedules are effective for new sales on or after January 1, n The base commission schedule is applied per case and on a graded scale basis. The commission rates begin again at the top of the scale at the beginning of each policy year. n Commission schedules apply to all producers except general agents. n All schedules are subject to regulatory approval where applicable and compliance with maximum permitted payment levels. 1

4 Schedule 1 For all states except Arizona, Arkansas, California, Colorado, Delaware, Georgia, Maine, New Jersey, New York, Ohio, Oklahoma, Southeastern and Northeastern Pennsylvania, Texas, Utah and Virginia Aggregate Annual Premium Percent of Medical Premium $0 $35, % Medical products $35,001 $200, % $200,001 $400, % $400,001 $1,000, % $1,000,001 $4,000, % $4,000,001 and above 1.0% Base commission schedules Graded commission scales produce commissions starting at the top of the scale (shown on the right of each schedule) and move down the scale as the accumulated paid premium ranges (shown on the left) are reached per case during the policy year. The specified commission percentage rate only applies to the respective premiums falling within the associated premium levels for each rate. Schedule 2 For Arkansas, Colorado, Georgia, Maine, New York,* Ohio, Oklahoma, Texas and Virginia Aggregate Annual Premium Percent of Medical Premium $0 $400, % $400,001 $1,000, % $1,000,001 $4,000, % $4,000,001 and above 1.0% Schedule 3 For Delaware, Southern New Jersey and Southeastern Pennsylvania 5% flat for employers with employees 4% flat for employers with 301 3,000 employees Schedule 4 For Northern New Jersey 5% flat for employers with employees 4% 1% graded scale (shown in Schedule 2) for employers with 301 3,000 employees Schedule 5 For Northeastern Pennsylvania** 4.5% flat for employers with employees 3.5% flat for employers with 301 3,000 employees Please contact your local Aetna representative for Arizona, California and Utah commission schedules. * For HMO products including QPOS in New York, compensation (including New Sales and Retention Bonus compensation) will never exceed four percent. ** Counties: Bradford, Clinton, Columbia, Lackawanna, Luzerne, Lycoming, Northumberland, Pike, Snyder, Sullivan, Susquehanna, Wayne, Wyoming.

5 2009 medical bonus programs* For 2009, you can qualify for two medical bonus programs. The New Sales Bonus program pays you for selling new business from January 1, 2009 through December 31, The Retention Bonus program pays you for retaining existing members in your book of business from December 31, 2008 through December 31, You can get credit for up to 6,000 members per case. A member is defined as an enrolled employee or enrolled dependent. New Sales Bonus To qualify for the New Sales Bonus, a producer must sell one of the following from January 1, 2009 through December 31, 2009 to receive a payment of $40.00 per member on fully insured cases and $8.00 per member on Administrative Services Contract (ASC) cases: n 4 new medical cases with a combined total of 1,000 members. n 3 new medical cases with a combined total of 2,000 members. n 2 new medical cases with a combined total of 3,000 members. Retention Bonus To qualify for the Retention Bonus, a producer will have qualified for the 2009 New Sales Bonus and have a minimum book of business of five cases as of December 31, The book of business minimum case count can include new business written in 2009; however, the retention calculation and payment will only be based on the number of members in place on December 31, 2008 that are still active on December 31, Payment will be made as follows: n Retain 90 percent of existing medical members and receive $20.00 per member on fully insured cases and $2.00 per member on ASC cases. n Retain 95 percent of existing medical members and receive $25.00 per member on fully insured cases and $2.50 per member on ASC cases. n Retain 100 percent of existing medical members and receive $30.00 per member on fully insured cases and $3.00 per member on ASC cases. * These programs may not be available in all geographic regions. Please check with your Aetna representative for details. Base commission plus bonus may not exceed four percent in New York for HMO and QPOS products. 3

6 Dental products Base commission schedules Aggregate Annual Premium Percent of Dental Premium Graded commission scales produce commissions starting at the top of the scale (shown at right) and move down the scale as the accumulated paid premium ranges (shown at right) are reached per case during the policy year. The specified commission percentage rate only applies to the respective premiums falling within the associated premium levels for each rate. $0 $5, % $5,001 $20, % $20,001 $75, % $75,001 $400, % $400,001 $1,000, % $1,000,001 and above 1.0% Vital Savings by Aetna 15% of collected fees

