Here’s what’s happening in the health, benefits, and senior insurance industry in 2024 so far. 

We’ve seen some things unfold in 2023 that have changed the insurance industry — and 2024 will have its own set of challenges and changes. Staying in tune with the health insurance marketplace is critical to building and maintaining a strong book of business. 

Since we’re only a few months into 2024, it’s a great time to explore trends and current events happening in the health, benefits, and senior space. Here are some of the key headlines that insurance professionals should be aware of.

Medicaid “Continuous Enrollment” Period is Ending 

During the COVID-19 pandemic, Medicaid was a key health insurance provider. Thanks to a “continuous enrollment” provision, unenrollments were paused, enabling many people to keep their coverage even if their income or circumstances changed. 

The unwinding of the Medicaid continuous enrollment provision was implemented in March 2023, requiring states to reevaluate eligibility requirements from April 1, 2023 to July 31, 2024. Throughout this process, Medicaid enrollees who are deemed ineligible or who can’t complete the renewal process will be unenrolled from Medicaid. Because of this, many people will be exploring their health insurance options — and looking to insurance agencies for guidance. 

New 48-Hour Rule for Electronic Scope of Appointment (SOA) Management Policies for Medicare Insurance Plans

The SOA is a form required for all new and renewal Medicare sales appointments. To improve transparency for customers, the SOA form provides them with a list of topics that may be discussed during this meeting. This ensures the insurance agent only discusses the products the client is interested in and prevents them from feeling pressured to buy additional products. New changes from the CMS Final Rule 2024, SOA forms must now be collected no less than 48 hours before your appointment.

This written documentation will be especially important since there’s been an ongoing issue where agents are changing some policyholders’ agent of record and enrolling them in ACA coverage without their consent. Having a centralized and easily accessible location to securely manage signed consent documents, conversations with prospects and clients, and other communications is essential to help protect both you and your customers. 

Pro tip: Use AgencyBloc’s AMS+ solution to easily manage your SOA forms and stay compliant. With AMS+, you can digitally send your SOA forms to clients and prospects. Once it is signed, AMS+ will attach it to that client’s profile for easy access and compliance peace of mind. 

Rising Health Insurance Costs

For 2024, health insurance premiums increased by 4% compared to 2023 — 35 states saw an increase in health insurance premiums, and 12 states saw a decrease. In South Dakota and Arizona, health insurance premiums decreased by 10% and 9%, respectively. 

Experts say that rates are likely to rise for the 2025 OEP, which may cause your clients to carefully consider their coverage options. Now is the time to begin adequately preparing for those conversations and implementing some tools that can lighten your workload during the OEP. 

Pro tip: Help your group insurance clients find the best coverage using AgencyBloc’s Quote+ solution. Quote+ allows you to provide your clients with the best coverage for their needs by simplifying the process of shopping and comparing medically underwritten, community rated, and ancillary product quotes in a single location. 

Changes to Medicare Advantage for the 2025 Contract Year Are in Progress

The Centers for Medicare and Medicaid Services (CMS) proposed a rule in November 2023 that would impact Medicare Advantage plans. This has stirred a lot of conversation among insurance professionals, as they are proposing changes to commission structures that would impact insurance agencies and their upline organizations. Many organizations have commented on the ruling, and their proposed changes are currently being considered by the CMS. Read the full ruling here: CMS Newsroom Fact Sheet. 

The CMS also released an advance notice in January 2024 for the 2025 calendar year. This notice proposed annual updates to payment policies for Medicare Advantage and Medicare Part D Prescription Drug Programs. This notice is designed to support and strengthen the Medicare Advantage and Part D programs. It also complements the proposed rule mentioned above. Read the full notice here: CMS 2025 Proposed Payment Updates.  

Key Themes for 2024 

In addition to the events and trends listed above, there are some ongoing themes you will want to keep in mind throughout 2024: 

• Generation Z continues to age out of their parent’s health plans. Generation Z started aging out of their parent's health plans in 2023. From now on, there will continue to be an influx of Gen Zers in need of health insurance. Because of this, agencies may want to invest in market research to ensure their marketing and sales strategies align with this new generation’s wants and needs. 
  
  Read this blog for more insight about marketing to different generations: 15 Quick Tips for Marketing and Selling to Different Generations.
  
  Pro tip: Not sure which of your contacts are aging out and turning 26? The workflow automation tools in AgencyBloc’s AMS+ solution can notify your team automatically whenever someone turns 26 (or is nearing it!), which can help your team act sooner and win the sale.
   
• Seamless, convenient digital experiences are expected. This expectation is especially prevalent among Gen Zers. However, this expectation is on the rise among people of all ages. Because of this, you want to prioritize your online presence. 
  
  Ensure you use various social media platforms, have a mobile-friendly, SEO-focused website, and use various forms of digital tactics like email marketing, blogs, text messaging, and more. 
   
• Education around life and health insurance continues to be critical. People still need to be educated on life and health insurance. For instance, Gen Zers, Millennials, and Gen Xers know they need life insurance — but many either don’t have any or don’t have enough. To overcome their hesitations, you will want to continue showing them the value of life insurance. 
  
  In addition, many individuals know they need health insurance. However, navigating the nuance of it can be daunting and confusing. And employers need your guidance around evolving employee expectations regarding their benefits packages.
  
  Use your marketing tactics to overcome these hurdles and earn their trust. Publish helpful blogs on your website, send educational emails, post informative social media content, and keep a pulse on industry trends. Doing these things builds not only trust, but a strong brand consumers will look to when they need coverage or advice.
   
• Artificial Intelligence (AI) continues to evolve and mature. AI continues to be a trending topic in almost every industry, and it’s expected to continue improving and evolving as time goes on. Insurance professionals are using AI to improve their efficiency and effectiveness—especially when it comes to the underwriting process and claims management. 

While these are promising use cases, keep in mind that AI and its capabilities are still in their early stages. There are some risks to be aware of when it comes to data security, compliance, privacy, and more.

What’s Next?

We can try to predict what will happen in the future; however, things can change rapidly. One thing we know for sure is how difficult it is to keep track of industry changes while staying effective and efficient. 

The health, benefits, and senior insurance space is ever-evolving, and new regulations are always coming out that require knowledge and compliance. Using the right technology can help your team accelerate growth while maintaining compliance, which is essential for day-to-day operations.

If you haven’t already, consider implementing an industry-specific management platform to help you and your team stay organized and optimized. AgencyBloc is an insurance-specific management platform that offers a suite of solutions, called the Plus Suite, designed to support individual health, group benefits, and senior insurance agencies, GAs, IMO/FMOs, call centers, and carriers. With AMS+, Commissions+, and Quote+, you’re easily able to expand your bandwidth, keep a pulse on industry changes and trends, and stay compliant.

Posted by Allison Babberl on Monday, March 4, 2024 in Health Insurance

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