Western Growers Assurance Trust is now Western Growers Health.
A new day is dawning at Western Growers Assurance Trust, and we’re excited to announce that we are now Western Growers Health!
This evolution reflects our dedication to innovation and our unwavering commitment to serving the agricultural community with excellence.
While our look may be new, our mission remains the same: delivering tailored, innovative healthcare solutions that meet the unique needs of the ag industry.
To learn more, visit wg-health.com.
Prepping For Medicare
July is a great issue, and we enjoy the many article contributions all centered on Medicare. Our next special issue is Group/Employee Benefits and will be the September issue. We appreciate our new advertisers, and we look forward to working with new advertisers and hope each of our subscribers give our advertisers a long look to do business with them in the future. Finally we welcome your client success stories too.
Prepping for Medicare AEP and Employer Open Enrollment
AEP last year was filled with changes, especially last-minute changes. With Wellcare PDP forcing major adjustments made on the fly with PDP clients during AEP many brokers “lost” commission income. To prepare for this year, take a look at Elliott Martin's article. Last AEP, the Martin Agency had success using video to educate clients to self-serve in many cases. The thought this AEP we are hearing from the street is how educating clients to self-direct through the process to get PDP quotes, when possible, can save time. Prerecorded videos made available via email, live Zoom client meetings, and then placed on an agency website seem to be options to get the client work done while using tech to save everyone time. Carrier changes with local marketplace provider changes is something to keep an eye on for all clients. Providers dropping plans due to "cost management” seems to be a real option as looming concerns rise up again. Providers are facing possible cuts to MediCal and an increase in the number of uninsured people landing in the emergency rooms. The response last year was providers either moving hard into managed care plans or hard away from MAPD. Add to this the MediCal trend how some medical groups in rural areas often make changes due to carrier contracting disagreements toward
year end, and this AEP could be a rough ride for brokers. Keep an eye on Med Supp carriers as both increases in premiums and reductions in commissions are being used by carriers to cover their costs.
Focusing on New Business
With many ways to grow your Medicare book, focus first on what your FMO can provide. Then, if you want to find how other FMOs focus on new business look at two articles which offer solutions to grow new business. First Sierra's and Financial Grade's articles on this topic provide tips and valuable tools to add new business. These two FMOs know how to grow new business. While each has unique tools they share in the commitment to their new business model which is focused on how to help brokers with personal support to either enter the Medicare business or grow more business with advanced technology and other tools.
More ways to grow new business can be found in the article covering books of business acquisition, and the outline on how to work with a team of planning experts to grow clients in the future by protecting another broker’s commissions as the Successor - Buyer. Also, for existing clients, read how to find ways to identify problems you can resolve. Most common needs for Medicare clients is to address the cost of long-term care as well as finding a Dental plan with the largest provider network in the US and a $10,000 annual max. You can find these ideas covered in the articles by Marc Glickman, CEO of Buddy Insurance and Sam Melamed, CEO of NCD dental plans.
Hope you all enjoy the summer months and we will see you at the Medicare Summitt in September.
5
PUBLISHER'S NOTE
Prepping For Medicare
TABLE of CONTENTS
AEP last year was filled with changes, especially last-minute changes. With Wellcare PDP forcing major adjustments made on the fly with PDP clients during AEP many brokers worked free and “lost” commission income. To prepare for this year, take a look at Elliott Martin's article. Last AEP The Martin Agency had success with using video to educate clients to self-serve in many cases.
By Phil Calhoun
18
CALIFORNIA POSITIVE
Exploring California Mountain Trips In The Summer Visiting California’s numerous mountains allows visitors to see several natural wonders in one park or area, with plenty of things to see and healthy activities to do. As your clients start making their summer vacation plans, here are a few spots in California that offer mountainous adventures.
By CalBroker Magazine
20
MEDICARE
California’s Aging Population - PART 2
As the baby boom generation ages, California’s older adult population is increasing significantly. Because of advances in health care and improved living conditions, people are living longer, but they are also living through more disabled years.
By
Hans Johnson, Eric McGhee, Paulette Cha, and Shannon McConville, with research support from Shalini Mustala
22
MEDICARE SUPPLEMENT PLANS
Medicare Supplement Plans - The Ins and Outs
For many agents who sell Medicare products, there’s a high likelihood Medicare Supplement products are available in their offerings to clients. But, for those who have not considered selling Medicare Supplement plans, we’ll provide an overview of the products. And, for those of you who do offer Medicare Supplements to your clients, we’ll also discuss some more detailed information you may not have thought about or considered.
By David Ethington
24
ANCILLARY INDIVIDUAL BENEFITS
Insurance Innovation: The NCD Story
In a recent interview, Phil Calhoun—representing California Broker Media with 250,000 California-licensed subscribers—sat down with Sam Melamed, the CEO of NCD, to discuss the company’s mission, product offerings, and the unique value it brings to brokers and clients nationwide.
Via Interview with Sam Melamed CEO of NCD by Phil Calhoun
26
SCAN HEALTH PLAN
Winter Is Coming For California’s Health Insurance Brokers
For brokers measuring their sales numbers, the signs of a decline are evident. Make no mistake: we are entering a bear market. But how can brokers navigate and succeed in this challenging environment? It’s time to rethink our approach to enrollment.
By Michael Blea
28
BUILDING YOUR MEDICARE AGENCY
Playbook: Navigating California’s Evolving Market
In this interview with Phil Calhoun of California Broker Magazine, Pete Blasi, CEO of Financial Grade, shares how he’s helped brokers succeed in the Medicare market for over 20 years. He highlights the importance of education, systems, and client retention strategies to grow and sustain a thriving Medicare business.
Via Interview with Pete Blasi CEO of Financial Grade by Phil Calhoun
30
MEDICARE ADVANTAGE
Best Medicare Advantage Plans In California 2025 Medicare Advantage plans offer more benefits than Original Medicare, and they're often cheaper than paying for Medicare and a Medicare Supplement plan. However, they offer less flexibility since you’ll need to get care from within the plan’s network of providers. Weigh your options to determine what plan best suits your needs.
By Kate Ashford
32
TECHNOLOGY & MEDICARE
Adapting To The New Normal
In the past, re-shopping a client's Part D plan could be a 20- to 45-minute task. Multiply that across hundreds of clients, and it quickly becomes a full-time seasonal job. While we have never entered this field solely for commissions, we also can't ignore the economic reality: it's increasingly difficult to remain profitable servicing a product that doesn't pay.
By Elliott Martin
34
TECHNOLOGY IN MEDICARE
Empowering Medicare Agents Through Technology
Technology is reshaping the Medicare marketplace, drawing on insights from Amanda Hargis of First Sierra. It covers the evolution from paper-based to digital processes, the impact of electronic platforms and AI on agent workflows, changing client expectations, the need for younger agents, and the future of technology in the industry.
By Amanda Hargis
MEDICARE SUPPLEMENTS
Tips & Thoughts About Our Medicare Supplement Market
Many agents today are primarily selling the Medicare Advantage plans and are hesitant to present the Medicare Supplement plans. They are missing a great opportunity for almost half of the Medicare sales in California.
By Margaret Stedt
38
HEALTH & WELLNESS
Your Summer Wellness Guide
Being proactive about our health and making some intentional choices now can help fuel a summer that supports energy, mobility, cognition, stress resiliency and overall vitality. Here are some easy to implement tips for a healthy summer, all based on the wholeperson wellness strategies that we teach every day at St. Jude Wellness Center.
By Megan Wroe
40 MARKETING
Use This Pre-Appointment Routine For More Referral Results
Almost every athlete has a pre-game routine that puts them in the right mental and physical state for the competition. What about you? What is your pre-appointment routine?
By Bill Cates
42 PROFESSIONAL DEVELOPMENT
Letters On Integrity Inspiring Ethical Excellence
Who becomes the face and voice of integrity at home, at work, and in the community? Courageous ones do. They are everyday heroes who face conflicts yet triumph with choices and actions that are viewed by others as serving a greater good.
By Russ Williams
44 LTCI
Annuity Hybrid With LTCi Extension
With the increasing popularity of annuity hybrids paired with LTCi extensions, a modern approach to long-term care planning emerges. This solution blends flexibility, tax advantages, and accessibility. Read on to learn why these innovative products are transforming long-term care planning for clients over 65.
By Marc Glickman
46
SUCCESSION PLANNING
Crafting A Powerful Succession Plan
Have you ever had a client look you in the eye and ask, “What happens to me if something happens to you?” Or gently wonder aloud, “Are you ever going to retire?” These are questions that can take any advisor by surprise—but ones that underscore the heart of succession planning. Whether retirement is on the horizon or far off, the time to prepare is now.
By Dr. Daralee Barbera
48 COMMISSION PLANNING
How To Be A Successor – Buyer
Of Commissions
In a recent webinar, Phil Calhoun and David Ethington delved into their proven "Preferred Successor - Buyer" program, designed to help active brokers protect, grow, and eventually sell their health insurance commissions by finding a broker designated as a Successor – Buyer who is part of a team of planning professionals. This article explains how the commission planning process works, the shocking number of health brokers in need of planning, strategies, and a method to help active brokers work with younger brokers to solve the risk of loss when no health insurance commission protection plan is in place. Brokers deserve to secure their legacy, this planning work will protect commissions and help the industry.
By Phil Calhoun and David Ethington
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This information provides an over view on how Medicare sign-up is evolving and what to expect in the near future.
1.
Digital Modernization & AI Integration
• Modernized enrollment systems: CMS is replacing outdated contractor-based systems (like PECOS) with modern in-house, cloud-based platforms for provider and patient enrollment—aiming for faster, smoother processing and better data accuracy. kiplinger.com medtechintelligence.com explore-medicare.org
• AI-enhanced plan selection: Payers and brokers are increasingly using AI to streamline Medicare Advantage enrollment. These tools automate verification, data tracking, and error resolution, and are designed to lead to faster processing and fewer mistakes.
2. Simplified Forms & Structured Data Collection
• Updated enrollment forms: Starting January 1, 2026, CMS is removing voluntary demographic questions (e.g., race, ethnicity, gender identity) from Medicare Advantage (MA) and Part D forms - making enrollment cleaner and easier to navigate cms.gov.
• Clearer guidance: CMS has updated the MA/Part D Enrollment and Disenrollment Guidance - simplifying language, reducing redundancy, and including visuals like graphics and tables to help beneficiaries understand their options. icf.com cms.gov
3. Improved Timeliness and Accessibility
• Faster coverage start: Final rules already allow coverage to begin the month after enrollment, helping close coverage gaps thanks to earlier legislative updates. investopedia.com kff.org
• Expanded Special Enrollment Periods (SEPs): CMS has added or clarified SEPs—such as for dualeligible individuals or after major life events - enabling more flexibility to enroll outside traditional periods.
4. Financial Flexibility with Prescription Drug Costs
• Prescription Payment Plan: As of 2025, beneficiaries can opt for predictable monthly copayments for Part D rather than facing large lump sums - CMS aims in 2026 to offer automatic renewals and explore real-time enrollment over web or phone. natlawreview.com kffhealthnews.org
• Cap on Out-of-Pocket Drug Costs: Starting January 2025, Part D plans will cap beneficiary drug spending at $2,000 annually—helping simplify enrollment decisions and financial planning. apnews.com panfoundation.org investopedia.com
5. Future CMS Proposals (CY 2026 & Beyond)
• AI “guardrails”: For CY 2026, CMS is refining policies around AI in enrollment and plan administration—promoting transparency, equity, and fairness when adopting tech solutions natlawreview.com+1cms.gov+1.
• Coverage Expansion: CMS's proposed rule may add new optional benefits (e.g., weight-loss drugs, broader insulin types), which could influence enrollment materials and selection processes.
How Medicare Sign-Up Is Evolving continued
What This Means for You
Opportunity Benefit
Faster, smoother enrollment
More flexible options
Clearer, more equitable processes
Transparent drug costs
Better informed decisions
What You Can Do Now
Digital platforms and streamlined forms reduce delays and confusion.
Plain-language forms and AI oversight aim to reduce bias and errors.
Annual caps and spread-out payments make costs predictable at sign-up.
Enhanced guidance helps beneficiaries navigate choices with clarity.
• Stay informed: Watch CMS updates, especially for the January 1, 2026 form changes.
• Embrace AI tools: If you're a broker or payer, consider investing in AI-driven enrollment platforms.
• Educate clients: Help them understand new payment options, SEPs, and enrollment flexibility.
• Prepare for new benefits: Monitor upcoming optional coverage options that may affect plan offerings.
In Summary
The future of Medicare enrollment is becoming faster, clearer, more flexible, and tech-driven. Beneficiaries and professionals alike should prepare for smoother processes, smarter planning tools, and expanding benefits. These improvements will help ensure that signing up for Medicare is no longer a bureaucratic burden, but an empowering step toward better healthcare access.
The Medicare Advantage market is undergoing a period of correction after rapid growth in the early part of the decade. Last year showed the first signs of a tempering of this growth, and the cooldown continued into this year.
Prior to the annual enrollment period (AEP), many for-profits signaled their intent to slow growth or even contract membership in response to a “perfect storm” of pressures—including rising utilization, lower-than-expected rate increases, and increased regulatory scrutiny around key financial levers. AEP results show a variety of health plans were beneficiaries of the resulting displaced enrollment.
