Business Continuity Plans under 422.504(o) and 423.505(p)

Attachment 5c – Initial and Total Compensation Excel
Workbook “Agent Compensation Information” (Attachment 4).

Instructions
For any MA or PDP organization that did not sell products
through agents and brokers in any given year, such
organization is not required to provide such information
for such year. Nonetheless, every organization must
provide 2019 information and information for the other
years in which they participated in Medicare Advantage and
the prescription drug programs.
In addition to the compensation structures requested in
attachments 2a and 2b, each MA and PDP Parent Organization
must submit a separate CMS template Excel workbook
(Attachment 4 - Agent Compensation Information Workbook)
that provides data on both the Initial and Life
Compensations paid in 2016 – 2018, and the compensation
schedule set for 2019. This information must be provided
describing the compensation paid directly to writing agents
(street level) by the plan; compensation paid directly to
writing agents (street level) by marketing organizations
contracted by the plan; and the compensation paid by the
plan to the contracted marketing organizations. Structure
of Excel Workbook


The excel workbook is divided into separate worksheets
for years 2016 through 2019. For each year, it is also
divided into three worksheets:
o “Marketing Organizations” – Collects data on
compensation paid by an MA or PDP Organization to an
intermediary, such as a field marketing
organization.
o “Writing Agents (Plan Paid)” - agents paid directly
by the MA and PDP Organizations, and
o “Writing Agents (M.O. Paid) – agents paid directly
by marketing organizations contracted by the plan

Finally, each worksheet for years 2016-2018 is also divided
to include both initial compensation actually paid and
total compensation expected to be paid over the life of the
compensation structure.

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Years 2016-2018 Initial Compensation Actually Paid


For each of the years 2016 through 2018, the following
data must be provided for initial compensation actually
paid under structures applying to payment in three
situations. This information must be provided describing
the compensation paid directly to writing agents (street
level) by the plan; compensation paid directly to
writing agents (street level) by marketing organizations
contracted by the plan; and the compensation paid by the
plan to the contracted marketing organizations:


o Contract/pbp number.
o Number of beneficiaries -- This number is the
numberof beneficiaries enrolled in that contract/pbp
in that year for which the compensation was paid.
o Minimum – This is a number calculated based on the
initial compensation actually paid from the year’s
structure(s) with the lowest initial compensation
for that contract/pbp. Minimum equals the total of
all the initial compensation actually paid from such
structure(s) divided by the number of beneficiaries
whose enrollment was paid for under such
structure(s).
o Maximum – This is a number calculated based on the
initial compensation actually paid from the year’s
structure(s) with the highest initial compensation
for that contract/pbp. Maximum equals the total of
all the initial compensation actually paid from such
structure(s) divided by the number of beneficiaries
whose enrollment was paid for under such
structure(s).
o Mean -- This is a number calculated based on the
initial compensation actually paid from all the
year’s structure(s) applicable to that contract/pbp.
Mean equals the total of all the initial
compensation actually paid from all the
structure(s) applicable to that contract/pbp,
divided by the number of beneficiaries whose
enrollment was paid under such structure(s).
o Median -- This is a number derived from calculating
the initial compensation actually paid for each
schedule applicable to that contract/pbp. The median
is derived by arraying all the initial compensation
values from low to high and selecting the midpoint

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value. If there are an even number of values, and,
therefore, no midpoint value, calculate the median
by averaging the two values closest to the midpoint.
Years 2016-2018 Total Compensation Expected to be Paid over
Life of Compensation Structure
Note: when completing the required templates, for the “life
cycle” compensation, enter the total amount an agent could
potentially be paid if the beneficiary the agent helped
enroll stays in that plan.


For each of the years 2016 through 2018 the following
data must be provided for total compensation actually
paid over the life of the compensation structures
applying to payment in three situations. This
information must be provided describing the compensation
paid directly to writing agents (street level) by the
plan; compensation paid directly to writing agents
(street level) by marketing organizations contracted by
the plan; and the compensation paid by the plan to the
contracted marketing organizations: : o Contract/pbp
number.
o Number of beneficiaries -- This number is the number
of beneficiaries enrolled in that contract/pbp in
that year for which compensation was paid.
o Minimum – This is a number calculated based on the
total compensation expected to be paid from the
year’s structure(s) that have the lowest total
compensation amount paid over the structure’s life
for that contract/pbp. Minimum equals the total of
all the expected compensation to be paid over the
life of the structure(s) divided by the number of
beneficiaries whose enrollment in that year was
initially paid for under such structure(s).
o Maximum – This is a number calculated based on the
total compensation expected to be paid from the
year’s structure(s) with the highest total
compensation amount paid over the structure’s life
for that contract/pbp. Maximum equals the total of
all the expected compensation to be paid over the
structure(s) life divided by the number of
beneficiaries whose enrollment in that year was
initially paid for under such structure(s).

