Office Hours with Tidewater March Recap

For agent use only. This information is subject to change.

That’s exactly how this month’s Office Hours kicked off – and it couldn’t have been more accurate. As we wrap up OEP and look ahead to the rest of the year, the theme of this month’s call was clear: stay informed, stay diversified, and stay proactive.

From major commission updates and carrier suspensions to Medicare Advantage growth trends and new product opportunities, a lot is happening in our industry right now – but with the right strategy, there is significant opportunity ahead.

Whether you joined us live or couldn’t make it, this recap has everything you need to catch up and guide your success this year.

Main Points Covered

The main topics covered during March’s call include:

• Industry and Market Updates
• Medicare Advantage Trends
• Policy & Regulatory Updates
• Prescription & Drug Updates
• Product & Carrier Opportunities
• Medicare Supplement Updates
• March Training Opportunities

Industry & Market Udpates

Humana Comission Change

Humana announced a significant commission adjustment that took effect on March 3rd.

What’s changing?

Previously, agents were paid the full initial commission of $347 (street level) for individuals aging into Medicare – regardless of the time of year the application was written. Now, initial commissions for new Medicare (T65) enrollments will be prorated, just like other enrollments.

This does not affect members switching between plans, only new to Medicare Advantage enrollees and age-ins.

Humana says this is part of a broader growth management strategy to maintain product and program stability. The takeaway for agents is that diversification matters. While some carriers are making adjustments, others are still paying the full $347 throughout the year. If you need details on which carriers are maintaining full commissions, reach out.

Ronnie emphasized that the market will level out – but agents who diversify products will be best positioned for long-term success.

Elevance Medicare Suspension

On Monday, the Securities and Exchange Commission (SEC) implemented a sales suspension for Elevance Health after allegations that risk adjustment data were improperly submitted. CMS indicated that overpayment data was submitted via an encrypted USB – an unacceptable format. As a result, sales are frozen in states where the product is available, meaning no new business can be written. Current Medicare Advantage (MA) members are not impacted by the suspension, and if corrections are made, CMS may lift it.

Medicare Advantage Trends

Despite expert predictions that Medicare Advantage enrollment would shrink, it did not.

Medicare Advantage Growth

According to a 2026 HealthScape report:

• MA grew 2.5%
• Over 50% of Medicare eligibles are now enrolled in MA
• Traditional Medicare also grew by 600,000 beneficiaries

Carriers that saw the largest MA growth during AEP include Humana, Devoted, Alignment, and Clover (you can read more on specific numbers here). While other carriers intentionally desired to reduce memberships. For example, UnitedHealthcare lost nearly 930,000 members nationwide as part of a strategic reset (please note that MA remains a core part of their long-term strategy). Seven states also saw MA declines (VT, WY, NH, ID, MN, MD, SD), largely due to carriers exiting unprofitable markets.

The Real Growth Story: SNPs

Special Needs Plans drove a majority of enrollment growth:

• C-SNPs grew 12.2%
• D-SNPs grew 5.7% (now 6.4 million enrolled nationwide)
• SNPs accounted for 83% of the total MA market growth

Carriers are investing in SNPs because they allow for year-round selling opportunities.

If you are not writing SNPs, you are missing growth.

PPO Decline

There has been a 10% drop in PPOs offered nationwide (as carriers are shifting towards HMOs). However, PPO enrollment remains strong.

Star Ratings

The number of 4-star plans is decreasing – and because star ratings impact every part of the business, carriers are encouraging agents to conduct complete client presentations. When agents clearly explain plan benefits upfront, clients are less likely to call in with complaints that negatively impact a plan’s star rating.

Policy & Regulatory Updates

Risk Adjustment Review

CMS is proposing modifications to MA risk adjustment scores, among allegations that carriers tried to boost them to maximize their federal payouts.

Site-Neutral Payment Proposal

In February, President Trump released a healthcare package that will require health systems to assign unique National Provider Identifiers (NPIs) to their outpatient departments by 2028.

The change is driven by growing concerns over hospitals charging additional facility fees when performing outpatient services at locations they own – costs that Medicare Advantage plans often do not cover. Hospitals argue that higher payments are necessary due to greater overhead and more complex patient populations.

The goal of site-neural payment is that Medicare should pay the same amount for the same service, regardless of where it is performed. The bottom line is that patients should not be caught in the middle of inconsistent pricing.

Prescription & Drug Updates

Inflation Reduction Act Impacts

The Inflation Reduction Act continues to expand Medicare Part D drug coverage, with noticeable changes taking effect next year. Wegovy will become one of the negotiated drugs under Medicare Part D for beneficiaries with cardiovascular disease. Additionally, Medicare’s “Bridge Program” – which was previewed in February’s office hours – is still awaiting final details. Stakeholders are watching closely to see whether this program could extend coverage to weight-loss-related treatments, potentially broadening the impact of these policy changes.

TrumpRx.gov

TrumpRx launched this year, offering discounts on approximately 43 different medications. These medications span multiple categories, including weight-loss treatments, respiratory therapies, and fertility, giving consumers broader access to high-cost name-brand drugs. While TrumpRx does not function as a pharmacy and does not sell medications directly, it allows users to print coupons or save them to their mobile wallet for use at participating pharmacies with a valid prescription.

The program is open to everyone, but is especially valuable for uninsured individuals, those struggling with medication costs, or those dropping ACA coverage.

