Broker Compensation Guide

Transcription

1 2014 Broker Compensation Guide

2 10 Great Reasons to Choose Starmark 1. Affordable coverage through flexible self-funded health plan designs, including HSA-friendly plans. Employers can customize plans to meet their needs and budget. 2. Strong network access and in-network discounts with access to national and regional PPO networks, plus network access while outside the primary PPO area. 3. CareChampion 24/7 health advocacy program 1 to help employers and members navigate the healthcare system. 4. Healthy Foundations, a comprehensive suite of health and wellness management tools, helps maximize the health potential of every plan member. Plus, plans include a discount program 2 for vitamins, and vision and hearing services/supplies. 5. Easy employee enrollment online or via telephone through Express Connect Seamless integration of claims processing and HRA administration with the Starmark HRA. 7. Unparalleled personal service, including a personal welcome call for each new group. Plus, Starmark follows up to ensure customer satisfaction continues throughout the year. 8. A complete benefit offering, with ancillary plans including dental PPO and indemnity plans, access to vision insurance 4 and more. 9. Convenient online tools help brokers sell new groups and retain existing business. 10. Quick access to information through makes plan administration easy for employers. Plus, members can view claims and a summary of benefits, as well as access tools and information to better manage healthcare costs. 1 CareChampion 24/7 is an optional benefit. 2 The discount program from New Benefits, Ltd., a discount medical plan organization, is not insurance and is not available with Starmark HealthyEdge SM plan designs or Vermont residents. Trustmark and Starmark are not affiliated with New Benefits, Ltd. 3 Express Connect availability may vary by state. 4 Fully insured vision plans offered through EyeMed are underwritten and insured by Fidelity Security Life. Trustmark and Starmark are not affiliated with EyeMed Vision Care or Fidelity Security Life Insurance Company. The growth and success of the Trustmark Companies is a long, proud story. For over a century, we ve been providing the kind of financial security that has helped businesses and families realize their own visions and dreams. Each and every day, we make good on our promise to treat each challenge that comes our way with fairness and the highest level of integrity. Personal. Flexible. Trusted. These words are our creed, and we live them every day.

3 2014 Broker Compensation Guide Table of Contents Starmark s broker compensation puts meaningful financial rewards within easy reach. Use this guide to learn more about our broker compensation programs, policies and administrative practices. The information contained within this guide applies to Starmark products and services. I. Compensation Schedules II. General Policies & Practices...7 III. Compensation...10 IV. Cancellations and Reinstatements & Rescissions...13 V. Terminology/Definitions VI. Online Resources

4 Broker Stop-Loss and Medical Compensation Schedules I. Compensation Schedules The compensation percentage is paid based on the number of eligible employees enrolling at the time the group is issued and remains in effect until the renewal of that group regardless of any changes in the group size during that time. Premium is used to calculate the payable compensation for the group which increases or decreases based on add-ons or terminations after issuance. The schedules reflect our standard compensation payable for groups with five or more enrolled lives. We reserve the right to pay non-standard compensations for groups of 51+ lives. Starmark HealthyEdge SM State Where Available (Except WA) First-Year Compensation (standard level) Compensation for Subsequent Policy Years (standard level) 11% * 10% * Washington 7.8% ** 7.8% ** ** All compensation is based on a group s paid stop-loss premium. Stop-loss premium is the amount that is paid monthly before administration and claim prefunding expenses. Brokers have flexibility with first-year compensation. Ask your Starmark representative for more information. ** All compensation is based on a group s paid stop-loss premium and claim prefunding. Stop-loss premium and claim prefunding are the amounts that are paid monthly before administration expenses. Washington (WA) does not allow any variance from standard commissions. Not withstanding anything in this Compensation Guide to the contrary, compensation and bonus schedules may be changed or discontinued at any time at Starmark s discretion, or as required by any state or federal authority. The HealthyEdge compensation schedules described here are for new business and renewal cases issued on or after June 1,

5 Broker Stop-Loss and Medical Compensation Schedules Starmark Healthy Incentives State Where Available (Except WA) First-Year Compensation (standard level) Compensation for Subsequent Policy Years (standard level) 16% * 12% * Washington 7.8% ** 7.8% ** ** All compensation is based on a group s paid stop-loss premium. Stop-loss premium is the amount that is paid monthly before administration and claim prefunding expenses. Brokers have flexibility with first-year compensation. Ask your Starmark representative for more information. ** All compensation is based on a group s paid stop-loss premium and claim prefunding. Stop-loss premium and claim prefunding are the amounts that are paid monthly before administration expenses. Washington (WA) does not allow any variance from standard commissions. Not withstanding anything in this Compensation Guide to the contrary, compensation and bonus schedules may be changed or discontinued at any time at Starmark s discretion, or as required by any state or federal authority. The Healthy Incentives compensation schedules described here are for new business and renewal cases issued on or after August 1,