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o Mean -- This is a number calculated based on
thetotal compensation expected to be paid over the
structure’s life represented by all of the year’s
structure(s) applicable to that contract/pbp. Mean
equals the total of all the expected compensation to
be paid over the life of all the structure(s)
applicable to that contract/pbp, divided by the
number of beneficiaries whose enrollment was
initially paid under such structure(s)in that year.
o Median -- This is a number derived from calculating
the total compensation expected to be paid over the
structure’s life for each schedule applicable to
that contract/pbp. The median is derived by arraying
all the total compensation values from low to high
and selecting the midpoint value. If there are an
even number of values, and, therefore, no midpoint
value, calculate the median by averaging the two
values closest to the midpoint.
Year 2019 Initial and Renewal Year Compensation
and Compensation Paid over the Life of the Structure
– Contracted Marketing Organizations
For 2019, the following data must be provided for
structures applying to payment to contracted marketing
organizations (Worksheet: “2019 Marketing Orgs”):
o Contract/pbp number – Provide each contract/pbp
number in as many rows as there are compensation
structures that apply to it.
o Structure number – Provide each unique number
identifying each compensation structure applicable
to the contract/pbp number. (The structure number
should match the structures submitted under
Attachment 2a.) o Initial Compensation – Enter the
amount to be paid to the contracted marketing
organization for an initial enrollment.
o Renewal Years – Enter the amount to be paid to the
contracted marketing organization for renewal
compensation. The spreadsheet has ten renewal years
listed - complete as many renewal years as needed
for life cycle structure. Do not delete columns – if
no commission is paid in a renewal year listed on
the spreadsheet enter a zero (0).

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o Number of Agents – Enter the number of agents
contracted to sell under the compensation structure
for that contract/pbp. (As of November 15, 2008)
Year 2019 Initial and Renewal Year Compensation and
Compensation Paid over the Life of the Structure - Writing
Agents (Paid by Plan and Paid by Marketing Organization)


For 2019, the following data must be provided for
structures applying to payment to agents and brokers
paid directly by the MA and PDP organization (Worksheet:
“2019 Writing Agents (Plan Paid)”) and payment to agents
and brokers paid by marketing organizations (Worksheet:
“2019 Writing Agents (M.O. Paid)”):
o Contract/pbp number – Provide each contract/pbp
number in as many rows as there are compensation
structures that apply to it.
o Option One or Option Two: Plans should indicate “1”
or “2” indicating which option they used for
calculating the 2019 renewal compensation amount.
o Structure number – Provide each unique number
identifying each compensation structure applicable
to the contract/pbp number. (The structure number
should match the structures submitted under
Attachment 2b.) o Initial Compensation – Enter the
amount to be paid for an initial enrollment. This
amount should equal 200 percent of the annual renewal
compensation amount.
o Renewal Years 1 through 5 – Enter the renewal
compensation amount to be paid in each of the years
1 through 5. This amount should be calculated in
accordance with the instructions in Attachment 5b,
under “2009 Compensation Structures”, and should be
the same for all renewal years.
o Number of Agents – Enter the number of agents
contracted to sell under the compensation structure
for that contract/pbp. (As of November 15, 2008)

Other Instructions


Complete the sheets exactly as requested. Plans must use
the Excel format provided:
o The workbook should be at the Parent
Organizationlevel.

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o Round to whole dollars, no punctuation, no
decimalpoints.
o Put only one dollar amount in each cell.o Insert “0”
if the value is zero.
o If there are no data for a year, leave cell(s)blank.
o Do not modify the worksheets in any way.
o If the same values apply to multiple
contract/PBPs,enter those amounts multiple times
(separately for each contract/PDP).


Save the file in Excel 2003 version.
o Use the naming convention “Attachment[insert
Attachment number]_Organization_[insert additional
identifying information as necessary]”



For those organizations using Option 1, submit the
certification (Attachment 1b) by November 13, 2018. In
addition, all organizations (including those
organizations using Option 1) must submit all remaining
data and certification 1a in a zip file to
[email protected] no later than
November 17, 2018.

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