READ FULL ARTICLE →
Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable as CMS Implements Improvements to the Programs in 2025: Medicare Part D
Today, the Centers for Medicare & Medicaid Services (CMS) announced that average premiums, benefits, and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program will remain stable in 2025. Average premiums are projected to decline in both the MA and Part D programs from 2024 to 2025. Enhancements adopted in the 2025 MA and Part D Final Rule, as well as payment policy updates in the 2025 MA and Part D Rate Announcement, support this stability and increase enrollee protections and access to care for people with Medicare. In addition, the Inflation Reduction Act is reducing prescription drug costs and delivering more comprehensive benefits than ever before, including an annual $2,000 cap on out-of-pocket drug costs. CMS is committed to ensuring these programs work for people with Medicare, that they have access to strong and stable choices, and that they have the information they need to make informed choices about what is best for them. READ FULL ARTICLE →
Medicare Is A Target As Senate GOP Faces Megabill Math Issues
By Jordain Carney, Meredith Lee Hill and Robert King
Republicans have so far kept hands off the politically sensitive program. But senators are now desperate to find additional spending cuts. Senate Republicans are eyeing possible Medicare provisions to help offset the cost of their megabill as they try to appease budget hawks who want more spending cuts embedded in the legislation.
Making changes to Medicare, the federal health insurance program primarily serving seniors, would be a political long shot: It would face fierce backlash from some corners of the Senate GOP, not to mention across the Capitol, where Medicare proposals were previously floated but didn’t gain traction.
But Senate Republicans are now seriously considering it as they race to pass their party-line tax and spending package before a self-imposed July 4 deadline. The idea came up in closed-door meetings this week and, crucially, some Republicans believe President Donald Trump is on board with touching the program as long as it’s limited to “waste, fraud and abuse.”
READ FULL ARTICLE →
Seeing The Bigger Picture: How Payers & Providers Can Find Common Ground In Medicare Advantage: Both Health Systems & Health Plans Face Pressures Like Never Before
In the past year, a growing chorus of disputes has risen between health systems and Medicare Advantage (MA) plans. So far this year, 15 health systems have finalized terminations with MA plans.1 These disputes have ranged from health systems ending a single plan’s MA contract to terminating the entire portfolio of MA contracts. While conflict between payers and providers is hardly novel, the volume is telling and, we believe, a product of a confluence of compounding pressures currently facing both health systems and health plans.
MA plans are facing mounting headwinds to their core business: Rising medical costs driven by increasing utilization are outpacing reimbursement rate increases.
READ FULL ARTICLE →
Medicaid Cuts Ahead: How the Big Beautiful Bill Impacts Care
By Jared Dashevsky, MD
IMedicaid Cuts Ahead: How the Big Beautiful Bill Impacts Care
A patient with COPD misses a few appointments. She runs out of her inhaler. She ends up in the emergency department—again. Why? She lost her Medicaid coverage because she didn’t report 80 hours of work online.
That kind of story could become a lot more common. On May 22, Congress approved the “Big Beautiful Bill,” a $1.7 trillion federal spending cut. Nearly half of those cuts target public health insurance—specifically Medicaid and ACA Marketplaces. In this article, I’ll break down what the bill actually says about insurance, how much it cuts, and what it could mean for patients, physicians, and the hospitals we work in.
The Deets: The Big Beautiful Bill
On May 22, Congress approved the “Big Beautiful Bill” aiming to shave $1.7 trillion off federal spending. Nearly half of that comes from changes to Medicaid and the ACA Marketplaces. According to the CBO, those insurance tweaks alone should save about $793 billion over ten years. READ FULL ARTICLE →
CMS Updates Hospital Price Transparency Guidance Following Executive Order
By Andrew Cass
CMS updated its hospital price transparency guidance May 22, requiring hospitals to post the actual prices of items and services, not estimates. The update comes after President Donald Trump issued an executive order Feb. 25 aimed at boosting healthcare price transparency.
In the updated guidance, CMS said hospitals must display payer-specific standard charges as dollar amounts in their machine-readable files (MRFs) whenever calculable. This includes the amount negotiated for the item or service, the base rate negotiated for a service package and a dollar amount if the standard charge is based on a percentage of a known fee schedule.
CMS also said hospitals should discontinue encoding “999999999” (nine 9s) in the estimated allowed amount data element within the MRF, and instead encode an actual dollar amount.
CMS said it is aware there are “infrequent scenarios” where a hospital has limited historical claims data to derive the estimated allowed amount, such as when a hospital has just negotiated contracts with new payers. In the past, CMS recommended that hospitals encode nine 9s in the data value to indicate there is not sufficient reimbursement history. But after reviewing the MRF files of 68 large hospitals, CMS determined that hospitals are employing the workaround “much more frequently than expected.”
READ FULL ARTICLE →
Medicare Advantage Health Plan Outlook For 2026: Annual Survey Of Health Plan Executives
In this annual survey, health plan leaders share their perspectives on the state of the Medicare Advantage (MA) market, the outlook for the next 5 years, and strategic priorities for the year ahead.
The MA market has faced significant disruption over the last few years (e.g., rising medical cost/utilization, Stars headwinds, risk adjustment model changes, and now regulatory uncertainty)—all of which has influenced priorities. MA leaders are focused on weathering the storm and navigating the disruption. Signs indicate that the forecast is becoming more favorable, and leaders are striking a more optimistic tone for the upcoming year, with increased focus on cost control and financial sustainability.
Leaders also realize they still have to position themselves to take advantage of the future growth opportunity. We offer five core actions for health plans to lay the foundation for future growth.
READ FULL ARTICLE →
Oz Hints At Impending CMS Rule To Force Drug Price Transparency
The Trump administration hopes to issue a rule this year empowering regulators to “very forcefully” go after companies that don’t share information on drug costs, the CMS administrator said Tuesday. The CMS could issue a rule this year requiring healthcare companies to share more information on drug costs, as the Trump administration continues to push for more price transparency in the sector, Administrator Dr. Mehmet Oz said Tuesday.
“If we can do this in an effective way — and we’ll have a rule on this by the end of the year, we hope — then we’ll be able to very forcefully go after folks who are not transparently sharing what it actually costs, or what the transaction prices were, for the drugs that Americans are trying to pick up,” Oz said.
READ FULL ARTICLE →
Getting Care In A Disaster Or Emergency
Being prepared for a natural disaster is crucial to protecting your safety and well-being. Visit Medicare.gov/ emergency to learn how to get the care you may need if an emergency is declared and you have to evacuate to a safe area. Getting your prescription drugs during a disaster or emergency: You can move most prescriptions to another nearby in-network pharmacy, and back to your regular pharmacy when the emergency or disaster ends. Contact your Medicare drug plan if you need to use an out-of-network pharmacy. Seeing a doctor during a disaster or emergency: If you have Original Medicare, you can always see any doctor who accepts Medicare. If you have a Medicare Advantage Plan or other Medicare health plan, contact your health plan about making temporary changes, like using an out-of-network doctor during an emergency or disaster.
Learn more about accessing critical care (like cancer treatments or dialysis) or repairing or replacing equipment (like wheelchairs or walkers that were damaged or lost during a disaster or emergency).
Sincerely,
The Medicare Team.
READ FULL ARTICLE →
New Analysis Rebuts MedPAC’s Claims about Medicare Advantage
Advisory Commission’s (MedPAC) approach and data, calling into question MedPAC’s findings both of so led “favorable selection” into MA and of
Key methodological flaws in MedPAC’s analysis were detailed in a recent report.
MedPAC’s artificial reliance on FFS spending patterns to questions about MedPAC’s approach to evaluating both the differences between MA and FFS populations and the implications for comparing MA and FFS’s
CMS Finalizes 2026 Payment Policy Updates for Medicare Advantage & Part D Programs
Today, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Rate Announcement for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs that finalizes the payment policies for these programs. This release — combined with the CY 2026 MA and Part D final rule that was released on April 4 — makes annual routine and technical updates to the MA and Part D programs.
The actions taken by CMS help protect beneficiaries and taxpayers from waste, fraud, and abuse, while also driving access to high-quality, affordable healthcare through Medicare Advantage. By finalizing these payment policies, CMS is ensuring that Medicare Advantage continues to offer access to critical services in an efficient, accountable manner, further strengthening the program’s ability to serve beneficiaries. READ FULL ARTICLE →
MAPD Commission Increase 2026
New Jersey and California Lead the Way
CMS is proposing the increases in MAPD commission for a certified Medicare Insurance Professional to receive.
MAPD Commission Increase 2026: New Jersey & California
Lead the Way
CMS is proposing the increases in MAPD commission for a certified Medicare Insurance Professional to receive.
Democrats Introduce Bill To Establish A Medicare 'Part E' Public Option
By Paige Minemyer
Democrats in the House and Senate have introduced new legislation that would establish a "Part E" for Medicare, which would allow people to opt into the program.
Reps. Jimmy Gomez, D-Calif., and Don Beyer, D-Va., on Monday put forward the Choose Medicare Act. Under the proposal, a potential Medicare Part E would have the program compete with private insurance. Democratic Sens. Jeff Merkley, of Ore., and Chris Murphy, of Conn., introduced a companion bill in that chamber.
Medicare Part E as outlined in the bill would sustain itself through premiums, with enrollees able to sign up through any state or federal insurance marketplace. Any existing subsidies available for Affordable Care Act (ACA) plans would be applicable to Part E coverage.
The bill would also allow employers to choose to provide Part E coverage to workers.
Mental Health & Substance Use Disorders
Medicare covers many mental health services to support you, including depression screenings, individual and group therapy, and family counseling. You may be able to get mental health counseling and treatment, including addiction recovery, from home via telehealth. If you're feeling isolated, it can take a toll on your mental health. Get tips on caring for your mental health, and learn when to seek professional support.
Sincerely,
The Medicare Team
READ FULL ARTICLE →
A Remedy For Missed IRA Distributions
By Eric Rasmussen
The IRS slaps big penalties for retirees who miss the required minimum distributions from their qualified retirement plans. But what if the person has a good excuse? For example, what if they started suffering symptoms of dementia or Alzheimer’s and miss their distributions for a couple of years?
In fact, there’s a form for that. Form 5329 allows taxpayers to report additional taxes and make up shortfalls in their required distributions so that hopefully they can avoid penalties if there was a reasonable cause, and tax experts say that Alzheimer’s would likely be one of those.
“In the circumstances where we’ve been approaching the IRS with the discovery that our RMDs have been missed I’ve always found that they’ve been pretty lenient,” said Thomas C. West, a senior partner at Signature Estate & Investment Advisors in McLean, Va., who deals with estate and longevity issues. “The big thing that I always try to do is I try to solve all of the problems before I contact the IRS with my clients.”
READ FULL ARTICLE →
Social Security Cost-Of-Living Adjustment May Be 2.5% In 2026, New Estimates Find
By Lorie Konish
Key Points
Social Security beneficiaries may see a 2.5% increase to their monthly checks in 2026, based on new government inflation data released Wednesday. Those estimates may be subject to change, since there are four more months of data before the official cost-of-living adjustment for next year is announced. Here’s what experts are watching. Millions of Social Security beneficiaries received a 2.5% boost to their benefits in 2025, thanks to an annual cost-ofliving adjustment that went into effect in January.
In 2026, Social Security checks may go up by the same amount — 2.5% — based on the latest government inflation data, according to new estimates from both The Senior Citizens League and Mary Johnson, an independent Social Security and Medicare policy analyst.
That is up from the 2.4% increase for 2026 that those sources forecast last month. A 2.5% cost-of-living adjustment would be “about average,” according to Johnson.
READ FULL ARTICLE →
California’s Deficit Dilemma: Cut Spending, Borrow Money Or Raise Taxes?
By Dan Walters
The California Legislature has just a few days to pass a 2025-26 state budget to meet the state constitution’s June 15 deadline. The deadline will be met, if for no other reason than legislators would, at least theoretically, have their salaries suspended were they to miss it. However, the budget they enact may bear only a passing resemblance to what will eventually, perhaps many months later, become a complete fiscal plan.
The revised budget that Gov. Gavin Newsom proposed a month ago projects that general fund tax revenues for the year would be about $20 billion short of covering the spending that he has proposed — and that’s after counting the billions of dollars in reductions, primarily in health care and other services for the poor, he’s asked the Legislature to swallow.
READ FULL ARTICLE →
California Hospital Prepares for Surge in Patients
By Anna Skinner, Senior Reporter
At least one California hospital is preparing for a surge in patients presenting with heat-related illness as a heat wave brings abnormally warm temperatures to the Golden State this weekend.
Why It Matters
National Weather Service (NWS) meteorologists are already issuing guidance ahead of a surge in temperatures this weekend, with inland areas across much of the state expecting temperatures to hit triple digits.
Since it is one of the first heat waves of the season, people might be unprepared for the hot temperatures, putting them at a greater risk for heat-related illness.
READ FULL ARTICLE →
RFK Jr. Says Food And Pharma Are Poisoning Americans: His Big Report Says A Fix Is Coming
By Carmen Paun, Chelsea Cirruzzo, Marcia Brown and David Lim
The Make America Healthy Again Commission that Robert F. Kennedy Jr. leads will release a strategy to combat chronic disease by summer’s end.
A much anticipated report led by Health Secretary Robert F. Kennedy Jr. says that children’s health is in crisis and that it’s likely the result of ultraprocessed food, exposure to chemicals, lack of exercise, stress, and overprescription of drugs. But the report, from the Kennedy-led Make America Healthy Again Commission, shies away from the strident language Kennedy has used in the past in demonizing the food, farming and pharmaceutical industries, and leaves for another day proposals for how to improve kids’ health. The accused industries have been lobbying furiously to persuade Kennedy to tone down the rhetoric.