6 Broker Ancillary Compensation Schedules Dental State All Active States Group Size First-Year and Renewal Compensations Two to % 26 to % 51 to % 76 to % % Not withstanding anything in this Compensation Guide to the contrary, compensation and bonus schedules may be changed or discontinued at any time at Starmark s discretion, or as required by any state or federal authority. Life/AD&D, Short-Term Disability (STD), Long-Term Disability (LTD) State All Active States (Except AK and TX) Group Size First-Year Compensation Renewal Compensation Two to % 6.5% 11 to % 5.5% 26 to % 4.5% % 2.5% Alaska Two to % 5.0% 51 to % 4.5% % 2.5% Texas Two to % 6.75% 11 to % 5.75% % 4.75% Not withstanding anything in this Compensation Guide to the contrary, compensation and bonus schedules may be changed or discontinued at any time at Starmark s discretion, or as required by any state or federal authority. The dental compensation schedule is for dental cases sold after September 30, The fully insured ancillary compensation schedules are for new business and renewal cases issued on or after October 1,

7 General Policies & Practices Disclaimer: If there is any conflict between this Broker Compensation Guide and the Broker Agreement, the Broker Agreement shall prevail. II. General Policies & Practices Address Changes To ensure timely and accurate compensation payments, brokers should promptly report any change in or mailing address to Starmark and the State Department of Insurance. Starmark can be reached by calling , ext or by ing the new information to Advertising, Sales and Promotional Materials Brokers shall utilize only sales materials previously authorized in writing by Starmark and shall adhere to all MGA and Starmark advertising policies. Brokers cannot use the Starmark or Trustmark Life name, trademark or logo without prior written consent. Assignment A Broker of Record may assign to another broker or agency his or her compensation. The assignee must be licensed in the state the group is located and appointed with Trustmark Life Insurance Company. Once compensation is paid to an agency, it can only be changed to pay another entity by obtaining a written release from the agency or by obtaining a letter from the group confirming that their broker has established a new business relationship with them. All compensation changes will take effect on the first of the month following 30 days after receipt of the request. We reserve the right to reject any request for assignment. Assumed Blocks of Business Business assumptions and block of business rollovers will require approval from Starmark and may be excluded from standard compensation and bonus programs. Bonus Bonus programs and/or special incentive programs may be available to brokers throughout the year. The bonus period may vary from program to program. Bonuses earned are noted on the compensation statement. Bonus statements are communicated separately. If compensation on a group is split between two or more brokers, the bonus will be communicated to the Broker of Record and payment will be split using the same percentage as the compensation payment split. Bonus payments may be subject to recovery from future compensation if groups used in the bonus calculation cancel during the first 12 months of coverage. All of the bonus programs information and rules can be located at Broker Agreement Brokers must execute a Broker Agreement in order to sell Starmark products. In the event that a state or federal law or regulation, or any regulatory or any enforcement action should require that this Agreement be changed, altered or modified, then Starmark or Trustmark Life will provide the broker with written notice of required amendments to this Agreement which shall become effective upon sending such notification to Broker. Starmark or Trustmark Life may otherwise amend or amend and restate by providing prior written notice of such amendment to Broker. Failure of Broker to object in writing to such proposed amendment within 30 days following receipt thereof shall constitute Broker s acceptance of such amendment. See your Broker Agreement for details. Broker Business Associate Agreement As required by federal law and applicable regulations issued by the U.S. Department of Health and Human Services, Trustmark requires all brokers to enter into a Business Associate Agreement ( BAA ) with Trustmark and brokers must comply with the BAA s terms including, without limitation, restrictions on use and disclosure of protected health information and notifications regarding any impermissible use or disclosure of protected health information. 7