7 2009 dental bonus programs For 2009, you can qualify for two bonus programs. The New Sales Bonus program pays you for selling new business from January 1, 2009 through December 31, The Retention Bonus program pays you for retaining existing members in your book of business from December 31, 2008 through December 31, You can get credit for up to 6,000 members per case. A member is defined as an enrolled employee or enrolled dependent. New Sales Bonus To qualify for the New Sales Bonus, a producer must sell one of the following from January 1, 2009 through December 31, 2009 to receive a payment of $4.00 per member on fully insured cases and $1.00 per member on ASC and Vital Savings fees: n 4 new dental cases with a combined total of 1,000 members. n 3 new dental cases with a combined total of 2,000 members. n 2 new dental cases with a combined total of 3,000 members. Retention Bonus To qualify for the Retention Bonus, a producer will have qualified for the 2009 New Sales Bonus and have a minimum book of business of five cases as of December 31, The book of business minimum case count can include new business written in 2009; however, the retention calculation and payment will only be based on the number of members in place on December 31, 2008 that are still active on December 31, Payment will be made as follows: n Retain 90 percent of existing dental members and receive $3.00 per member on fully insured cases and $0.30 per member on ASC cases. n Retain 95 percent of existing dental members and receive $4.00 per member on fully insured cases and $0.40 per member on ASC cases. n Retain 100 percent of existing dental members and receive $5.00 per member on fully insured cases and $0.50 per member on ASC cases. 5

8 Group insurance products Life and Disability Base Commission Schedules Life and Accidental Death & Dismemberment Annual Premium Percent of Premium Of the first $15, %* Of the next $10, % Of the next $25, % Of the next $100, % Above $150, % *15% for New York and Wisconsin. Short Term and Long Term Disability Annual Premium Percent of Premium Of the first $15, % Of the next $10, % Of the next $25, % Of the next $100, % Above $150, % 6

9 Life and disability bonus programs Our life and disability programs can also dramatically boost your income based on new business production and persistency results. It s simple to qualify for the Group New Business Bonus sell five or more insured group products with a 2009 effective date. The products that apply to this bonus program include basic life, supplemental life, short-term disability and long-term disability (excludes group universal life, dependent life and AD&D). Group Insurance Retention Bonus program To qualify for the Group Insurance Retention Bonus, a producer will have qualified for the 2009 Group Insurance New Business Bonus. The Retention Bonus is calculated by applying the incentive percent to the total premium received during calendar year 2009 on all basic life, supplemental life, short-term disability and long-term disability coverage in place on December 31, 2008 and still active on December 31, Group New Business Bonus Program Products Sold Percentage of Premium Maximum Payment Per Product % $6, % $10, % $15,000 Number of Group Insurance Coverages on December 31, 2009 Retention Percent Less than or more 90.0% 94.99% 0.5% 0.75% 1.0% 1.5% 95.0% or greater 1.0% 1.25% 1.5% 2.0%

10 Seek new opportunities Aetna Affordable Health Choices Aetna Affordable Health Choices are limited-benefits programs designed to provide medical, dental and other benefits to working people who otherwise might have no employee benefits at all hourly, part-time, seasonal or those serving a waiting period for other plans. Base Commission Schedule 10% of premium* Aetna Global Benefits Aetna Global Benefits provides insured products designed for expatriates working outside their home country. Base Commission Schedule 10% of premium * In New York, broker commission is five percent of premium.

