For agent use only. This information is subject to change.
We’ve got 33 days to go. You got this. We can do this. Let’s be smart and finish strong.
Ronnie James
Regional Sales Director, Tidewater Management Group
As the Annual Enrollment Period reaches its midpoint, our November Office Hours call served as an important check-in for agents. Office Hours host Ronnie James shared industry updates, market changes, sales opportunities, and practical reminders to help agents stay focused for the remainder of the enrollment season. Most importantly, he reminded agents that success isn’t measured by enrollments alone. Every client conversation, review, and relationship-building opportunity matters and can create future business opportunities long beyond this season.
Whether you joined us live or couldn’t make it, this recap includes everything you need to catch up and guide your success.
Main Points Covered
The main topics covered during November’s call include:
- Keep Playing the Long Game
- Medicare Supplement Market Updates
- Dental Benefits Continue to Drive Conversations
- Part D Costs: Understanding the Bigger Picture
- Star Ratings and Medicare Advantage Trends
- The Growing Importance of CSNPs
- ACA Open Enrollment is Underway
- ACA Alternatives Worth Exploring
- Don’t Overlook Ancillary Opportunities
- A Valuable Resource for Senior Clients: Aging Life Care Managers
- Long-Term Care is an Important Conversation
Keep Playing the Long Game
One of Ronnie’s key messages centered on the current market. Many agents are meeting with consumers who are exploring options but ultimately not making changes. Rather than viewing those conversations as unsuccessful, Ronnie encouraged agents to see them as relationship-building opportunities.
With consumers facing uncertainty and evaluating their coverage more carefully, trusted local agents play an essential role in helping clients understand their options. So this enrollment season, remember that even when a client doesn’t enroll, those conversations can lead to future opportunities and referrals.
Medicare Supplement Market Updates
Several notable Medicare Supplement changes were discussed during the call:
- Stopped accepting electronic Medicare Supplement applications in South Carolina, Texas, and Wisconsin, effective November 1, and will fully exit those markets on November 20
- Paper applications may still be accepted where available
Bankers Fidelity
- Withdrawing its Medicare Supplement plans from Virginia
- Agents were encouraged to take a closer look at the newer Lumos Medicare Supplement option that appears competitive in several markets
- When writing the Innovative Plan G, Ronnie recommended using a December 1 effective date when possible to maximize value for clients due to the plan’s unique structure
Dental Benefits Continue to Drive Conversations
Dental is one of the most discussed benefits among seniors.
Ronnie highlighted Wellabe’s standalone dental product, particularly its rollover feature, which allows unused benefits to carry into the following year. He also reminded agents that dental networks vary by carrier and plan. Consumers should understand whether benefits are reimbursement-based or require use of in-network providers before enrolling.
A few additional reminders include:
- Some Devoted Health plans use reimbursement models, while others require network participation
- Several major carriers continue to utilize dental networks
- Certain HealthSpring plans are gaining traction due to their flexible dental benefits that allow members to choose their providers
Part D Costs: Understanding the Bigger Picture
Ronnie provided helpful context around Medicare Part D premiums and federal subsidies.
While many consumers are noticing premium increases and discussing recent subsidy changes, Part D remains heavily subsidized by the federal government. Ronnie explained that beneficiaries typically see only a portion of the actual cost, with significant funding occurring behind the scenes through government support programs.
Understanding this information can help agents educate clients who may be frustrated by premium changes heading into next year.
Star Ratings and Medicare Advantage Trends
Several carriers are challenging recent CMS Star Ratings, making it an important area for agents to watch.
Ronnie mentioned:
- Multiple carriers, including Aetna, Alignment Health, and Centene, are questioning recent ratings through legal action
- Humana experienced a major rebound, achieving its highest-ever Star Rating performance and positioning itself favorably for future payments
While these developments won’t immediately impact enrollments, they could influence plan designs, commissions, and other strategies in the future.