8 General Policies & Practices (Cont.) Broker of Record Changes A group may request a Broker of Record change in writing. The request must be on company letterhead, signed by an officer or owner of the group, and currently dated. Starmark will notify the existing Broker of Record and the original managing general agent on the group via when a request for a Broker of Record change has been made, provided a current address is on record. The change will take effect on the first of the month following 30 days after receipt of the request and when the newly requested broker is properly licensed and appointed with Starmark. If a Broker of Record change is requested during the first 12 months of the group becoming effective, compensation will be paid to the new Broker of Record after the first-year vesting period has ended for the writing broker. It is the responsibility of the new Broker of Record to confirm our receipt of the notification of change in Broker of Record. We will not pay compensation to the writing broker for the first 12 months if the writing broker was not licensed in the state as of the date the employer application is signed. If we receive a Broker of Record change from a group whose writing agent was not licensed as of the date the employer application was signed, we will honor the Broker of Record change and pay compensation to the new broker, as long as the new broker is properly licensed as of the date of the Broker of Record change, on a going forward basis. We will not allow a retroactive change to the Broker of Record, which would result in paying retroactive compensation back to the date the employer application was signed. Groups with Broker of Record changes that impact the medical persistency bonus will be removed from the original writing agent s calculations retroactive to the January 1st benchmark as long as the group does not terminate before the new Broker of Record is effective. If the group terminates before the new Broker of Record is effective, the group will be included in the original writing agent s January 1st benchmark and persistency calculations. For new business, when a group is in the first year and there is a Broker of Record change, the new business bonus will pay to the original writing agent. If there are outstanding licensing requirements, the new broker must submit the paperwork prior to the effective date of the change. If the required paperwork is not received by this date, the original broker will remain the Broker of Record. Paperwork received after the effective date will require the new broker and group to resubmit their request, resulting in a new effective date. The new broker, original broker, MGA for the group and the group are sent confirmation letters of the change. MGAs are vested for life on a group. Request for an MGA record of change can only be considered for review when received from the current, active Broker of Record. 8

9 General Policies & Practices (Cont.) Document Center Immediate, secure and around-the-clock access to important Starmark documents is available online for brokers, employers and members. Documents available in the Document Center for you to service your groups include; Plan Document, Stop-Loss Insurance Contract, Administrative Services Agreement, Monthly Aggregate Claim Liability Summaries and Application for Stop-Loss Insurance Coverage. Your groups and their members also have access to the Document Center to access their important documents. To access documents in the Document Center, you are required to register on the Starmark website and accept the terms and conditions. Licensing and Appointment As required by state law, a state appointment will be made upon submission of the broker s first piece of business, except in states where pre-appointment is required. Brokers are responsible for knowing and complying with all applicable state regulations regarding licensing and appointments. A completed Appointment Questionnaire, available via the Starmark website, must be submitted in order for a broker appointment to be made. Although Errors and Omissions (E&O) coverage is not required for appointment, it is highly recommended that brokers secure this coverage. Please note that many E&O carriers require a separate rider be purchased when selling stop-loss insurance. Trustmark Life Insurance Company is responsible for any initial appointment fees due to the state(s) in which the broker will write business. The first completed application must be issued by Starmark within 18 months of the initial appointment. If no new applications taken by the broker are issued within an 18-month period, or if no business remains in-force, Trustmark Life Insurance Company will not continue to pay the broker s appointment fees, unless otherwise required by law. Pursuant to state requirements and Starmark policy, when compensation is payable to an agency, both the agency and the broker must be licensed and appointed in the state where the business is being written. Trustmark Life Insurance Company complies with all state and federal regulations. We reserve the right to require a credit and/or criminal report on any broker applying for an appointment and will comply with any states requiring a credit and/or criminal report. Premium Refunds At times, premiums will be refunded to employers in accordance with usual business practices and applicable laws/regulations. Amounts equal to compensation paid on refunded premiums will, at Trustmark s discretion, be deducted from earned compensation and/or bonus amounts otherwise payable to the broker and/or demanded from the broker. Renewal Commissions The states of Ohio and Massachusetts require anyone receiving renewal compensation payments to maintain an active license. Renewal compensation payments, for any group situs in these two states, will cease on any broker or assignee that does not have an active license. 9