11 Cross-Sell Bonus programs Medical Super Cross-Sell Bonus* For new business effective in 2009, the Medical Super Cross-Sell Bonus program pays you for the sale of three Aetna products to a new or existing customer. Aetna will pay an additional one percent (1%) of premium or ASC fees on the medical coverage when the new medical is sold in combination with both a dental and life and/or disability sale or to an existing Aetna account that has life and/or disability and dental product coverage. Earn the Medical Super Cross-Sell Bonus when: n Medical is sold to a new or existing dental and life and/or disability customer. n Medical and dental are sold to a new or existing life and/or disability customer. n Medical and life and/or disability are sold to a new or existing dental customer. Dental Cross-Sell Bonus For new business effective in 2009, sell a fully insured dental product to a new or existing medical customer and you will be eligible for an additional one percent (1%) of paid dental premium for the first policy year. Group Insurance Cross-Sell Bonus For new business effective in 2009, sell a Group Insurance insured product basic life, supplemental life, short-term disability or long-term disability coverage as a supplement to a new or existing medical or dental account, and you ll be eligible for a one-time additional bonus. A lump sum bonus of one percent of first-year estimated premium will be paid for each qualifying coverage sold. The maximum bonus is $5,000 per coverage. * This program may not be available in all geographic regions. Please check with your Aetna representative for details. Base commission plus bonus may not exceed four percent in New York for HMO and QPOS products. 9

12 Medicare products New Business Group Medicare Advantage and Group Prescription Drug Program (PDP) Producer Commission Schedule (per application) Maximum $250,000 per group Medicare Advantage $200 Prescription Drug Program $70 Renewal Group Medicare Advantage and Group Prescription Drug Program Producer Commission Schedule (per application) Maximum $100,000 per group Medicare Advantage $75 Prescription Drug Program $25 10

13 Bonus guidelines and information General guidelines n Bonuses will be tracked at the producer s local office level. n Cases sold under Medicare, Aetna Affordable Health Choices, Student Health Plans and Aetna Signature Administration are not eligible for qualification or payment under the bonus programs. n The 2009 Producer Compensation Plans, including the bonus programs described herein, supersede the prior compensation schedules incorporated into existing Producer Agreements with Aetna for agents, brokers and consultants selling to employer groups with 51+ employees. n The Aetna 2009 bonus programs are effective from January 1, 2009, through and including December 31, 2009, unless terminated or otherwise modified by Aetna. n Aetna s bonus programs are offered at the sole discretion of Aetna and can be terminated or modified by Aetna at any time and without notice. Any subsequent bonus program is at the discretion of Aetna. n Bonus programs may not be available in all geographic regions. n Commissions and bonus programs may be modified to comply with state law, regulations or approvals. n Bonus programs outlined in this document are not charged to the customer s experienced-rated contracts but will be disclosed in accordance with Aetna s Producer Compensation Disclosure policy. n Application of bonus programs and determinations of eligibility and payment amounts, if any, will be made by Aetna at our sole discretion. Decisions made by Aetna will be final. Medical, Dental and Group Insurance New Sales and Retention Bonus program guidelines n There is a maximum per-case cap of 6,000 members for all medical and dental bonuses. n There is a maximum annual cap of $250,000 per producer location for the medical New Sales Bonus. n There is a maximum annual cap of $350,000 per producer location for the medical Retention Bonus. n A combined New Sales and Retention Bonus for medical may not exceed $500,000. n There is a maximum annual cap of $50,000 per producer location for the dental New Sales Bonus. n There is a maximum annual cap of $50,000 per producer location for the dental Retention Bonus. n There is a maximum annual cap of $50,000 per producer location for the group insurance New Sales Bonus. n There is a maximum annual cap of $50,000 per producer location for the group insurance Retention Bonus. n In the event of a Broker of Record (BOR) change, the incumbent producer will retain the case through 2009 for qualification purposes only. n The producer does not need to be compensated under the base compensation program for a case to qualify, e.g., the producer can be receiving a consulting fee as opposed to commission payments. The relationship between the producer and plan sponsor must be documented to Aetna s satisfaction. n Bonus payment, if earned, will be made in one installment in the first quarter of n Cases for which bonuses will be paid must be active at the time the bonus payment is made. 11

