Welcome to 2025: Embracing Change in Medicare

The first episode of Insurance360 in 2025 brings to light the slew of changes set to impact Medicare agents, especially those dealing with dual-eligible plans. Traditionally, the Medicare landscape has been dynamic, with new regulations continuously reshaping how business is conducted. This year is no different.

Key Changes to SEPs

One of the most significant changes is the elimination of the quarterly SEP for dual eligible and LIS beneficiaries. In 2025, beneficiaries who qualify for LIS or dual special needs plans (DSNP) will no longer have the quarterly SEP option. This is a substantial shift that agents must adjust to, as it alters how they plan their business strategies throughout the year.

Additionally, the monthly Integrated Care SEP has been introduced. This is available to full dual eligible beneficiaries in areas where Fully Integrated Dual Eligible (FIDE) or Highly Integrated Dual Eligible (HIDE) plans are offered. Although not applicable in all states, agents need to understand the specifics of this SEP, as it provides monthly enrollment opportunities for eligible individuals.

Impact on Marketing and Strategy

For agents, these changes mean reassessing how they build and retain their client base. The absence of the quarterly SEP makes retention strategies even more crucial. Educating clients on these changes, ensuring they understand their options, and reminding them to consult their agent before making any changes are key components to maintaining a stable book of business.

Special Guest Nikki Skubal from Aetna emphasizes that while these changes seem daunting, they offer a chance for agents to focus on retention and strategic growth. She suggests leveraging tools like the Benefits Checkup program at https://benefitscheckup.org/, which helps identify clients eligible for LIS or other benefits, potentially opening new SEPs for enrollment.

Adapting to a New Normal

The landscape of Medicare is one where agents must always be ready to adapt. While these new rules present challenges, they also offer opportunities to redefine business strategies, deepen client relationships, and refine marketing tactics. With services like Aetna’s Benefits Checkup and support from both carriers and agencies, agents can navigate these waters effectively.

As Nikki advises, contacting support teams such as Pinnacle or Aetna broker managers is crucial when questions arise. Staying informed, being nimble, and maintaining a commitment to client service are the best ways to ensure success in this ever-changing market.

Looking Forward: Embracing 2025 and Beyond

The Medicare landscape continues to be one of complexity and opportunity. Embracing these changes with a proactive mindset will equip agents to meet the challenges of 2025 and excel within them. As always, the ultimate goal remains the same: providing the best possible service to those in need.

Follow Pinnacle’s YouTube channel and social media for ongoing updates and best practices. While the influx of information may seem overwhelming, leveraging these resources will help streamline and simplify the process for both agents and their clients.

Watch the full Insurance360 podcast episode here: https://youtu.be/x-aaj2sL_xM

The ever-evolving world of insurance can feel overwhelming, especially during critical times like the Annual Enrollment Period (AEP). In a recent episode of Insurance 360, Pinnacle Financial Services’ podcast, hosts Bob Brzyski, VP of Marketing, and Rob Valincius, National Agent Training Director, sat down with Greg Yodis, Senior Sales Director of Life, Annuity, and Long-Term Care, to discuss pressing challenges in the industry and how agents can adapt.

From the complexities of Medicare Advantage plans to the importance of long-term care insurance, this episode delivers invaluable insights for agents navigating an unpredictable market.

Midway Through AEP: Challenges and Opportunities

As we hit the midpoint of the AEP, many agents are feeling the pressure of unexpected developments. Changes in commission structures and shifts in plan availability on quoting platforms have introduced new challenges. Carriers suppressing commissions or moving plans off electronic platforms force agents to navigate manual applications, creating logistical hurdles and complicating the trust dynamic between agents and carriers.

Greg and the hosts explored how these dynamics impact not only agents’ workflows but also the beneficiaries they aim to serve. Staying flexible and client-focused, they stressed, is essential for successfully managing these disruptions.

Shifts in Medicare Advantage and Their Implications

Medicare Advantage plans are undergoing significant changes due to CMS rulings and carrier decisions. This evolving landscape has sparked debates about whether these shifts prioritize profitability over client needs. Greg shared insights on how agents can navigate these changes while staying client-focused, ensuring they remain advocates for beneficiaries’ best interests.

Spotlight on Long-Term Care: November’s Call to Action

November is Long-Term Care Awareness Month, making it the perfect time to highlight the importance of proactive long-term care planning. As Greg pointed out, this is often an overlooked yet critical aspect of a client’s financial future.

The episode dives into:

• The Need for Awareness: Many clients underestimate the impact of long-term care on their retirement savings and family resources.
• Innovative Solutions: Hybrid products like life insurance and annuities with long-term care benefits offer flexibility and affordability, making them ideal for clients who may not qualify for traditional policies.
• Proactive Strategies: Discussing alternative options, such as short-term care and other funding strategies, equips agents with solutions to align coverage with clients’ financial goals.

Why Long-Term Care Planning Matters

Greg Yodis stressed that long-term care planning isn’t just about securing coverage—it’s about protecting your clients’ financial independence and providing peace of mind for their families. By guiding clients through the options available, agents can help them safeguard retirement savings and align solutions with their unique needs.

Closing Thoughts

As AEP progresses and the insurance industry continues to shift, agents and clients alike must remain adaptable and informed. From navigating Medicare Advantage challenges to the importance of long-term care planning, the latest episode of Insurance 360 offers actionable insights to help agents thrive in an ever-changing environment.

💡 Don’t miss this insightful conversation! Watch the latest episode of Insurance 360 here: (link)

Join us in celebrating Long-Term Care Awareness Month by empowering your clients with tailored strategies to secure their financial futures.