10 General Policies & Practices (Cont.) Compensation Unlicensed Brokers A broker unlicensed at submission of new business will not be paid compensation for the first year. Payment can begin at renewal provided he/she has obtained a valid license. Texas is an exception to the rule above: Texas - If license is renewed within 90 days, no gap in license, compensation should be paid. If license is not renewed within 90 days, gap in license, no payment of compensation while license is lapsed. Payment would begin upon renewal. Vesting Compensation will be payable to the broker for the first year the coverage is in-force, even if a request is made in that time frame to name a new Broker of Record. After one year of coverage in-force, compensation is not vested. III. Compensation Compensation Schedule/Bonus Changes If state laws or federal regulatory authorities requiring minimum loss ratios or maximum expense ratios are enacted federally or in any state, Trustmark Life Insurance Company will comply with the law in a way that may entail a change in our compensation schedule and/or provisions or eliminations of such compensation. Any such change or elimination will apply to all policies and/or certificates, in such cases, either as each policy/certificate renews or as otherwise required to comply with the law. We may modify or terminate compensation and/or bonus programs at any time, for any reason unless state law prohibits such a change. Compensation Splits A completed Compensation Notice is required to indicate that compensation on a group is to be split between two or more brokers. Renewal and other administrative correspondence will be directed to the primary Broker of Record. 10

11 Compensation (Cont.) Compensation Ownership & Changes The Broker of Record is considered the owner of compensation for the group. The Broker of Record must initiate any change to whom compensation payment is made while he or she is considered by the group to be the Broker of Record unless payment is being made to their agency. A broker may submit a new Compensation Notice or signed letter detailing requested changes to whom payments are to be made. If compensation is assigned to an agency, a release from the agency will be required. Starmark is not responsible for enforcing any payment agreement between a broker and an agency. The release from the agency must be a letter on the agency s letterhead, contain a current date and be signed by a responsible party from the agency. The new entity must be appropriately licensed and appointed. All compensation changes will be effective the first of the month following the receipt of the request. Non-Commissionable Business Brokers who retain a separate agreement/arrangement on their compensation with a group will not be considered for Starmark bonus programs. Other non-commissionable business for reasons other than a separate agreement/arrangement will be reviewed for determination of eligibility for bonus programs. Direct Deposit/Manual Check Compensation payments are paid via direct deposit. Direct deposit compensation is sent to the specified bank on the first business day of the month. Please allow two to three business days for the bank to process the deposit. An is sent to confirm payment. Compensation statements are sent within the first five business days of the month. In special cases when a compensation paper check is requested rather than direct deposit, a minimum of $100 of earned compensation is required prior to issuing a paper check. There is no minimum amount of earned compensation for payments made via direct deposit. To ensure timely and accurate compensation payments, promptly report any change in address, including address changes, to the Starmark Broker Compensation and Vendor Payments Department at , ext or at Lic-comm@starmarkinc.com. Additionally, you should report any changes to your State Department of Insurance. 11

12 Compensation (Cont.) Indebtedness Indebtedness means all advances, loans, charge-backs, compensation paid in error, overpayments, and other customary account charges. The broker promises to pay indebtedness incurred to Trustmark Life Insurance Company on request, or we will withhold all compensation, bonuses or other compensation otherwise due to the broker or agency until the overpayment is repaid in full. Trustmark Life Insurance Company reserves the right to withhold compensation earned from other lines of business to repay indebtedness. Compensation is not payable on premium collected through a collection agency or other collection method. Payment Determination, Timing & Reporting Compensation is paid on the first business day of each month for any group payment applied in the prior month. The compensation percentage is paid based on the number of eligible employees enrolling at the time the group is issued and remains in effect until the renewal of that group, regardless of any changes in the group size during that time. Cost is used to calculate the payable compensation for the group, which increases or decreases based on add-ons or terminations after issuance. Compensation will be the percent of the premium, as set forth in the company s standard Compensation Schedule, received and retained by Starmark for coverage sold and issued during the period for which compensation is payable, and during which the broker is recognized by Starmark as Broker of Record and complies with applicable laws, regulations and the standards of Trustmark Life Insurance Company. Retroactive changes to employee counts or premiums will be applied to the compensation rate that was in effect for the month the adjustment was made. Brokers who earn more than $600 in compensation each year will be mailed an IRS Form 1099-MISC by January 31. Brokers earning less than $600 should report their earnings and use their compensation statement as reference. Starmark s Understanding Your Starmark Commission Statement Report flyer (T701-15) is an effective tool to aid understanding of the compensation statement. This brochure is available on the Starmark website. Trustmark Life Insurance Company is the final arbiter of any issues related to compensation or bonus programs. 12