14 Bonus guidelines and information (continued ) n For Group Insurance, Retention Bonus payments will be based on the actual paid premium and/or ASC fees received in New Sales Bonus payments will be based on the estimated annual premium and/or ASC fees expected to be received in the first policy/contract year for such cases. Estimates will be made by Aetna based on data available at time of quoting and enrollment. n For medical and dental, New Sales Bonus payments and Retention Bonus payments will be based on an average of the membership reported based on the dates and membership source at Aetna s discretion. Medical Super Cross-Sell, Dental Cross-Sell and Group Insurance Cross-Sell Bonus program guidelines n No credit will be applied when a product is converting within a line of coverage, converting from an administrative services contract to insured policy or when a plan sponsor designates a new producer in a Broker of Record change after the original effective date of coverage. n There is a Dental Cross-Sell Bonus Program per-case cap of $10,000. n There is a Group Insurance Cross-Sell Bonus Program cap of $5,000 per cross-sold coverage. n A bonus payment will be made monthly for insured medical and dental business based on paid premium received during the first policy year. n For self-funded (ASC) medical business, bonus payment, if earned, will be made in one installment in the first quarter of This one percent (1%) bonus will be based on the estimated annual ASC fees expected to be received in the first contract year. n A bonus payment will be made monthly for Stop Loss business based on paid premium received during the first contract year. n The Group Insurance Cross-Sell Bonus will be based on the estimated annual premium and/or ASC fees and will be paid in one installment at the end of the quarter following the effective date of the sale. n Sales credit for bonus qualification is defined as the addition of a line of coverage effective for 2009 that was not in effect with Aetna on December 31, Broker of Record Aetna honors Broker of Record letters when a producer takes over an Aetna case from another producer. The notification of this change must be submitted on the plan sponsor s letterhead and signed by a company officer. The Broker of Record letter that designates a change for commission payment will become effective on the first of the month following receipt by Aetna s commission unit (unless another future date is designated in the letter). Aetna will not honor Broker of Record letters from accounts where no external compensation is currently being paid. When a Broker of Record change occurs, and Aetna remains the incumbent carrier, the basic commission payments move to the newly appointed producer. Any new cases included in a producer s book of business as a result of a Broker of Record change will not be eligible for or considered for qualification under any bonus program or bonus payments included within the 2009 Producer Compensation Plans, including the New Sales Bonus and Retention Bonus programs. Additionally, while the basic commission payment moves to the newly appointed producer, the prior producer will be credited with any such cases in the producer s book of 12

15 business through December 31, 2009, solely for purposes of determining the case count and membership count in connection with qualification for the New Sales Bonus or Retention Bonus programs. License and appointment The state issues a license that allows a producer to sell insurance within that particular state. The contract state of the employer determines the state in which an agent needs to be appointed. Since full-risk products are underwritten by specific legal entities within the Aetna group of subsidiary companies, the appointment is directly tied to product(s) and the respective underwriting legal entity. It is the responsibility of the producers to renew their licenses and obtain appointments as required. Aetna will renew appointments when an agent is active and a current license is on file. The payment of compensation depends upon the appointment status and the satisfaction of state-specific requirements. Failure to comply may result in forfeiture of compensation. A new producer must complete and submit the following information: a signed Producer Agreement, W-9, Confidential Data Sheet and license copy. Disclosure of compensation As a condition of accepting compensation, the producer agrees to disclose in writing to each customer in advance of purchase the nature of any compensation the producer will receive or may be eligible to receive from Aetna in connection with the placement or servicing of the customer s business, as well as the nature of any other material business relationship that the producer has with Aetna. The producer will provide any additional disclosure required under state or federal law, including if applicable any disclosure that may be required pursuant to the Federal Department of Labor s ERISA Prohibited Transaction Exemption Aetna may disclose to customers compensation paid to the producer or for which the producer may be eligible in accordance with Aetna s policies on producer compensation disclosure and in accordance with applicable state or federal law. Contact information For information about commission payments: BrokerComm@aetna.com Phone: Fax: For information about licensing and appointment: License and Appointment Administration Unit 1 Prudential Circle Sugar Land, TX Phone: Fax: or LAAU@aetna.com For information about Aetna products and services: Contact your Aetna representative or call the closest Aetna office, listed at contactskey.html. A complete resource listing is available on Aetna s website at 13

16 The interpretation, application and administration of the provisions of the programs included in this publication shall be solely determined by Aetna, and its decision shall be final. This program is subject to regulatory approval and may vary from state to state. For specific rules and more information about the Life and Disability schedules, New Sales Bonus Program or Retention Bonus Program, contact your Aetna sales representative. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to G (11/08) 2008 Aetna Inc.