Solutions for the health crisis will come within 100 days, Kennedy promised reporters during a call Thursday
READ FULL ARTICLE →
2025 JULY CONFERENCES
June 28 - July 1 NABIP: Future Foreward: Annual Convention @ Miami, FL
EVENTS
July 7 @ 2:30-4pm EPI: The Five Conversations That Drive Business Succession Planning @ SF, CA
July 9 @ 2:30-4:30pm EPI: Investigating Exit Options From Various M&A Expert Perspectives @ San Diego, CA
July 10 @ 2:30-4:30pm EPI: Investigating Exit Options From Various M&A Expert Perspectives @ Costa Mesa, CA
July 16 @ 11am-1:00pm EPI: Disaster Preparedness & Contingency Planning For Exit-Ready... @ Westlake Village, CA
July 17 @ 9am-12pm NAIFA CA: Inland Empire’s Mastering the Course: Insights for Industry Leaders @ Corona, CA
July 23 @ 2:30-4:30pm EPI: Coaching Business Owners To Maximize And Grow The Value Of Their Business @ LA, CA
July 24 @ 11:30am-1:30pm EPI: The Ripple Effect: How Tariffs Influence Business Valuation In A Global... @ Norco, CA
Benefit Mall / CRC Benefits February Compliance Update Webinar w/ Misty Baker & Carol Taylor
Benefit Mall / CRC Benefits March Compliance Update Webinar: RxDC Explained w/ Misty Baker & Carol Taylor
Benefit Mall / CRC Benefits April Compliance Update Webinar: MLR & 5500 w/ Misty Baker & Carol Taylor
Benefit Mall / CRC Benefits May Compliance Update Webinar w/ Misty Baker & Carol Taylor
Benefit Mall / CRC Benefits June Compliance Update Webinar w/ Misty Baker & Carol Taylor Commission Solutions 2025 Webinars Commission Solutions January 8, 2025 Webinar: Mary’s Journey To Protect, Grow and Sell Her Commissions Commission Solutions January 16, 2025 Webinar: How to Sell Your Health Insurance Book of Business Commission Solutions February 12, 2025 Webinar: Rick’s Journey to Protect, Grow, and Sell his Commissions Commission Solutions February 20, 2025 Webinar: How To Use Advanced Tax Planning/Maximizing Retirement Income Commission Solutions March 12, 2025 Webinar: How Health Commissions Were Protected and How the Plan... Commission Solutions March 20, 2025 Webinar: How to Use Advanced Tax Planning for Maximizing Retirement Income Commission Solutions April 9, 2025 Webinar: Broker Succession Planning and the Impact on Loved Ones Commission Solutions April 17, 2025 Webinar: Help Baby Boomers as their Preferred Byer and Successor
Covered California: Important Tax Information: How to get a Small Business Credit
IEHP: Health Education for Members Join no-cost health education classes just for IEHP members. Pinnacle: Announcing Healthview, Refreshed: Simply A Better Experience
Sutter Health Plan: Prioritizing Mental Wellness
Exploring California Mountain Trips In the Summer
By Cal Broker Magazine
California is a land of towering trees, sweeping seascapes, and rugged mountains, so it’s no wonder that it attracts visitors from all over who want to experience its beauty firsthand. Visiting California’s numerous mountains allows visitors to see several natural wonders in one park or area, with plenty of things to see and healthy activities to do. As your clients start making their summer vacation plans, here are a few spots in California that offer mountainous adventures. Knowing the terrain and activities involved in these spots can help them understand the right insurance coverage they need to give them peace of mind during their getaway.
Northern California
Northern California has a mild, Mediterranean climate that can be damp and foggy in the cooler months and hot and dry during the summer. The terrain includes rugged mountains throughout the Sierra Nevada Mountains, as well as giant redwood forests, where travelers can hike, bike, camp, and explore.
Shasta-Trinity National Forest
Shasta-Trinity National Forest is a must-visit in Northern California. It’s home to Mount Shasta, the second-highest mountain peak in the Cascade Range. The park itself covers more than two million acres and has five different
wilderness areas. There are plenty of trails around the area where trekkers can get different viewpoints of the surrounding area, camp, and hike. Another feature of the park that attracts visitors is Shasta Lake. The lake’s placid waters are an ideal spot to try all kinds of water sports, like boating, swimming, fishing, and paddling. Visitors can camp in the area, explore the hiking trails around the lake on bike or foot, and relax in the eating and rest areas.
Lassen Volcanic National Park
Lassen Peak, in the Cascades, is the world’s largest plug dome volcano. The park is home to several volcanoes that helped to create the slopes and cliffs that visitors enjoy hiking today. Hikers can explore 150 miles of trails that loop around lakes, meadows, volcanic peaks, and even hydrothermal zones. Some fun, healthy activities your clients can try after hiking include boating, fishing, and swimming in the park’s lakes. This park is also a popular spot for stargazing, horseback riding, and even parkcaching.
Central California
Central California has a unique climate that is influenced by the San Francisco Bay. When it comes to nature, this part of the state has mountain ranges, giant sequoias, and several lakes and rivers for water activities.
Sequoia National Park
Sequoia National Park is located in the southern part of the Sierra Nevada range. Visitors can come for a day hike, or plan to stay for a few days and set up camp. One thing to keep in mind is that the weather changes with the elevation, so visitors need to be prepared for all kinds of weather. The top activity here is wandering the trails and sequoia groves. Other parts of the park have areas to enjoy a picnic and spot wildlife. Sequoia National Park also has spots for adventurous activities like fishing, rock climbing, and horseback riding.
Yosemite National Park
Yosemite National Park contains a mix of landscapes, like cascading waterfalls, deep valleys, and rolling meadows. This park also has towering sequoia trees, but is famous for its distinctive mountains, like El Capitan, Half Dome, and Mount Lyell. There are plenty of hiking trails to discover different lookout points and landscapes. However, there are other ways to discover the park besides just on foot. Visitors can roam the trails on horseback or even on mules. Something else that’s great about this park is that there are 12 miles of paved paths for bikes and e-bikes. People who like water sports can go floating or rafting on the Merced River, as well as swimming and paddling on Tenaya Lake.
The key to a safe and fun trip to the California mountains is being prepared. “ “
Southern California
Southern California is a magical mix of arid deserts, rolling mountains, and beautiful forests, all of which offer great opportunities for hiking and camping. Southern California has a Mediterranean climate, but it is warmer than northern and central California. The deserts can reach scorching temps, so hikers and campers should be prepared with the right gear and supplies.
Joshua Tree National Park
Joshua Tree National Park is the unique meeting place of two of Southern California’s deserts: the Mojave and the Colorado. This park, which covers nearly 800,000 acres, is home to the Little San Bernardino Mountains, ancient rock formations, and the curious trees from which the park gets its name. The park has 300 miles of trails and nine campgrounds available for visitors to see some of its most emblematic sights. Within the park, hikers will find cactus gardens, a variety of rock formations, and nature trails that highlight the park’s flora and fauna. The Joshua trees are a natural wonder that definitely can’t be missed.
Mount San Jacinto State Park
Mount San Jacinto is the highest peak in the San Jacinto Range. The park covers 14,000 acres and 50 miles of trails for hiking and biking. The trails vary in difficulty so that visitors can enjoy both different views and challenges. As hikers loop the trails, they can see pine forests, meadows, and deserts. Mount San Jacinto is home to all kinds of wildlife and is a popular spot for birdwatching, in particular. One thing that visitors shouldn’t miss is a ride on the Palm Springs Aerial Tramway, a cable car that has impressive panoramic views of the park.
Preparing for a California Mountain Trip
The key to a safe and fun trip to the California mountains is being prepared. With the right gear and equipment, travelers can be better prepared for the terrain and elements that await them. It’s also important to look into factors like the level of difficulty of the hikes, if the activities offered in the area are family-friendly, and if equipment is available to rent, if necessary. Knowing exactly where they’re going and what to expect can also help when it comes to choosing the right insurance coverage for the trip. Being prepared for any and all situations means your clients will have better peace of mind as they enjoy their vacation.
Sources:
1. https://www.fs.usda.gov/r05/shasta-trinity
2. https://www.nps.gov/jotr/index.htm
3. https://www.nps.gov/lavo/index.htm
4. https://www.nps.gov/seki/index.htm
5. https://www.nps.gov/yose/index.htm
6. https://www.parks.ca.gov/?page_id=63
ANTICIPATING DRAMATIC GROWTH IN THE NUMBER OF OLDER CALIFORNIANS
By Hans Johnson, Eric McGhee, Paulette Cha, and Shannon McConville, with research support from Shalini Mustala
The Population of Older Californians Will Continue to Grow and Diversify. The significant shifts in California’s demographic landscape over the past two decades are projected to continue and even accelerate through 2040. Several key factors are driving these changes: the aging of the baby boom generation, increased longevity, and the long-term effects of past immigration patterns.
The baby boom, from 1946 to 1964, created exceptionally large population cohorts that are now entering older ages. The youngest baby boomers are now 60 years old while the oldest are 78. In 2040, the youngest will be 76 and the oldest will be 94. As this generation ages, the older adult population is increasing significantly. Because of advances in health care and improved living conditions, people are living longer, but they are also living through more disabled years (Tesch-Römer and Wahl 2016).
It is important to note that the COVID-19 pandemic caused a brief— and traumatic—deviation from the long-term pattern of increases in life expectancy. The latest estimates suggest that life expectancy has resumed its pre-pandemic trend of gradually increasing longevity. (1) The Department of Finance projects moderate increases in life expectancies through 2060.
California’s Older Adult Population Will Increase Dramatically By 2040. California’s older adult population (aged 65 and over) is projected to increase by a remarkable 59 percent, from 5.7 million to just over nine million. This growth stands in stark contrast to the projected changes in other age groups. The working-age population (20–64 years old) is expected to increase only three percent, while the population under age 20 is anticipated to decrease by 23 percent. California is projected to have 3.4 million more older adults aged 65 and over, and 1.7 million fewer residents less than 65 years old.
This disproportionate growth in the older population will lead to a significant shift in the state’s age structure. Almost one-quarter of Californians (22%) will be age 65 or older by 2040, a substantial increase from 14 percent in 2020. The old-age dependency ratio (the number of older adults per 100 adults of working ages) is projected to
grow from 24 to 38.(2) In other words, there will be 38 older adults for every 100 working adults in the state.
The most dramatic growth is projected among the oldest age groups— or the oldest old (Figure 1). The population aged 80 and over is expected to more than double, increasing by nearly 1.8 million in 2040. This rapid growth in the oldest age groups, driven by both the aging of baby boomers and increases in longevity, is especially significant because of this group’s relatively high personal care and health care needs. The dramatic population increase for this group overwhelms any improvements in well-being. For example, there will be so many more very old Californians that reductions in the share with self-care limitations will not counterbalance a dramatic increase in care needs.
Declines in the state’s child population reflect low birth rates. Like the rest of the United States and most developed countries in the world, California has experienced a sustained decline in birth rates. In California, the total fertility rate—the average number of births in a woman’s lifetime—has fallen from 2.15 in 2008 (just above the level needed to replace the population) to 1.47 in 2020. The Department of Finance (DOF) projects that these low levels of fertility will persist into the future.
Declines in the population aged 16 to 64 are driven primarily by interstate out-migration. For several decades, California has experienced substantial net outflows to other states, particularly among less-educated Californians. International immigration to the state counterbalanced some of this population decline, but the flow of immigrants has been modest in recent years.
Growth in the Older Adult Population Will Vary Across Counties. While all regions of the state will be impacted by growth in the older adult population, regional differences are a key consideration for planning and policy. The DOF population projections provide information at the county level, which we use to provide a high-level picture of how older adults will be distributed across the state.
California’s Aging Population - Part 2
Increases in the population of adults 65 and older in the Far North region of the state will be much lower than the statewide average. Several counties near the northern border are projected to see little or no growth—including Shasta, one of the largest counties in the region. Many Bay Area counties—including Alameda, Santa Clara, and Contra Costa—will see growth rates in the 70 to 80 percent range. In contrast, counties in the Central Valley (e.g., Kern, Stanislaus, Fresno, and Kings) are projected to have lower than average growth (about 40%), as are Central Coast counties including Santa Barbara and San Luis Obispo. Most large Southern California counties, including Los Angeles, will see increases around the state average (60%); this is not surprising, given that such a large share of the state’s population resides in that region.
When we look at growth among adults aged 85 and older, the regional patterns shift somewhat. Northern California regions stand out with some of the largest increases; in a few counties—including Mendocino, Trinity, and Plumas—the over-85 population will more than triple by 2040. Most large Bay Area and Southern California counties will see their populations age 85 and older more than double. Although counties such as Fresno and Stanislaus will have lower than average increases in older adults, they will see considerable growth (80%) in this age group.
California’s Older Adult Population Will Be Diverse.
The racial/ethnic composition of California’s older adult population is projected to become increasingly heterogeneous, with no single racial or ethnic group constituting a majority of the older adult population. The number of Latino, Asian, and Black older Californians is expected to double or nearly double by 2040, while the older white population will increase by 30 percent. While whites are projected to remain the largest racial/ethnic group of older adults, their relative share will decrease as other groups grow more rapidly (Figure 3).
A key driver of diversity among older adults is the dramatic increase in immigrants from Latin America and Asia in the 1980s. Upon arrival most were young adults, primarily in their 20s and 30s. Those early large cohorts of immigrant arrivals from the 1980s are now in their 50s and 60s, beginning to fundamentally alter the ethnic composition of California’s older population.
