AGENCY CLASSIFICATION AMENDMENT

Transcription

1 AGENCY CLASSIFICATION AMENDMENT THIS AGENCY CLASSIFICATION AMENDMENT (the Amendment ) is made with an original effective date of January 1, 2015 for quoting, new sales and renewal submissions (the Amendment Effective Date ), by and among Blue Cross and Blue Shield of Florida, Inc., on behalf of itself and its affiliates, Health Options, Inc. and Florida Combined Life (collectively Companies ), and the Agency, Agent, General Agent, General Agency or Agency Owner of General Agency (hereinafter Agency ) which is a party to the underlying Agent or Agency Agreement as hereby amended. WHEREAS, Companies and Agency previously entered into an Agent or Agency Agreement as applicable (the Agreement ); and WHEREAS, Companies and Agency wish to amend, effective as of the Amendment Effective Date, certain provisions of the Agreement to create and formalize an agency classification program, which requires certain modifications to existing contractual and compensation arrangements; NOW, THEREFORE, in consideration of the above and the promises set forth herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto, intending to be legally bound, do hereby agree effective as of the Amendment Effective Date as follows: ARTICLE I AMENDMENTS Section B. Commission Rules is amended by addition of the following as the terminal subsection: Agencies shall be classified into either of four separate categories with respect to submission of small group business (defined as groups of size 1-50):, Blue Preferred, Plus and Agencies. The said classification program shall be subject to the following criteria: Agencies 1) Agencies having accumulated 3500 or more total agency points as assessed and determine in their discretion, will automatically be deemed Agencies, and as such may continue to quote, submit and renew small group business directly with Florida Blue. 2) Agencies may utilize the Florida Blue Small Group Renewal Unit, for management and renewal of small group business.

2 3) Agencies will be eligible for applicable bonus programs offered through Florida Blue. Agencies 4) Agencies having accumulated total agency points as assessed and determine in their discretion, will automatically be deemed Agencies, and as such may continue to quote, submit and renew small group business directly with Florida Blue. 5) Agencies may utilize the Florida Blue Small Group Renewal Unit, for management and renewal of small group business. 6) Agencies will be eligible for applicable bonus programs offered through Florida Blue. Standard Plus and Standard Agencies 1) Agencies having accumulated 1249 or fewer total agency points as assessed and determine in their discretion, will automatically be deemed Standard Plus or Standard Agencies, and as such may quote, sell and renew small group business for Florida Blue. However, all such submissions by Standard Plus and Standard Agencies must be made through a General Agency (Wholesaler) as specified below. 2) Standard Plus and Standard Agencies must select one (1) of the following General Agency (Wholesaler) entities, and must designate one (1) specific office of such General Agency (Wholesaler), in order to continue selling and renewing small groups for Florida Blue: a. Centerstone Insurance and Financial Services, Inc. d/b/a BenefitMall b. Excelsior Benefits, LLC c. Rogers Benefit Group, Inc. General Agency (Wholesaler) entities will have the designation, and will be accountable for administering and managing new and renewal business quoting and submission for Standard Plus and Standard Agencies. Standard Plus and Standard Agencies must inform Companies in writing of the selected Wholesaler entity and office within the timeframe determined by Companies. Any proposed changes to the selection must be submitted to companies in writing, and are not effective until approved in writing by

3 Companies. The list of applicable General Agency (Wholesaler) entities may be changed from time to time at the discretion of Companies. 3) All commissions related to any new sales or renewals will be divided between the Standard Plus or Standard Agency, and the selected General Agency (Wholesaler) in accordance with the applicable compensation schedule, as attached hereto and incorporated herein. 4) Agencies will be eligible to participate for any Florida Blue bonus programs offered at their classification tier. 5) Standard Plus and Standard Agencies remain eligible to attain Agency status by accumulating 1250 or more total agency points as assessed and determine in their discretion. 6) Standard Plus and Standard Agencies that currently write Individual Under 65 business through a Master General Agency may continue to work with their Master General Agency for this segment. 7) Standard Plus and Standard Agencies that submit business through one of the General Agency (Wholesaler) entities listed above as of the Amendment Effective Date, may continue to make submissions through such General Agency (Wholesaler). If said Standard Agency elects to submit business through another of the General Agency (Wholesaler) entities listed above, such change may be made in accordance with this Amendment. A Standard Plus or Standard Agency that works with more than one General Agency (Wholesaler) office as of the Amendment Effective Date must select and designate only one (1) office for future business submissions. Business submitted through any wholesaler or other means not specified herein will not be accepted. ARTICLE II MISCELLANEOUS Section 2.1. Except as expressly amended hereby, the Agreement shall remain in full force and effect. On and after the Amendment Effective Date, the Agreement shall be deemed to be amended and modified as herein provided and, except as so amended and modified, the Agreement shall continue in full force and effect and the Agreement and this Amendment shall be read, taken and construed as one and the same instrument. On and after the Amendment Effective Date, the term Agreement as used in the Agreement and all other references to the Agreement therein shall mean the Agreement, as amended by this Amendment. Capitalized terms used but not otherwise defined herein shall have the meaning ascribed to them in the Agreement.

4 Section 2.2. This Amendment may be signed in any number of counterparts, each of which shall be deemed to be an original, but all of which together shall constitute one and the same instrument Small Group Commission Schedule Small Group 4-50 Eligible Employees and 4+ Enrolled Contracts BlueOptions, BlueSelect, BlueCare (HMO), and BlueChoice (PPO) Rates not using a GA (Wholesaler) Location South FL and Treasure Coast Plus Remaining FL Plus New Sales Renewals Points $40 $ $36 $ Plus $34 $30 Rates using a GA (Wholesaler) Location South FL and Treasure Coast Remaining FL Plus Plus New Sales Renewals $36 $32 $32 $28 $28 $24 $26 $22 $24 $20 $22 $ Group Base Commissions 51+ groups will continue to be paid at negotiated commissions rates. Agencies utilizing GA (Wholesalers) will be required to split commissions. For group sizes 51+, any changes of commission will require the group to be re-rated with the new commission amount. Commissions calculated as a percentage of premiums are based upon reconciled premium only. [Remainder of page intentionally left blank]

5 IN WITNESS WHEREOF, this Amendment has been duly executed as of the Amendment Effective Date. BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. FLORIDA COMBINED LIFE, INC. HEALTH OPTIONS, INC. Agency: By: Name: EIN#: Agency Owner Signature Print Name and Title Officer able to Legally Bind the Organization On Behalf of (Name Agency) Date Signed