13 Cancellations, Reinstatements, Rewrites & Terminology IV. Cancellations and Reinstatements & Rescissions Cancellations If a policy or coverage is surrendered, rescinded or cancelled, and premiums are refunded or waived, the broker will in all cases lose the rights to corresponding compensation. Any compensation payments made on refunded or waived payment will require repayment on demand. Reinstatements & Rescissions In the event a policy lapses because payment is not paid and the policy is reinstated, compensation on the new or reinstated policy is only payable at our discretion. If it is necessary to rescind coverage for any policy, the broker will promptly refund us any compensation received for that case. V. Terminology/Definitions For purposes of information contained within this guide: First-year Compensation defined as monthly compensation payable during the initial 12-month term of a policy s coverage. Renewal Compensation defined as monthly compensation payable during the term of a policy s coverage other than the initial 12-month term. Employee(s) refers to the covered employee or employee-covered lives. Group is used to identify the employer, case, customer, client and policy. These terms may be used interchangeably and refer to the entity purchasing the insurance coverage(s). Broker is used to identify the Agent, Broker, and Writing Agent. Starmark Self-funded plans are administered by Starmark, and stop-loss insurance is provided by Trustmark Life Insurance Company. Trustmark Life Insurance Company may be referred to in this guide as Trustmark or Trustmark Life 13

14 Online Resources VI. Online Resources Starmark provides many online resources to help you sell, install and maintain your business, and stay up-to-date with the changing marketplace and healthcare reform. Our website offers a wealth of information with convenient access for you, employers and members. Accessing information is easy! Get started today Step 1: Go to Step 2: Select Broker from the drop-down menu Step 3: Register or login Our online resources provide brokers with a virtual office, 24/7. Through our website, you may access the following information: Administration forms to assist your clients with plan administration Compensation broker compensation schedules and bonus programs, compensation administration, appointment paperwork Document Center Access your groups important Starmark documents, including Plan Document, Stop-Loss Insurance Contract, Administrative Services Agreement, Monthly Aggregate Claim Liability Summaries and Application for Stop-Loss Insurance Coverage. Networks network listing and service area ZIP codes along with provider look-up News links to resources such as our broker newsletter, healthcare reform blog, health and wellness blog, toolkits and our Twitter feed Pharmacy formulary and other drug lists, brochures on pharmacy programs, and pharmacy locator Renewal renewal packets for your clients and FAQs about the renewal process Sales Tools/State Resources access online toolkits for product brochures, flyers, videos and healthcare reform information. Plus, find all the state resources you need, including statespecific applications, brochures and materials. State Resources state-specific brochures and applications, and Broker Guide Underwriting medical questionnaires and guidelines Stay up-to-date with what s going on! When you visit the News section of the Starmark website, you can access links to our broker newsletter, healthcare reform blog, and health and wellness blog. From each of these sites you may sign up to receive notifications of new posts by entering your address in the subscription box. 14

15 Trustmark and Starmark a long history of serving our customers We hold true to three core corporate values: Personal, Flexible and Trusted. We follow through on our commitments, provide personal service, and offer innovative, customizable products. About The Trustmark Companies: In business since 1913 for more than 100 years $1.9 billion in total assets 3,000 full-time and 4,100 part-time employees 25+ offices nationwide More than 2 million covered lives or plan participants Trustmark Life is rated A- (Excellent) by A.M. Best About Starmark: Part of the Trustmark Companies Provides group health benefits to small to mid-size employers Offers customizable products with self-funded plan designs Secure and convenient paperless employee enrollment through Express Connect Customer-centric approach Online tools make administering health plans easier My experience with Starmark has been outstanding. They have provided exceptional customer service, punctual responses and excellent reporting. Starmark is on the cutting edge in the industry. ~ Rick Herdes, Benefits 7, Inc. To learn more about Starmark and Trustmark, visit 15

16 Trustmark, an employee benefits company for over 100 years, is dedicated to providing financial security, improving health and well-being, and helping people navigate the healthcare system. Serving more than 2 million covered lives or plan participants, Trustmark is rated A- (Excellent) by A.M. Best. Self-funded plans are administered by Starmark, and stop-loss insurance is provided by Trustmark Life Insurance Company. With expertise in group healthcare benefits, Starmark offers self-funded plan designs, tools to manage healthcare costs, paperless employee enrollment, nationwide network access and seamless HRA administration for small to mid-size businesses. Plan design availability and/or coverage may vary by state. Self-funded plans are administered by Starmark, and stop-loss insurance is provided by Trustmark Life Insurance Company. PERSONAL. Flexible. Trusted. With expertise in group healthcare benefits, Starmark offers self-funded plan designs, tools to manage healthcare costs, paperless employee enrollment, nationwide network access and seamless HRA administration for small to mid-size businesses. 400 Field Drive Lake Forest, IL Star Marketing and Administration, Inc. S (12-13)