It is worth noting that in recent years, migration of older adults, both international and domestic, has not been a primary driver of the growth and diversity of California’s older population.(3) Instead, the growth in the state’s older population is primarily driven by the aging of existing residents, including those who immigrated decades ago, and their increased life expectancy.
There will also be variation across the state in racial and ethnic changes in the population of older adults (Figure 4). In 2020, only 12 counties did not have a majority-white older adult population; by 2040 that number doubles to 24 counties. As previously discussed, the population of adults 65 and older who identify as Latino and Asian and Pacific Islander will more than double by 2040 and the older Black population will nearly double (90% increase). Counties that will see the highest growth rates in Latino older adults include relatively smaller counties like Mendocino and Marin, along with larger counties such as Monterey and Orange. Among Asian older adults, Santa Clara County will have one of the highest increases, with the number of adults aged 65 and older of Asian and Pacific Islander descent growing from about 98,000 to nearly 225,000.
The share of older adults who are foreign born is expected to increase to over 40 percent by 2040 (compared to 29% in 2020), again reflecting immigration patterns from decades ago. The largest increases will be among 65 to-74-year-olds (Figure 5). The majority of Latino older adults (59%) will be foreign-born, similar to levels today. Almost 9 of 10 Asian older adults will be foreign born. Again, these levels are similar to those of today.
For many agents who sell Medicare products, there’s a high likelihood Medicare Supplement products are available in their offerings to clients. But, for those who have not considered selling Medicare Supplement plans, we’ll provide an overview of the products. And, for those of you who do offer Medicare Supplements to your clients, we’ll also discuss some more detailed information you may not have thought about or considered.
Medicare Supplement Plans, also known as Medigap, are private insurance policies that help pay for out-of-pocket costs not covered by Original Medicare (Parts A and B), such as:
• Copayments
• Coinsurance
• Deductibles
There are several standardized Medigap plans (labeled A through N), and each offers different levels of coverage. While Medigap policies are sold by private insurers, all plans with the same letter offer the same basic benefits, regardless of the company.
Key Features:
• You must have Medicare Part A and Part B to buy a Medigap policy.
• Medigap does not cover prescription drugs—you’ll need a separate Part D plan for that.
• It only covers one person; spouses need separate policies.
• Medigap doesn’t work with Medicare Advantage plans.
These plans can help reduce unexpected healthcare expenses and provide more predictable costs in retirement.
Why is it important for Medicare beneficiaries to consider these plans?
• Typically, beneficiaries only have one opportunity to join this type of plan with Guaranteed Issuance and that is when they first become eligible for Medicare.
° If that opportunity is missed, then they must go through Medical Underwriting. If they have any pre-existing health conditions, there is a chance their application will be denied.
• This type of Medicare product allows beneficiaries to see any medical provider that accepts Medicare, with some exceptions.
• Beneficiaries will avoid the pitfalls of Insurance providers and Medical Group providers coming to contract disagreements. These disagreements can lead to disruptions in care if they are covered under a Medicare Advantage plan.
Why is it important for Agents to offer these products?
• The simple answer is that you become more appealing to Medicare beneficiaries when you can speak to ALL of their plan options.
• The retention rate is high. According to the Kaiser Family Foundation, one in five Medicare enrollees choose a Medicare Supplement product. And of those that choose this product, 90 percent retain their policy.
° This means that retaining your clients requires less time, which allows you to spend more time gaining new business.
• Commissions: many of the carriers pay at least a 20 percent commission in the first year of the policy.
° We’ll provide additional information on this later in the article.
For those of you who already market Medicare Supplement products, you might find some of the upcoming information very helpful for you when considering which carriers you’d like to offer to your clients. Please note that not all carriers are represented in this article. There are over 20 carriers in California. Please reach out to the carrier in question to verify the information as information frequently changes.
Rate locks are important to consider as this can protect your client from rate increases for six to 12 months depending on the insurance carrier. For example, Blue Shield and Humana have 12-month rate locks. This is important because when you are advising your client on the lowest rate option, you may not be thinking about the rate increase that’s lurking around the corner.
If you decide to enroll a new client into a Medicare Supplement prior to that carrier’s annual rate increase, it’s possible that your new client will get hit with an unexpected rate increase. But, if you put them with a plan like Blue Shield or Humana, your client will avoid this pitfall for the first 12 months they are on their policy. You can mention this to your new client to further show that you are the subject matter expert of these Medicare products all while strengthening the trust your client has with you.
United Healthcare, Anthem Blue Cross (Elevance), and Health Net all have rate locks built into their plans. Please speak to your carrier representative to get more information.
Plan changes often come up when your client wants to “shop” for alternative options due to rate increases or they want to change their benefit level. However, they are not always able to do this. If a client is healthy, they can facilitate this change through submitting an application that requires medical underwriting. If the member is unhealthy, they will need to wait until their birth month in order to use the “birthday rule” that allows them to make a plan change regardless of pre-existing health conditions. Alternatively, if your client is with United Healthcare/AARP’s Medicare Supplement plan, the member can move freely from plan to plan anytime throughout the year.
Commissions are always at the forefront of an Agent’s mind. Although we’re all going to do what’s right for the client, it is important to know the details of the insurance carriers we’re representing. Based on today’s information, below is a list of some of the carriers in California and how they pay.
• Anthem Blue Cross (Elevance): will pay lifetime commissions for those members that are underwritten or enroll due to being new to Medicare. Alternatively, they will only pay up to 10 years if a member is written using a Guaranteed Issue, such as, the “birthday rule”
• Blue Shield of CA: will pay lifetime commissions in all cases, unless the member is under 65 years of age. Commissions are reduced after Year 1 of the policy.
• Health Net: will pay lifetime commission in all cases, unless the member is under 65 years of age. Commissions are reduced after Year 1 of the policy.
• UnitedHealthcare/AARP: Beginning June 1, 2025 they will no longer pay lifetime commissions for new business written going forward. They will only pay up to year 10 of the policy.
• Humana Achieve: pays lifetime commissions but commissions are reduced the longer the policyholder remains active. They will pay on members who are under 65 years of age.
There are many more carriers to consider. Please reach out to your contracted carriers to learn more about their commission structures.
Guaranteed Issuance (GI) Guidelines are important to know and understand so that you can better assist your clients. The purpose of knowing the “GIs” is so you can address certain situations that would allow your client to make a plan change without having to go through medical underwriting. Here are some of the more common “GIs”:
• New to Medicare: the member is new to Medicare because they are either turning 65 or they are enrolling into Part B for the first time. In order to qualify, they must enroll within six months for the Part B start date
• Birthday Rule: For members that are currently enrolled in a Medicare Supplement plan, they have 30 days prior to their birthday and 60 days after their birthday to make a change to their policy. They can make a change as long as the benefits offered are equal or lesser value to their current plan.
• Loss of Employer Coverage: if a member loses their employer sponsored coverage, they can enroll in a Medicare Supplement plan. They must provide proof of notice of termination.
° Some carriers may require that it be an involuntary termination.
A lesser known but very useful “GI” applies to those clients that are enrolled in a Medicare Advantage plan. If the Medicare Advantage reduces benefits or increases the amount of cost-sharing or premium or discontinued a contract with a provider currently furnishing services then the member has the opportunity to enroll in a Medicare Supplement.
• If the member’s current Medicare Advantage plan offers a Medicare Supplement, they may have to enroll in that carrier’s Medicare Supplement. If the carrier does not offer a Medicare Supplement option, they may be able to shop other insurance carrier options. Please verify this information with each of the carriers as their definitions may be slightly different.
Household Discounts are an excellent tool for clients to take advantage of in order to save money. Typically, when more than one policyholder lives at the same address, they may be able to qualify for the household discount that reduces their monthly premium responsibility. Below are some of the carriers that offer household discounts:
• Anthem Blue Cross (Elevance): five percent discount for each member
• Blue Shield of CA: seven percent discount for each member, must be on the same plan
• Humana Achieve: 12 percent discount for each member
• Cigna: six percent discount for each member
• Physicians Mutual: 10 percent discount for each member
• United Healthcare/AARP: seven percent discount for each member
There is so much to know about Medicare Supplements. I encourage you to speak to your uplines, your carrier representatives, and your colleagues. Share your stories with one another as that is how we grow. If you’re looking for a group of agents, look no further than the California Agent and Health Insurance Professionals (CAHIP). Most counties have a local chapter that you can get involved with.
Check out https://cahip.com
Happy Selling!
David Ethington is VP of the Medicare Division and director of Broker Relations with Commission Solutions, part of Integrity Advisors. His work has excelled due to his commitment to providing the best service to both health clients and health brokers. David respects the hard work it takes to build a book of business and enjoys working with retiring brokers and their families. David has participated in the commission protection process for seven years. He’s also involved in acquisitions, especially in the broker relationship transfer of commissions. David lives in Orange County with his wife and their cats. He is an avid runner and completes several long-distance events annually.
David@commission.solutions 714-664-0605
Insurance Innovation: The NCD StoryConsidering NCD for Medicare Clients
Via Interview with Sam Melamed CEO of NCD by Phil Calhoun
The insurance industry is filled with stories of unconventional career paths and innovative business models, but few are as intriguing as the journey of Sam Melamed, who transitioned from rabbinic studies to become a leader in supplemental health benefits. In a recent interview, Phil Calhoun—representing California Broker Media with 250,000 California-licensed subscribers—sat down with Sam Melamed, the CEO of NCD, to discuss the company’s mission, product offerings, and the unique value it brings to brokers and clients nationwide.
As CEO of NCD, Melamed has been instrumental in shaping the company’s direction and facilitating industry dialogues. Calhoun and Melamed discussed the driving force that helped Sam into his product development and regulatory strategy work leading up to NCD.
As CEO of California Broker Media, Calhoun enjoyed learning how Melamed’s extensive background in insurance leadership brings a broker-centric perspective to the discussion. “It is ensuring the conversation addresses the real-world needs of agents and agencies across California and beyond,” stated Calhoun.
Sam Melamed’s Unconventional Path
Sam Melamed’s route to insurance leadership is anything but typical. He spent years studying to become a rabbi then realized he preferred another career path.
After getting married young, a neighbor introduced him to insurance sales—a field he initially found challenging. “I was just terrible. I couldn’t figure out how to do it,” Melamed admits, highlighting his early struggles with prospecting and closing.
Driven by curiosity, Melamed launched Insurance Forums, an online community for agents and brokers. He chose this path in a bid to understand his own sales difficulties. The forum grew into a small business, complete with an insurance magazine, giving Melamed firsthand insight into the challenges brokers face and the importance of quality industry content.
His career advanced when he joined ABC Insurance Trust, where he learned the nuances of association health plans, ancillary benefits, and employee benefits. Rising through the ranks to become CEO, Melamed honed his expertise in dental, vision, disability, and supplemental benefits.
NCD’s Mission and Market Approach
Four years ago, Melamed took the helm at NCD, a company specializing in dental and vision insurance, with plans to expand into other supplemental products. Under the leadership of CEO Liam Collopy, NCD carved out a unique space in the market by focusing on the underserved individual segment—a group often overlooked by major carriers like MetLife, which traditionally prioritize large group plans.
NCD operates as a Managing General Agent (MGA) and product development company, partnering with national carriers to create custom plans for individuals. Their flagship offering, developed with MetLife and the National Wellness and Fitness Association, was the first $10,000 annual maximum dental plan available to individuals—a benefit previously reserved for large group plans. These products are built on an association chassis and feature escalating benefits, including major services and implants, designed to be “the last dental plan you ever have to buy,” as Melamed puts it.
Broker-Centric Distribution and Support
NCD’s distribution model is designed with brokers in mind. Agents can contract directly with NCD or through major Field Marketing Organizations (FMOs) such as Integrity, Spark, Amara Life, and others. This flexibility allows brokers to choose the contracting path that best fits their business needs, whether that means consolidating for better bonuses and marketing support or working directly for personalized service.
One of NCD’s hallmarks is its obsession with customer and agent experience. The company boasts over 10,000 five-star reviews and is recognized as one of the highest-rated insurance plan administrators in the country. “We answer every phone call from agents in 30 seconds or less, every email in an hour or less, every text in 10 minutes or less,” Melamed explains, underscoring the company’s commitment to responsiveness and support.
“We answer every phone call from agents in 30 seconds or less, every email in an hour or less, every text in 10 minutes or less.”
Products for All Ages and Needs
NCD’s plans are available to any adult age 18 and over, with no upper age limits or price differences based on age. The company serves a diverse clientele, including retirees and residents of nursing homes, who continue to value dental and vision care well into their later years.
The dental network, powered by MetLife, is among the largest in the country and particularly strong in California. Members benefit from broad access to both general dentists and specialists, with significant savings when using in-network providers. Out-of-network coverage is also available, though members may pay more due to balanced billing and claims adjudication.
Culture and Mission: Spreading the Smile
NCD’s internal culture is shaped by its mission to “spread the smile.” This ethos is reinforced through initiatives like the “smile feed,” where team members share positive customer feedback throughout the day, keeping the focus on delivering exceptional service and fostering a positive work environment. Melamed credits this culture with attracting top talent and driving the company’s success, even when traditional ROI metrics might not fully capture the value of such an approach.
Relevance for California Brokers
With over 250,000 licensed life and health insurance professionals in California—many of whom are nonresidents but licensed to do business in the state—NCD’s offerings can be a perfect fit for Medicare and individual clients who often have limited options many of which are DHMO plans. NCD’s national reach, regulatory expertise, and broker-friendly approach, combine to make for a valuable partner for many agencies.