Product & Carrier Opportunities

Hospital Indemnity

Hospital Indemnity is a growing market, emerging as one of the fastest-growing supplemental products. In 2024, earned premiums surpassed $2 billion for the first time. Even with this growth, the market remains far from saturated as hospital indemnity policies covered just over 3 million customers by the end of 2024 (much less than the total number of individuals enrolled in major plans). For agents, this represents an opportunity to introduce hospital indemnity plans to clients.

HI Highlights

• Average annual premium: $703 per year (just under $60 per month)
• Highly accessible
• Strong comission potential

HI Carrier Highlights

ManhattanLife

• Offers under-65 hospital indemnity option
• Featuring a one-day $10,000 hospital benefit (once per year)

• Designed to support individuals moving off ACA plans due to rising premiums and/or those with high-deductible or catastrophic plans
• Available in NC, TN, GA, AL, FL, MS
• Recently doubled agent commissions

Wellabe/Medico

Wellabe added a prescription drug benefit rider to their hospital indemnity plan – and it’s a true game changer for agents.

Why it’s a game changer:

• The rider will pay a $20/prescription reimbursement annually, up to $300 or $600 per year, depending on the plan chosen.
• Higher premiums = higher commissions
• Base plan premiums are not increasing
• You can add this rider to any Medico policy written since 2018
  • Renewal commission applies

New Medico application requirement:

As of March 2nd, agents must enter a unique email address and phone number for every applicant. Clients will receive their policy by email only. Medico has fully discontinued paper applications and now only accepts e-applications.

Note:

Medico bases Medicare Supplement rates on their entire book of business – not just Medicare Supplement loss ratios. Writing strong, diverse business with Medico helps reduce the need for large Medicare Supplement rate increases, which matters because many carriers are raising rates significantly right now.

Mutual of Omaha

Mutual of Omaha is doubling incentives earned on all hospital indemnity business from March 1 through September 30, giving agents a faster way to qualify for their incentive trip.

Dental

Dental carriers are beginning to implement rate increases this year, due to industry-wide loss ratios and pending legislative changes.

Physicians Mutual:

• Announced a rate increase on dental products.

Wellabe:

• Announced rate increases on Gold and Platinum dental plans, buy-up benefit riders, and calendar-year maximum carryover riders.
  • Effective dates by state:
    • March 1: AL, AR, GA, LA, NC, OK, TN, WI
    • April 1: IN, KY, MS, OH, PA

Other Notable Carrier Updates

Wellcare Commission Changes

As of March 1, Wellcare will no longer pay commissions on select products in GA, TX, NJ, MS, and KY. Make sure to check IntegrityCONNECT to verify commissionable plans before submitting applications.

Cigna Platform Update

The Cigna website is no longer active. Agents must now use the HealthSpring platform.

Devoted Health Changes

As of March 1, there will be no more $50 HRA payment for standard MA plans. The $50 HRA payment will continue for SNPs and CSNPs, but it must be completed within 5 days of submission.

Also note that Devoted dental benefits must use Liberty Dental (Guardian PPO network leased).

Alignment Health

Alignment Healthcare is now in-network with Novant in the Triad area. This is a huge expansion opportunity for agents living in the Triad region of North Carolina.

Note with these plans:

• Always check the provider portal before submitting applications (to ensure your client’s provider is loaded in and they are not randomly assigned a provider)
• Alignment offers 5-star plans which create additional enrollment opportunities

Medicare Supplement Updates

Several carriers are implementing notable Medicare Supplement updates we need to be aware of.

Aflac: Announced upcoming rate increases for March and April – raninging from 7-15% depending on the state.

ManhattanLife: Expanding its guaranteed-issue window to age 70 in many states.

INA: Launching new product in Washington State – seeing strong and steady performance.

Mutual of Omaha: Increasing underwritten incentive to $250 per Med Supp app written March 1-June 30.

• Does not require prescription drugs for underwritten applications
• Most underwritten applications will receive an auto-decision in under 150 seconds

Tidewater is contracted with all the carriers mentioned in the Product and Carrier Opportunity and Medicare Supplement Updates section of this post, and we encourage you to consider adding these products to your portfolio. To explore our full product list, click here. When you’re ready to begin onboarding and contracting, click here. Our goal is to help you grow, diversify, and position yourself for long-term success.

March Training Opportunities

We host weekly trainings to help our partners grow tthier knowledge and continually stregnthen their skillset. Throughout March, we’re offering four key webinars that agents are highly encouraged to attend:

• Short-Term Care – March 11
• Hopsital Indemnity -March 17
• GTO’s Ancillary Benefits – March 25
• Mastering High Deductible G – March 31

Visit our trainings and events page to register and see more educational opportunities.

Why join?

These trainings help build confidence when meeting with consumers. Clients can immediately sense when an agent knows their products well – and that confidence positions you as a trusted expert. The more informed you are, the more effectively you can serve your clients and grow your business.

Final Takeaway: Diversify & Stay Educated

This month’s call reinforced two major themes:

1. Diversification is protection
2. Education is leverage

In this industry, commission structures may shift, carriers may adjust strategies, and regulations may evolve, but the agents who diversify product offerings, embrace products that are growing, and stay educated through training will continue to win – regardless of market shifts.

If you have questions about any updates or want to expand your portfolio with any of the products mentioned, we’re here to help. Let’s keep building together.

For agent use only. This information is subject to change.