The Growing Importance of CSNPs
One of the biggest Medicare Advantage trends discussed during the call was the growth of Chronic Special Needs Plans (CSNPs).
According to Ronnie, CSNP enrollment has more than doubled since 2024 and now accounts for a significant portion of Medicare Advantage growth.
Key takeaways include:
- Most CSNP growth is concentrated around conditions such as diabetes, chronic heart failure, and cardiovascular disorders
- Carriers are investing heavily in this space due to increased reimbursement opportunities
- UnitedHealthcare continues to lead nationally, while Devoted Health has become a major CSNP player in many markets
Agents who are not already incorporating CSNP opportunities into their portfolio and client conversations may be missing an important growth area.
ACA Open Enrollment is Underway
ACA Open Enrollment is now open, and Ronnie provided several updates on the marketplace landscape.
The highlights include:
- Premiums are increasing in many markets
- Some carriers are expanding while others are reducing marketplace participation
- More than 1,200 counties are expected to have two or fewer carrier options, reducing competition in certain areas
Ronnie encourages agents offering ACA to explore the resources now available through IntegrityCONNECT.
ACA Tools Available in IntegrityCONNECT
Agents can now access ACA enrollment tools directly through IntegrityCONNECT, including:
- Stride, Integrity’s enrollment platform
- HealthSherpa integration, allowing agents to continue using HealthSherpa while syncing policy visibility into IntegrityCONNECT
The major advantage is having ACA and Medicare business accessible through a single platform, helping agents manage their entire book of business more efficiently.
Log in to IntegrityCONNECT today and explore the ACA Dashboard.
*Contact us if you have questions, need assistance, or would like to schedule a technology training with a Tidewater team member.*
ACA Alternatives Worth Exploring
Recognizing that some clients may struggle with increasing ACA premiums, Ronnie reminded agents that alternative solutions are available.
A few carriers that could be alternatives include:
- UnitedHealthcare Golden Rule products, including short-term medical, indemnity, and supplemental coverage options
- ManhattanLife Affordable Choice
Ronnie’s overall message was that agents should be prepared to present multiple solutions when appropriate.
Don’t Overlook Ancillary Opportunities
Ronnie emphasized that agents who have clients choosing lower-premium Medicare Advantage plans often create additional opportunities for ancillary products.
As give-back plans continue to perform well, agents should consider discussing:
- Cancer plans
- Hospital indemnity plans
- Home health care coverage
- Other protection products that help address potential gaps in coverage
These conversations not only provide additional protection for clients but can also help agents grow their business through cross-selling opportunities.
Explore Tidewater’s ancillary and supplemental coverage products here.
Learn how to elevate client coverage through cross-selling here.
A Valuable Resource for Senior Clients: Aging Life Care Managers
The call also briefly addressed the role of Aging Life Care Managers.
These professionals help coordinate care, navigate healthcare systems, assist families with transitions, and connect seniors with appropriate resources. Ronnie noted that awareness of these services remains low, despite high satisfaction rates among families who use them.
For agents working with aging clients, this can be a valuable resource to recommend when families need additional guidance and support.
Long-Term Care is an Important Conversation
The call concluded with an important reminder about long-term care planning.
Ronnie shared that many Americans mistakenly believe Medicare will cover long-term care expenses. In reality, clients need to prepare through savings, Medicaid eligibility, or long-term care insurance solutions.
As healthcare costs continue to rise, agents have an opportunity to educate clients and help them plan before a care need arises.
Final Thoughts
November’s Office Hours call was a timely mid-AEP reminder that success this season isn’t just about today’s enrollment. It’s about building relationships, staying informed, adapting to market changes, and continuing to provide value to clients.
With about one month left in AEP, you still have plenty of opportunities. Stay focused, continue having meaningful conversations, and remember Ronnie’s advice: play the long game and finish strong.
We’ll see you next month at December Office Hours as we wrap up the last few days of AEP and help you position yourself for success as we head into the first of the year after the enrollment season.
For agent use only. This information is subject to change.