Calhoun suggested “Many brokers operate across group, individual, and Medicare markets. NCD’s products are designed to fit seamlessly into these varied books of business. Brokers look to provide high-value supplemental options that can be offered at key touchpoints in the client’s health coverage journey and NCD plans are a great fit.”
The conversation between Calhoun and Melamed offers a window into the values and vision driving NCD’s growth in the supplemental benefits pace. Melamed’s career journey through his continued focus on insurance innovation, combined with NCD’s broker-centric focus, highlights how thoughtful product design, relentless customer service, and a mission-driven culture can set a company apart in a crowded market. For brokers and agencies seeking high-value dental and vision solutions for their clients, NCD stands out as a partner committed to both excellence and empathy.
Sam Melamed is the CEO of NCD, a leading provider of supplemental health benefits for the Medicare Advantage and ACA markets. With a background in insurance innovation and digital community building, he guides NCD in delivering tech-driven, broker-friendly solutions. Sam is also a frequent voice in industry podcasts, sharing insights on ancillary products and healthcare trends. His leadership focuses on simplifying benefits while supporting carriers, brokers, and members alike.
Winter is Coming for California’s Health Insurance Brokers
By Michael Blea, Chief Growth Officer at SCAN Health Plan
I've spent three decades in this industry, and I’ve witnessed the cyclical nature of the market. I remember the Balanced Budget Act of 1997, which created the Medicare+Choice Program, which became known as Medicare Advantage.
I recall the economic downturn of the late 2000s, when one of the largest insurers abruptly downsized. One morning they sent busloads of sales and telesales representatives to a hotel, told them their positions had been eliminated and promised to ship their belongings to their homes. It was a stark reminder of the volatility inherent in our profession.
Since then, a new generation of brokers has entered the field. Most of them have experienced nothing but boom times. However, for those of us who have weathered the busts, ominous clouds are gathering on the horizon, signaling potential trouble ahead.
Market Shifts and Financial Pressures
Insurers are beginning to exit the Medicare Advantage (MA) markets. Some carriers aren’t paying commissions on stand-alone prescription drug plans.
Others have removed their MA plans from online enrollment platforms. The Inflation Reduction Act has introduced changes that lower reimbursement rates and increase financial pressures on insurers. It’s not just insurers feeling the strain; at least 15 hospitals and health systems have also pulled out of Medicare Advantage.
For brokers measuring their sales numbers, the signs of a decline are evident. Make no mistake: we are entering a bear market. But how can brokers navigate and succeed in this challenging environment? It’s time to rethink our approach to enrollment.Here’s how:
Focus on Quality Sales
Dumping clients into an MA plan without considering their long-term health needs does little to benefit them. Insurers are looking for members who are connected with the right doctors and who will remain loyal to both, in return for supporting their health. Brokers should adopt this focus as well. Quality sales, where clients are matched with plans that truly meet their needs, will lead to better health outcomes, more satisfied customers and longer-term stability for everyone.
Look to the Long Term
Our current system allows for annual enrollment and disenrollment in plans, leading to significant churn. However, this churn does not benefit either the member or the insurer. Health costs decrease and health outcomes improve when insurers, physicians, and members can make long-term investments in health. Brokers should seek out plans with provider networks that will support members for years to come, fostering stability and continuity of care.
Support Your Community
Some brokers go above and beyond by helping clients find care, navigate medical bureaucracies, locate the best prices on medications, and even connecting them with life-saving social services. These brokers are not just salespeople; they are trusted members of their communities. By leveraging this trust, they help clients access a range of health solutions that may not be provided by an insurer. Brokers have a role to play in better health, and this is a powerful way for them to fulfill it.
Brokers who
focus
on health and serve that purpose will find that they not only survive this period
but also come out on top
Be a Trusted Advisor
Each year, thousands of people enroll in plans and are randomly assigned providers. When these mismatches occur, members often drop out of the plan. The lack of stability leads to missed preventive care and can lead to health declines. Brokers have a special role to play as trusted confidantes. By serving as a link to the right providers, brokers can help ensure smoother relationships between carriers and physician groups. This, in turn, yields better long-term health outcomes and more enduring customer relationships. Greater member satisfaction and improved health outcomes also lead to higher star ratings, which are vital for plans, providers, and patients alike.
Choose Higher-Rated Plans
Amid these market shifts, it’s crucial that brokers steer clients toward higher-quality plans. Pay attention to plan ratings; if a plan’s ratings decline, it’s a sign that it’s probably not the best option for your client. On the other hand, high-quality plans with high star ratings have more resources to support your clients’ health. Enrolling them in these plans is an easy way to ensure long-term satisfaction and customers who will be as loyal to you as they are to their doctor and carrier.
Navigating Stormy Waters
Yes, we are in stormy waters, and there are signs of problems ahead. However, this does not mean we are heading for collapse. Medicare Advantage remains the best plan option for most seniors, providing the coverage and benefits they need to lead healthy lives in their later years. Brokers who focus on health and serve that purpose will find that they not only survive this period but also come out on top.
Michael Blea leads SCAN’s Medicare growth operations across five states—California, Arizona, Nevada, New Mexico, and Texas. With over 25 years in the health insurance industry, he has deep expertise in scaling Medicare distribution channels. Previously, he was Vice President & General Manager at Golden Outlook, where he built one of the nation’s largest field marketing organizations. He also held leadership roles at Health Net and Secure Horizons/PacifiCare.
Financial Grade’s Playbook for Medicare Brokers Navigating California’s Evolving Market
Via Interview with Pete Blasi CEO of Financial Grade by Phil Calhoun
For two decades, Pete Blasi has been quietly shaping the Medicare brokerage landscape in California and beyond.
As the CEO, and president of Financial Grade, Blasi brings a rare blend of hands-on sales experience, strategic vision, and a deep commitment to broker education. In a recent conversation with Phil Calhoun, CEO of California Broker Magazine, Blasi opened up about his journey, the evolving needs of brokers, and the actionable strategies that have made Financial Grade a trusted partner for hundreds of California insurance professionals.
Financial Grade is a leading Medicare-focused field marketing organization (FMO) based in California. The company partners with independent insurance brokers to provide access to top Medicare Advantage, Medicare Supplement, and ancillary health products, while also delivering robust training, compliance support, and business development resources.
From Financial Advisor to Medicare Market Pioneer
Blasi’s entry into the Medicare space was serendipitous but quickly became a calling. “About 20 years ago, I founded Financial Grade after helping a client unravel Medicare,” Blasi recalls. “There was limited knowledge and resources to really get Medicare—especially all the different products that could serve clients’ needs. I saw the future, with Baby Boomers coming and increasing complexity, and jumped in as one of the first distributors in the Medicare market in San Diego.”
This foresight proved prescient. The Medicare market has since exploded, with California’s aging population and regulatory environment creating both challenges and opportunities for brokers and agencies.
The Broker’s Pain Points: Organization, Education, and Retention
Having worked with hundreds of brokers over the years, Blasi has a clear-eyed view of their biggest needs. “Brokers are great conversationalists and salespeople, but being organized is often a challenge,” he notes. “They need tools and processes to manage the client journey—from initial engagement and enrollment to ongoing follow-up, reminders, birthday cards, and annual policy reviews. A system is essential.”
This focus on systems is more than operational—it’s about building trust and delivering consistent value. “Systems and processes prove you’re a trusted advisor,” Calhoun observes, and Blasi agrees: “You really want to gain, but you also want to retain those clients year after year.”
Education as a Differentiator
Blasi emphasizes that successful Medicare brokerage starts with education, for both brokers and their clients. “Medicare is different from other types of insurance. Whether a broker comes from under-65 health, P&C, or another line, proper education is key,” he says. Financial Grade offers a structured track for agents,
covering both “Insurance 101” and “Medicare 101,” ensuring they understand not only the basics but also the nuances of the client journey as needs change over time.
He also highlights the importance of understanding ancillary opportunities: “Beyond Medicare, there are add-on products—dental, hospital indemnity, and more— that can serve clients and expand the broker’s value proposition.”
Touchpoints and Client Engagement: The Financial Grade Formula
One of Blasi’s core philosophies is that enrollment is just the beginning of the client relationship. “You want to call clients three days after enrollment, engage with them several times a year, and provide additional education. The idea is to serve them well, year over year,” he explains.
This approach is especially crucial in California, where strict Department of Insurance regulations require brokers to maintain clear records and demonstrate ongoing service. Regular touchpoints not only support compliance but also foster loyalty and retention—key drivers of long-term revenue.
Scaling Up: Supporting Growth-Oriented Brokers
For brokers who have built sizable books—300, 500, or more Medicare clients—scaling can become a challenge. “Sometimes brokers outgrow their FMO,” Blasi observes. “Many FMOs provide support but haven’t built a huge book themselves. We have a unique knowledge base from running our own national call center and direct-toconsumer platform. We share best practices for gaining and retaining membership year over year.”
Blasi stresses the importance of recognizing the multiple opportunities within each client relationship. “Every client comes with multiple opportunities—not just for additional revenue, but for deepening the value you deliver. Our goal is to help brokers engage clients throughout the lifecycle, ensuring they know you’re there to answer questions and provide solutions.”
Action Steps for California Brokers
For brokers considering entering the Medicare market or seeking a more robust partnership, Blasi recommends engaging with Financial Grade’s educational resources and community events. “Every month we host a broker engagement webinar, and our broker engagement managers act as coaches.
We also organize in-person events, like our upcoming Topgolf event in Los Angeles, where brokers can meet the team and learn from peers and industry experts.” Blasi invites interested brokers to contact their office directly: 855-202-5789. “We’re always happy to speak with brokers—whether they’re new to Medicare or looking to take their practice to the next level.”
The Bottom Line
As California’s Medicare market continues to evolve, brokers face increasing complexity, competition, and opportunity. Financial Grade, under Pete Blasi’s leadership, offers a proven blueprint: invest in education, implement systems for client engagement, leverage strategic partnerships, and never lose sight of the value in every client relationship.
For brokers considering their next move, Financial Grade hosts a monthly broker engagement webinar, where broker engagement managers act as coaches addressing different topics and highlighting what Financial Grade is doing in the community. Brokers interested in learning more can call the Financial Grade office, explore financialgrade.com, or attend an upcoming event. With Financial Grade’s commitment to education, community, and broker success, California’s insurance professionals have a valuable resource as they navigate the dynamic Medicare market.
Pete Blasi is the founder and CEO, leads the organization with extensive experience in the senior health insurance industry. He has played a key role in developing independent agents by forming partnerships with top-rated insurance carriers and value-based care organizations (VBCs), guiding industry best practices. In addition to his responsibilities at Financial Grade, Pete serves as the President and CEO of My Senior Health Plan (MSHP), a direct-to-consumer telephonic engagement model focused on assisting the Medicare-eligible community in understanding and selecting appropriate Medicare coverage and benefits. Pete graduated from San Diego State University with a degree in management and has been a driving force behind both organizations since their founding in 2005. He has been featured multiple times on news channels such as ABC as a Medicare expert. He actively shares insights on Medicare-related topics, including recent updates to Medicare Part D and Medicare Advantage plans, through blog posts and national webinars. His organizations have been nominated for the Better Business Bureau’s Most Ethical Business award, a recognition he takes great pride in. webinars.
Best Medicare Advantage Plans in California 2025
By Kate Ashford, CSA®, edited by Holly Carey
Aetna, Alignment Health Plan, Kaiser Permanente, and SCAN Health Plan all get top marks in California.
More than 6.8 million people in California are signed up for Medicare, making it the largest U.S. state for Medicare beneficiaries. There are more than 450 Medicare Advantage plans available in California.
Medicare is the federal health insurance program for people age 65 and older. Medicare Advantage is a bundled alternative to Medicare sold by private insurance companies. It offers all the same benefits and usually some extras, such as cost help with dental and vision coverage. Medicare Advantage plans offer more benefits than Original Medicare, and they're often cheaper than paying for Medicare and a Medicare Supplement plan. However, they offer less flexibility since you’ll need to get care from within the plan’s network of providers. Weigh your options to determine what plan best suits your needs.
Top-rated Medicare Advantage plans in California
Each year, the Centers for Medicare & Medicaid Services (CMS) awards every Medicare Advantage plan a star rating on a scale of 1 to 5, with 5 being a top-rated plan. Below are companies with plans that received top marks in California for the 2025 plan year.
4.5-star plans
There are no 5-star rated plans available in California for 2025. The companies below offer plans in California that are rated 4.5 stars out of 5 by CMS:
• Aetna • Alignment Health Plan • Kaiser Permanente
• SCAN Health Plan
4-star plans
The companies below offer plans in California that are rated 4 stars out of 5 by CMS:
• Alignment Health Plan • Astiva Health
• Providence Medicare Advantage Plans
• Sharp Health Plan
This list doesn’t include special needs plans, which restrict membership to people with certain diseases or characteristics, such as having a chronic illness or living in a nursing home.
What to know about Medicare Advantage in California
Nearly one in six people in California are 65 and older, and there are a wide variety of Medicare Advantage plans in the state. The average monthly premium in 2025 for a Medicare Advantage plan in California is $12.48. (This is down from $16.25 in 2024). There are 465 Medicare Advantage plans available in California in 2025. (This is up from 421 plans in 2024). All Medicare-eligible people in California have access to a $0-premium Medicare Advantage plan.
Third-party ratings
In its 2024 U.S. Medicare Advantage Study—its 10th iteration—J.D. Power measured member satisfaction with Medicare Advantage plans based on eight factors ranging from level of trust to how well a provider resolves problems or complaints. The study was fielded in the 10 biggest Medicare markets, which includes California.
In California, these Medicare Advantage providers scored above the regional average (643 points) on measures of member satisfaction (based on a 1,000-point scale):
Kaiser Permanente (666 points)
Alignment Health Plan (665 points) SCAN Health Plan (652 points) Medicare resources in California
California Health Insurance Counseling and Advocacy Program (HICAP): Offers assistance with understanding Medicare plans, comparing coverage, and filing appeals and challenging denials.
Kate Ashford is a writer and spokesperson for NerdWallet. She is a certified senior advisor (CSA)® and has more than 20 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she’s been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
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ADAPTING TO THE NEW NORMAL: HOW AGENTS CAN NAVIGATE PART D COMPENSATION CUTS WITHOUT ABANDONING THEIR CLIENTS
By Elliott Martin
WE MUST ALSO EDUCATE OUR CLIENTS NOT JUST ABOUT THEIR DRUG PLANS, THE INDUSTRY IS CHANGING BUT ABOUT HOW “ “
Starting in 2025, many Medicare Part D carriers eliminated agent compensation altogether—a trend that shows no signs of reversing as we look toward 2026. For agents who have spent years guiding clients through the complexities of re-shopping Part D plans during the Annual Election Period (AEP), the impact has been significant. Suddenly, we’re asked to provide the same level of service, care, and customization, possibly without any financial compensation. The result? A growing tension between doing right by our clients and maintaining a profitable, sustainable business.
In the past, re-shopping a client's Part D plan could be a 20 - to 45 - minute task. Multiply that across hundreds of clients, and it quickly becomes a full-time seasonal job. While we have never entered this field solely for commissions, we also can't ignore the economic reality: it's increasingly difficult to remain profitable servicing a product that doesn't pay.
A Tactical Pivot: Automation and Education
Last year, we decided not to walk away. Instead, we took a strategic pivot. We created a short, easy-to-follow tutorial video that guided clients through the process of comparing and enrolling in Part D plans using our personal plan-finder URL provided through our upline. This allowed clients to enter their prescriptions, select their preferred pharmacy, and enroll through us— maintaining attribution and preserving some continuity.
Of course, this required a major mindset shift for us and our clients. Many of them were accustomed to having every detail handled by us directly. So, we took the time to educate them on why this change was happening. We explained that while we were still here to guide them, we could no longer take on the entire burden of Part D comparisons without support.
Retraining Clients: What We Told Them
Rather than frame the change as a loss, we emphasized the benefit of staying connected to us while gaining more control over their coverage. Our communications highlighted:
• How to use the plan-finder tool (with step-by-step video guidance)
• What information they needed to gather beforehand (medications, dosages, pharmacy preferences)
• Why it was still important to review their plan each year
• That we remained available for questions or quick plan guidance for those that raise their hands
• How this new process sped up the overall experience
To our surprise, the response was mostly positive—some clients of course were disappointed but understanding of the new reality and others jumped right in, maybe even preferring to DIY-it when they knew they’d likely stay with their same Part D. Over time, we noticed something encouraging: the clients who engaged in the process became more informed and more confident in their Medicare decisions.
Balancing Client Care and Profitability
This new model isn't perfect, but it DOES create a sustainable middle ground. We're still offering support, still adding value, but we're no longer pouring as many long hours into a non-compensated product. Most importantly, we're preserving the relationship—a critical aspect of long-term client loyalty and retention.
It also opened the door to something we hadn't anticipated: new sales opportunities.
Now, when we're in front of clients during the Part D season, we're using that time to review other needs. If we're going to spend 10 minutes on a plan review, why not spend another 10 discussing:
• Dental, vision, and hearing plans
• Hospital indemnity or critical illness coverage (for those under 65 in CA or where applicable for clients in other states)
• Long-term care alternatives
• Life insurance reviews and risk assessments
• Retirement income planning conversations
• Referrals for family members approaching 65
• Requesting Google Reviews to boost our online presence
These conversations can turn a non-paying interaction into a valuable, revenue-generating engagement. And because it stems from genuine concern and relationshipbuilding, it doesn't feel like a hard sell.
Looking Ahead: A Shift in Strategy, Not Mission
As we brace for another AEP under this new compensation model, we must evolve. That doesn’t mean compromising the integrity of our service. It means being strategic about where we focus our time, how we automate the administrative side of the business, and how we create value beyond the Part D plan itself.
We must also educate our clients—not just about their drug plans, but about how the industry is changing and what that means for the services we can continue to provide.
There’s no single solution, but there is a path forward. By combining technology, education, and a consultative approach to client conversations, we can adapt to this new normal. And in doing so, we protect our business, serve our clients, and uncover new opportunities for growth.
After all, the goal has never changed: to help our clients live healthier, more secure lives in retirement. The way we get there is simply evolving.
Elliott Martin is an independent insurance agent based in Irvine, California, at his family’s firm, Martin & Associates Insurance Services, Inc. He specializes in helping clients navigate Medicare and fill coverage gaps with private insurance plans. Known for his clear guidance and client-focused approach, Elliott helps individuals access flexible, nationwide healthcare options with confidence.
EMPOWERING MEDICARE AGENTS THROUGH TECHNOLOGY
By Amanda Hargis
FIRST SIERRA’S AMANDA HARGIS
The Medicare industry is undergoing a profound transformation, driven by rapid advancements in technology. In a recent interview with California Broker Magazine, Amanda Hargis of First Sierra Insurance Services shared her perspective on how technology— especially digital tools, automation, and artificial intelligence—is reshaping the landscape for agents and clients alike.
THE EVOLUTION OF TECHNOLOGY IN MEDICARE
FROM PAPER TO DIGITAL: A BRIEF HISTORY
Hargis reflects on the early days of her career, when Medicare enrollment was a paper-based process. Agents would shuffle between carrier-specific formulary books and provider directories, manually searching for information and completing applications by hand. The shift to digital tools was initially met with skepticism; many agents, including Hargis herself, were hesitant to abandon pen and paper.
THE RISE OF ELECTRONIC PLATFORMS
Today, agents have access to comprehensive electronic platforms that consolidate all carrier contracts, client information, and enrollment tools into a single, userfriendly interface. These platforms streamline quoting, enrollment, and client management, enabling agents to focus more on client service and less on administrative tasks. First Sierra provides its agents with an electronic enrollment platform at no extra cost, allows them to manage all aspects of their business—from applications to client retention—in one place.
THE IMPACT OF TECHNOLOGY ON AGENT WORKFLOWS
EFFICIENCY AND EFFECTIVENESS
Technology has dramatically improved the efficiency of Medicare agents. Automated systems handle routine tasks such as quoting, drug formulary searches, and enrollment, freeing agents to spend more time with clients and prospects. Hargis emphasizes that these tools not only make agents more productive but also improves the quality of service they provide. By reducing administrative burdens, agents can dedicate time to educate clients and address their unique needs.
“Technology is changing everything—from how we communicate with clients to how we manage compliance,” she observes. “Brokers who embrace digital tools are better positioned to serve their clients and grow their businesses.”
CLIENT MANAGEMENT AND RETENTION
Modern client relationship management (CRM) systems are integral to agent success. First Sierra’s platform allows agents to track active and terminated policies, send automated messages (such as birthday cards or policy updates), and monitor client interactions. This level of organization ensures that agents can proactively address client needs, improve retention, and build long-term relationships.
DATA ANALYTICS AND AI: THE NEXT FRONTIER
Hargis is particularly excited about the potential of data analytics and artificial intelligence. These technologies enable agents to identify clients who require immediate attention—such as those affected by plan terminations or formulary changes—during critical periods like open enrollment. AI-driven systems can highlight at-risk clients, allowing agents to prioritize outreach and ensure continuity of care. This proactive approach contrasts sharply with the manual, spreadsheet-based methods of the past, which were time-consuming and prone to error.
ADDRESSING THE DIGITAL DIVIDE: CLIENTS AND TECHNOLOGY
CHANGING CLIENT EXPECTATIONS
There is a common misconception that Medicare clients—often older adults—are resistant to technology. Hargis challenges this notion, noting that many clients aged 65 to 80 (and even older) are increasingly techsavvy. They use smartphones, computers, and online tools to manage their health and insurance needs. For those less comfortable with technology, family members or caregivers often assist, ensuring that digital solutions remain accessible.
“No one can do it alone,” she says. “Leverage your network, attend industry events, upgrade to an FMO who leads with technology and don’t be afraid to ask questions.” Her own leadership at First Sierra Insurance Services is built on collaboration and a commitment to ongoing education.
THE DEMOGRAPHIC SHIFT
The Medicare population is evolving. As baby boomers continue to age into the program and Generation X approaches eligibility, the demand for digital solutions will only grow. Hargis points out that by 2030, the first wave of Gen Xers will enter Medicare, bringing with them higher expectations for digital engagement and online services. This shift underscores the importance of investing in technology now to prepare for the future.
THE ROLE OF AGENTS IN A DIGITAL WORLD
EDUCATION AND EMPOWERMENT
Hargis emphasizes that agents must be educators as much as salespeople. The complexity of Medicare products requires agents to explain options clearly and help clients make informed decisions. Technology supports this role by providing agents with up-to-date information, training resources, and communication tools. First Sierra offers webinars, recorded training sessions, and ongoing support to ensure agents stay current with industry changes.
COMPLIANCE AND BEST PRACTICES
We all know the Medicare market is highly regulated, with a growing list of strict compliance requirements. Technology helps agents navigate these rules by providing built-in compliance checks and documentation tools. Agents are encouraged to cover numerous client questions and seek guidance to ensure they operate within legal and ethical boundaries. Doing the work of a trusted advisor is a must, and technology helps cover all the important questions and review all plan coverage.
“At the end of the day, this is a people business,” she remarks. “Your reputation is your most valuable asset. Treat clients and colleagues with respect, and always act with integrity.”
She believes that the most successful brokers are those who are responsive, honest, and genuinely invested in their clients’ well-being. “Clients remember how you make them feel. If you’re responsive, honest, and genuinely invested in their well-being, they’ll stick with you—and refer others,” she says.
ATTRACTING THE NEXT GENERATION OF AGENTS
A CALL FOR YOUNGER TALENT
Hargis highlights the need for younger agents to enter the Medicare field. As experienced agents retire, there is a growing demand for new professionals who are comfortable with technology and eager to build longterm careers. She encourages recent graduates and career changers to consider Medicare as a rewarding path, noting that the industry offers stability, opportunities for growth, and the chance to make a meaningful difference in clients’ lives.
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The Future of Technology in Medicare
Continued Innovation
Amanda Hargis is the Director of Agent Support at First Sierra, where she leads agent training, compliance, and carrier relations. She supports independent life and health agents selling Medicare Advantage, Medicare Supplement, and Part D plans, while also helping advisors expand into Life Insurance, Long Term Care, and Final Expense solutions.
Looking ahead, Hargis anticipates even greater integration of technology in the Medicare marketplace. Advances in AI, machine learning, and data analytics will further streamline operations, enhance client service, and support agent success. Agents who embrace these tools will be better positioned to thrive in an increasingly competitive and complex environment.
Challenges and Opportunities
SOME TIPS AND THOUGHTS ABOUT OUR MEDICARE SUPPLEMENT MARKET
By Margaret Stedt, LPRT, CSA
The Medicare Supplement market continues to be a great opportunity for agents selling and servicing in Medicare beneficiaries in California. Many agents today are primarily selling the Medicare Advantage plans and are hesitant to present the Medicare Supplement plans. They are missing a great opportunity for almost half of the Medicare sales. Experienced Medicare Supplement agents are also becoming aware of carriers that are entering our marketplace, or they are exploring new relationships with carriers they did not consider previously. This is the time to take a deep dive into the Guaranteed Issue Guidelines by each carrier you represent and are considering to offer to your clients. You also want to look for additional benefits and programs such as household discounts, vision and hearing, and other ancillary benefits that a beneficiary might need.
There are quite a few challenges this year for the Medicare Supplement agent to continue to grow and service their book of business. First, we are seeing substantial rate increases for various plans. Timing varies for when carriers change rates (birthday month and base rate changes). Agents need to be aware of the dates when the rate changes occur and to prepare their clients for these changes. If you are not contacting your clients in a timely basis, you may find that your clients are looking online directly or calling the companies directly when they are receiving the adjusted billings. And, their P&C agent may be calling to offer them plans that you cannot!
One key solution for pricing is the California Birthday Rule that allows a Medicare Supplement plan covered person to change plans on or 60 days following their
birthday to an equal or lesser plan. As the agent, you need to review the Guarantee issue requirements for each of the carriers and their plans that you and your client are considering. Here’s an example to consider, some carriers will not accept a downgrade to a Plan G. Another example to consider, check to see if the effective date can be the first of the month for the birthday month or must be the first of the month following the covered person’s birthday. If a person’s birthday is July 22, you may submit a signed application July 22 through September 2 with the last possible effective date of October 1. Regardless, the application must be signed and submitted prior to the effective date. Also make sure to submit the required documentation requested by the plan.
Another solution is to look at the household discounts that are offered by the various carriers that run from five to seven to 12 percent. One requires that both of the covered persons be on the exact same plan including any ancillary plans/riders such as dental coverages. Others may only require that two members of the household be covered under a Medicare Supplement Plan to receive the discount. One carrier offers a discount if there are two or more adults living in the household and the other adult may be under age 65.
Outside of the initial enrollments and the birthday changes, you have many other opportunities to present the Medicare Supplement plans under the Guaranteed Issue Guidelines. While the GI situations follow the CMS and State requirements, there are variations between the companies in which plans can be offered and for situations like voluntary or involuntary termination from a group
insurance. There are also variations in whether certain plans can be offered to the Medicare Beneficiary if they are younger than 65 years old.
Always be truthful on the Medicare Supplement application as misrepresentations can result in the cancellation of the contract and other issues that could result in Errors and Omissions claims.
One issue that recently arose was the availability of returning to Medicare Supplement plan when the beneficiaries dropped their Medicare Supplement Plan and signed up for a PACE plan. They were unpleasantly surprised to be billed two months later for a large share of cost because they weren’t full dual (Medicare and Medi-Cal covered). Yes, they can return to the Medicare Supplement plans or other Medicare Advantage plans. A Medicare beneficiary enrolled in a Program of AllInclusive Care for the Elderly (PACE) plan can disenroll from PACE at any time, including mid-year, and is not required to wait for a specific enrollment period to do so. Upon disenrollment from PACE, the beneficiary will have a Special Election Period (SEP) to enroll in a Medicare Advantage (MA) plan or a standalone Prescription Drug Plan (PDP). This SEP lasts for two months after the effective date of PACE Plan disenrollment. If the beneficiary chooses to return to Original Medicare after leaving the PACE Plan, they may also purchase a Medigap (Medicare supplemental) policy within 63 days of the last date of PACE coverage, provided they are eligible and a plan is available in their state.
When you are working with clients on Medicare Supplement plans, advise them to always present both their Medicare Red, White, and Blue ID card and their Medicare Supplement card when accessing medical services. It is important they say they are covered under Original Medicare and their supplement plan.
Another tip is to help clients set up a My Medicare Account so they can track claims status. It will help you and them in resolving claims issues.
Reviewing the Medicare Supplement Plans:
These plans are designed to cover the out-of-pocket costs such as coinsurance and copays of Medicare Parts A and B. The Original Medicare Part A and B is the primary coverage (pays first) and the Med Supp is secondary. The plans will only pay if it is a Medicare approved service and Medicare pays first.
There is monthly premium for the plans. The rates for most of the plans in California are based on the covered person’s age and residence zip code or county. The rates will change from year to year based on age and a rating action by the company. If they move to another state, they may keep their plan but will pay the rates for the highest premium rate area.
Medicare Supplement Plans are subject to Underwriting and pre-existing clauses apply unless the beneficiary meets a Guaranteed Issue situation. Agents should review the underwriting guidelines (GI) for each company they represent.
As the plans are designed to cover the copayments and coinsurance amounts of Medicare, they do NOT cover additional services such as dental, Part D prescription drugs, hearing (hearing aids, exams and screenings) transportation, routine eye care, most glasses and contacts, and most health care outside the United States. However, in California, some companies are now offering the Innovative Plans (one company calls theirs Extra) that offer Vision and Hearing Benefits.
Advantages of a Medicare Supplement:
1) Choice of any doctor who accepts Medicare anywhere in the United States. This means if the beneficiary wants to see a John Hopkins doctor in New York or a doctor in UCLA, they have that option. Of course, they are responsible for all transportation, but at least they have the option.
2) Med Supp’s are portable, meaning if the covered person moves, the policy moves with them without any underwriting.
3) The policy is guaranteed renewable. This means the company cannot cancel the policy for anything other than non-payment. So, regardless of the use, the covered person can rest assured that they will always have coverage.
4) A MediGap Plan may reduce out-of-pocket costs. Medical costs are fixed and do not vary from month to month.
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MAGGIE STEDT C.S.A, LPRT is an independent contractor/licensed agent and consultant. She is acertified senior advisor and lifetime member of NAHU’s Leading Producers Roundtable at the Soaring Eagle Level. She has over 40 years of experience in essential areas of the insurance industry including sales and sales management, product development and product management. Maggie currently serves on the NAHU Medicare Advisory Committee. Founder of the annual Senior Medicare Summit, attendance grew from 200 in 2010 to close to 1,000 attendees in 2022. She served as past president of CAHIP; NAHU Region 8 Membership Chair 2014 –2018 and past president of OCAHU, serving two terms.terms.
The main disadvantages to Medicare Supplement plans are the premium costs that typically increase each year with no additional benefits, although companies may offer ancillary benefits such as gym membership, over the counter items, chiropractic and acupuncture services, and limited overseas travel (depending on the Plan). Remember the plans are designed to cover the copays and coinsurances of Medicare. (Plan C & F cover the Part B deductible.) The Medicare Beneficiary
Your Summer Wellness Guide: Practical Tips for a Healthy Season
By Megan Wroe, MS, RD, CNE, CLEC
Summer offers ample opportunities to embrace wellness, from exploring new places, playing outdoors, or simply enjoying a slower pace of life. Like any seasonal change, there are also new challenges, such as hot weather, travel, or disrupted routines that can also easily throw healthy habits off track. Being proactive about our health and making some intentional choices now can help fuel a summer that supports energy, mobility, cognition, stress resiliency and overall vitality. Here are some easy to implement tips for a healthy summer, all based on the whole-person wellness strategies that we teach every day at St. Jude Wellness Center.
“Our goal is to help you thrive through every season of life.” — St. Jude Wellness Center
Hydration
As we age, our thirst cues naturally decline, making dehydration a common cause of fatigue, brain fog, constipation, and skin issues. Add hot weather to this equation and people of all ages become high risk for dehydration in the summer months.
Tips to stay hydrated:
• Carry a refillable water bottle and sip steadily throughout the day rather than large amounts in one to two sittings.
• Choose low-sugar, low/no caffeine drinks for the majority of your liquid intake: sparkling water with fresh lemon or lime, herbal iced teas, coconut water, or fruit-infused water are great options.
• On flights or long car rides: aim for 8 oz of water per hour and limit alcohol and caffeine.
• Consider electrolyte mixes made with low glycemic sweeteners like monkfruit or stevia instead of high sugar sports drinks.
Check out our wellness center blog for hydrating mocktail recipes to add some variety and flair to your beverage menu!
Exercise Smart and Safe
Extended sitting—whether in a car, plane, or tour bus—slows circulation and stiffens joints. Regular movement will help you maintain your health goals and prevent unwanted discomfort while on the move.
Tips for summer exercise:
• At the airport: Walk the terminals instead of sitting at the gate.
• On long car rides: Stop every 90–120 minutes to walk and stretch.
• Do 10–15 reps every one to two hours of bodyweight moves such as squats, wall push-ups, or step-ups on stairs with handrails. 10 squats every 45 minutes of an eight-hour stretch mimics the benefits of hitting your 10,000 daily steps!
• Explore on foot or by bike: Walking/biking tours, nature hikes, beach strolls or boardwalk biking/skating are wonderful ways to stay active while sightseeing.
Remember that motion is lotion and movement is medicine. You don’t need a gym to move your body. When you ARE home this summer though, be sure to jump into some Functional Fitness classes like Cruising or Tai Chi Yoga at the wellness center!
Protect Your Skin
Our skin is our largest organ and is often forgotten about in wellness conversations. Sun protection is critical for protecting the skin, especially with increased outdoor time during summer.
Tips for healthy summer skin:
• Opt for mineral-based sunscreen (zinc oxide or titanium dioxide). Reapply every two hours while outdoors.
• Wear UPF-rated clothing and a wide-brim hat for added protection.
• Eat for skin health: omega-3 fatty acids (salmon, walnuts, flax), antioxidant-rich produce (berries, leafy greens, tomatoes).
• After sun exposure: soothe and repair skin with aloe vera or vitamin C serums and Epsom salt baths or foot soaks.
Learn more about holistic skincare in our recorded webinar and be sure to book a facial or back facial at the wellness center!
Support Sleep & Stress Resilience
Travel and longer daylight hours can disrupt sleep and strain the nervous system, which can lead to feelings of fatigue, body aches, and even cognitive delays. Prioritizing rest and finding ways to normalize your circadian rhythm is key during the bright, hot summer days when this can feel less natural than in the winter.
Tips for enhanced summer sleep:
• Stick to a consistent sleep routine—go to bed and wake up around the same time as much as possible, even when traveling.
• Use a sleep mask and white noise app to counter light and sound disruptions. You may want to consider temporary blackout window coverings if you are in a bright room, or bring black trashbags and painter’s tape to an Airbnb to make your room dark.
• Lean on AC in the later afternoon hours to make sure your room is cool at bedtime. Some people enjoy mattress cooling pads or room fans.
• Practice simple breathwork (such as box breathing or the 4-78 breath) before bed to calm the nervous system. Or try gentle stretching or restorative yoga before bed.
• While supplements are not typically powerful on their own, adding magnesium glycinate or taurate to your relaxing evening routine can help when circadian rhythm is off.
• Minimize alcohol intake, especially two-three hours before bed, as alcohol can inhibit the deeply restorative sleep our bodies need.
Wellness center offers a variety of restorative classes like yoga and sound bath, as well as private sessions of both massage therapy and yoga therapy. When on the road or unable to come in, we also invite you to try some of our breathwork or sound bath videos to keep up your stress resilience practice
Fuel Your Body for Adventure
Changing schedules, hot weather and summertime celebrations can lead to skipped meals and more “sometimes foods” than we usually choose. While there is always room for celebratory food, remember to incorporate nourishing options daily as well.
Tips for maintaining nourishing food options:
• Pack travel-friendly snacks:
° Packets of salted nuts
° Turkey or salmon jerky
° Cut vegetables with hummus packs
° Hard-boiled eggs
° Fresh berries or apples with nut butter packs
° String cheese with dehydrated fruit chips
° Crunchy chickpeas or edamame
° Low sugar granola with yogurt packs
• Build balanced meals on the go – prioritize protein and fiber
° Look for grilled fish or chicken with vegetables
° Choose salads with added protein
° Opt for grain bowls with legumes and greens
° Be the one who brings a fruit or veggie dish to the potluck!
• Limit alcohol and sugary drinks, which dehydrate and disrupt blood sugar
Food should fuel your adventures, not weigh you down. Our dietitian services and online nutrition education programs can help you master quick, nourishing meals and smart snacking strategies that fit daily life as well as celebratory moments.
Cognitive Wellness On the Go
New environments and schedules for the summer are perfect opportunities to stimulate your brain and support cognitive health, whether your goals are condition management or proactive aging.
Tips for ongoing cognitive stimulation:
• Engage in brain games while traveling: crosswords, Sudoku, or memory apps are easy to pack in a carry-on or find on your phone
• Stay socially connected both with loved ones as well as striking up random discussions with people in your travels. Conversation and new experiences support neuroplasticity.
• Find opportunities for play. Whether it’s taking your dog to the dog beach for ball play or exploring new parks with grandkids, engaging with new terrain where your body has to navigate with all of its senses is dual-tasking cognitive training at its finest.
Thriving minds and thriving bodies go hand in hand, which is why all services at the wellness center, from massage to nutrition to movement, all incorporate cognitive strategies. Join the wellness center newsletter for updates on a comprehensive brain gym program being developed in this upcoming year!
Wellness is a year-round journey, but summer is the perfect opportunity for a renewed focus on health. Whether you a looking to enhance your own healthspan or helping clients to navigate the health and wellness world, simple strategies and partnerships with trusted professional resources are the first place to begin.
St. Jude Wellness Center offers nutrition, fitness and stress resilience services to help optimize your health. To learn more about services, programs and monthly free webinars on a variety of health and wellness topics, visit the Programs & Events page at: www.stjudewellnesscenter.org stjudewellness@stjoe.org 714-578-8770
Megan Wroe, MS, RD, CNE, CLEC manages St. Jude Wellness Center, an integrative wellness department of St. Jude Medical Center. St. Jude Wellness Center is located in Brea, CA and offers a variety of nutrition, fitness and restorative programs and services for prevention and condition management such as PD.
For more information: www.stjudewellnesscenter.org
Use this Pre-Appointment Routine for More Referral Results
By Bill Cates, CSP, CPAE, President, Referral Coach International
Have you ever gotten to an athletic event early enough to watch the players warm up for the game?
Whatever the sport, almost every athlete has their pre-game routine that puts them in the right mental and physical state for the competition.
I was a professional musician for several years—a drummer—and I used to have a pre-performance routine that I followed religiously before every appearance.
What about you? What is your pre-appointment routine? Do you follow a checklist to make sure you don’t forget anything important? Do you prepare an agenda?
And what about referrals and introductions? If you use a pre-appointment routine related to referrals and introductions, you’ll never forget. You may wimp out, but you won’t forget.
Your Pre-Appointment Checklist to Get Introductions
1. Prepare your meeting agenda.
Running an appointment from an agenda makes for a more efficient meeting. Clients love knowing where the meeting is going and checking off the items. You increase the chances of staying on track and covering everything you intend to cover.
HINT: Ask your prospects and clients what they’d like to make sure is on the agenda BEFORE you create the agenda. This way, you’ll be prepared for everything.
2. Add value discussion or expectations check to the agenda.
The starting point of just about any request for introductions is the Value Discussion. This is where you make sure your prospects and clients are seeing the value of the meeting, the process, and/or the overall working relationship. This conversation will often lead to unsolicited introductions.
3. Think about specific people you know they know.
I call this “The Bullseye Referral Conversation.” Coming prepared for your request will boost your confidence and your results. The best way to ask for introductions is to come to the appointment with a request for an introduction to one or more specific people you know are in your client’s life. It’s the path of least resistance for both you and your clients.
You know that money intersects all aspects of one’s life. Being a great financial professional means gaining as much context as you can about your prospects and clients throughout the lifetime of your relationships. The more context you have, the better you can serve them. Plus, this will help you learn more about others in your clients’ lives— creating an inventory of possible introductions.
4. Think about relevant categories of people.
In addition to specific people that you know that they know, you can also suggest specific categories of life events and money-in-motion events. These events often trigger someone’s awareness for wanting to find a talented financial professional.
The goal of this step and the preceding step is to help your prospects and clients picture specific people in their mind. Instead of drawing a blank, they will begin thinking of others who should at least know about your important work.
5. Practice the conversation.
The best way to add confidence to your approach, that will lead to your clients responding positively, is through practice. The best practice is with a friend or colleague. Next best would be talking it out with yourself— maybe as you’re driving to an appointment.
If a baseball pitcher is working on a new pitch, do you think he’s going to try it in a game for the very first time? Heck no! Or if a musician has a concert coming up, is she going to read the music for the first time during the performance? Highly unlikely.
The most underutilized way to build skill and confidence around speaking to clients about introductions is through practice.
Just like a pre-game or a pre-concert routine brings focus, preparation, confidence and better results to the athlete and the musician, so too will a pre-appointment routine bring better results to you in the area of creating more introductions to prospects for your business.
Bill Cates, CSP, CPAE works with financial advisors to speed up their growth without increasing their marketing budget. Advisors tap into Bill’s proven process to multiply their best clients through introductions from advocates and Centers of Influence, communicate their value proposition more effectively, and create a reputation in a profitable target market. Bill helps advisors move from push prospecting to magnetic marketing – to attract more Right-Fit Clients™.
Bill is the author of 3 best-selling books, Get More Referrals Now, Beyond Referrals, and Radical Relevance. Bill’s newest book, The Language of Referrals was released in March of 2024. He is the founder of The Cates Academy for Relationship Marketing™, was named the #1 Financial Advisor Influencer by Indigo Marketing, and is the host of the acclaimed Top Advisor Podcast: www.TopAdvisorPodcast.com - now ranked in the Top 5% of podcasts worldwide.
BillCates@ReferralCoach.com www.ReferralCoach.com
CalBroker readers can get valuable free tools here: www.ReferralCoach.com/resources
LETTERS ON
INSPIRING ETHICAL EXCELLENCE
By Russ Williams
MANAGING CONFLICT HEROES OF INTEGRITY...IN THE MAKING
“Men acquire a particular quality by constantly acting in a particular way.” - Aristotle
Who becomes the face and voice of integrity at home, at work, and in the community? Courageous ones do. They are everyday heroes who face conflicts yet triumph with choices and actions that are viewed by others as serving a greater good.
Integrity, as defined in the Merriam-Webster dictionary, is a firm adherence to a code of especially moral or artistic values (incorruptibility), an unimpaired condition (soundness), and the quality or state of being complete or undivided (completeness).
“Heroes of Integrity” become sound of thought and incorruptible in behavior. These heroes know that the disposition of their mind and heart is constantly being pulled in two distinct directions: selfish good or selfless good. Rarely does an individual attain the ability to continuously act for the selfless good of others. Yet, the reality is... one’s moral and ethical pulse can be measured by how often an individual’s actions move with the purpose of serving the good.
Heroes of Integrity are ethical leaders. They lead by example as they act as exemplars of selfless good. Not a day goes by in my life that I do not notice a Hero of Integrity in-the-making. These individuals take charge of difficult situations where conflict does not erupt because disrespect is silenced. When I see the Hero of Integrity courageously building this life story, I am inspired to pursue doing the same. I become influenced by a Hero of Integrity in-the-making.
I find Heroes of Integrity in-the-making at the bank, the market, and the mall. Often, I observe them as hourly, part-time employees. Their employers expect them to be courteous to their customers. What I observe is not employer expectation. I see the effort of a Hero of Integrity in the making…one who is learning the art of serving the selfless good which, as Aristotle said, is acquiring a noble character by consistent action... in a certain way.
I see the effort of a Hero of Integrity in the making… one who is learning the art of serving the selfless good which, as Aristotle said, is acquiring a noble character by consistent action... in a certain way.
MISSION INTEGRITY ACTION
This week, as a Hero of Integrity in-the-making, I manage conflict by not showing disrespect to another. I understand that integrity requires that I pursue the selfless good that distinguishes me as one who is willing to courageously move as I manage conflict.
Journeying with you...inspiring ethical excellence!
Russ Williams contributes articles on professional growth for readers of California Broker Magazine. He serves as a mentor advisor and offers oneon-one professional consultations based on The Clarity Conversation, a 9-Session Self Renewal Consultation focused on overcoming nagging personal-professional challenges to re-claim personal-professional clarity renewing your influence for good at home, at work, and in the community.
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Annuity Hybrid with LTCi Extension
By Marc Glickman, FSA, CLTC, CEO and co-founder of BuddyIns.
As financial professionals, navigating the dynamic world of long-term care solutions has never been more critical, especially for an aging clientele keen on maximizing their assets. What product might be advantageous for Medicare clients who have assets that could be repositioned and who need coverage options to address long term care needs not covered by standard Medicare plans?
With the increasing popularity of annuity hybrids paired with LTCi extensions, a modern approach to long-term care planning emerges. This solution blends flexibility, tax advantages, and accessibility. Read on to learn why these innovative products are transforming long-term care planning for clients over 65. For clients who have more assets, an annuity + LTCi hybrid may be a solution to consider. Whereas the pricing of life hybrids can get relatively expensive at ages 65 and older, the pricing of annuity hybrids does not increase as much with age. The underwriting process for annuities is much less stringent with a page of knockout questions rather than the full underwriting that life hybrids often require. While there are not as many carriers offering annuity with true LTCi riders, the ones that offer the product are growing quickly in popularity.
Here are a few reasons why annuity products fit especially well for clients who are 65 and older:
1. They often have more readily available assets or cash equivalents that can be used to fund the single premium solution.
2. The immediate LTC insurance leverage can be 3x or more of the initial deposit, which compares favorably to traditional LTCi and life insurance hybrids at these ages.
3. The underwriting is designed for clients at these ages, and there's even a carrier with a guaranteed issue option should they not qualify for the best health rating.
4. Clients who already hold a non-qualified annuity can utilize a tax-free 1035 exchange to transfer the cash value into an annuity with an LTCi rider.
This allows the gains from the existing annuity to be excluded from taxation as ordinary income when allocated to the tax-qualified LTCi rider.
While not true LTCi, there are also fixed indexed annuities with ADL doublers that create additional income if the client meets the two out of six ADL eligibility trigger. A few of these products have expanded to cover home health care in addition to facility care. Carriers are seeing these features differentiate their FIA offerings. The true LTCi rider products have the added advantage of tax-free benefits.
Case Story: Repositioning Assets to Create LTC Planning Leverage
Steve had significant savings in cash, but he wanted a solution that would provide long-term care leverage without draining his assets. After consulting with a financial advisor, he discovered the annuity hybrid with LTCi extension—a product designed for individuals like him. Unlike traditional life hybrids, which become costly at his age, the annuity hybrid offers stable pricing and less stringent underwriting.
The Challenge
Steve had always been independent, navigating life with confidence. At 65, he found himself facing a new challenge— his health had begun to slow him down, and simple tasks like dressing and bathing required assistance. With no immediate family nearby, he worried about the financial strain of hiring professional caregivers.
Client Profile:
• Male age 65
• Health: Moderate, with a few chronic conditions that are progressing
• Financial: Significant savings in cash, which are able to be repositioned for long term care needs
• Coverage: Medicare Supplement, which doesn't cover LTC needs
Annuity Hybrid Funding Solution
After consulting with a financial advisor, he discovered the annuity hybrid with LTCi extension—a strategy designed for individuals like him. Unlike traditional life hybrids, which become costly at his age, the annuity hybrid offers stable pricing and less stringent underwriting.
With a single premium deposit of $100,000, Steve secured up to $8,792 per month for five years of home health, assisted living, or nursing home care. The indemnity benefit allows him to use the funds as needed, ensuring he could receive quality care without financial stress. Even better, he had the option to 1035 exchange his existing annuity, making the transition tax efficient
Value Proposition: Annuity Hybrid with LTCi Extension
Chart created using Benefit Buddy
Outcome
As Steve settles into his new care plan, he feels a sense of relief—his future is secure, and he can focus on enjoying life and getting the help he needs without worrying about the unexpected.
Annuity with LTCi Riders vs. Life with LTCi Riders
For the above client, this annuity with LTCi rider provides up to $8,792/month for five years of home health, assisted living, or nursing home care paid as an indemnity benefit. It’s competitive with a life-based hybrid policy, but with less strenuous underwriting. This product even has a guaranteed issue alternative should the client not qualify based on health.
Annuity Hybrid Breakdown
Sweet Spots:
• Available to clients of any health history (ages 55-80)
• LTC Leverage – two percent and five percent inflation protection and five-year benefit period available.
• Efficient Funding – Single pay and 1035 from existing annuity available.
• Indemnity Benefit – As long as you are receiving skilled care, spend your benefits how you wish.
• Partner Benefits – Some annuity hybrids with LTCi offer partner benefits, allowing coverage for two people under one policy, or for joint annuity owners to use their existing annuity value to fund a joint annuity LTCi plan that covers them both.
• More lenient underwriting – with guaranteed issue available. These plans are more accessible to those with pre-existing health conditions.
Product information available in the Buddy System
Sample Products:
• OneAmerica Annuity Care (Ages 40-85)
• Global Atlantic ForeCare Annuity LTC (Ages 50-80)
• EquiTrust Bridge (Age 55-80)
Publisher’s Note:
California Broker is pleased to have a collaborative relationship with Buddy Insurance, a leading long-term care insurance education, marketing and technology company. CEO Marc Glickman and his specialists will collaborate with health and life insurance professionals to help design LTCi options. Learn more about LTCi and refer clients — or learn how to write your own LTCi policies using Marc’s system.
Access all of the LTC planning tools shown in this article, plus our new Ai Advisor, with a 30-day free trial to the Buddy System. Sign up at the Buddy System Agent Portal to design your own plans or review the products in detail.
Marc Glickman, FSA, CLTC is CEO and co-founder of BuddyIns, a leading long-term care insurance education, marketing and technology company. Marc is a licensed insurance agent in all 50 states and serves on the Board of Advisors for CLTC. Marc has over 15 years of experience as an actuary including as the chief investment officer and chief sales officer for a major LTC insurance company. Marc earned his degree in economics from Yale University. In 2019, he was named one of the top 20 innovators in the insurance brokerage space.
Source:
1. https://buddyins.com/partner
Beyond the Exit: Crafting a Powerful Succession Plan That Protects Your Clients, Practice, and Legacy
By Dr. Daralee Barbera
Have you ever had a client look you in the eye and ask, “What happens to me if something happens to you?” Or gently wonder aloud, “Are you ever going to retire?” These are questions that can take any advisor by surprise—but ones that underscore the heart of succession planning. Whether retirement is on the horizon or far off, the time to prepare is now.
Why Succession Planning Can’t Wait
The urgency is real. Over the next decade 37.5 percent of financial advisors plan to retire, representing 109,093 FAs, and 41.5 percent of total assets. A natural group of successors—Next Gen financial professionals—have a rookie failure rate around 72 percent.
Regardless of the reasons, the resulting low retention creates missed opportunities for long-term advisor continuity and lowers the pool of potential successors for retiring advisors. To ensure successful transitions, planning must start with a commitment to attracting, recruiting, building, and retaining the next generation of future successors.
Who Will Carry the Torch?
Finding the right successor is both a strategic and human decision. There must be a cultural fit, shared values, and inspired trust that your clients can count on. Consider these sources of potential successors:
• Family and team members interested in getting licensed
• Next Gen advisors within your team or network
• Diverse candidates, such as rising women advisors
• Acquiring advisors through firm-led succession platforms
• Advisors aligned with your client philosophy
Women represent a growing and important talent pool of successors. Still underrepresented, just 23.9 percent of CFP® professionals are women. McKinsey & Company reported women are expected to control $30 trillion in U.S. assets by 2030, tripling the $10 trillion they already manage. Nearly 90 percent of women will, at some point in their lives, either manage money on their own, or share financial decision-making.
Yet, despite this growing influence, many women clients still report feeling underserved or misunderstood by the financial services industry. A 2020 New York Life Investments study found that empathy ranked highest among the traits women seek in a financial advisor. They want someone who listens, educates, and communicates clearly, not just someone who manages money.
Female advisors often excel in client retention and multigenerational planning. Advisors like Darci Kelley, Principal of Kelley Family Financial in Tustin, CA, are exemplifying the impact of women-led succession. Kelley’s team of multi-generational women creates a client experience rooted in empathy, continuity, and longterm trust. “Clients appreciate that we have a longevity plan,” Kelley says. “They interact with our entire team and feel confident knowing who will be there for their families in the years ahead.”
Planning with Precision: 5 Key Questions
Once a potential successor is identified, intentional planning is critical. Here are five questions to guide your transition strategy:
1. Who is the right choice to take over the practice? Evaluate beyond technical competence. Look at values, leadership style, and relational ability.
2. Why is the acquiring advisor in this profession? Ensure alignment on purpose. Shared mission and long-term vision help avoid costly mismatches.
3. What makes your practice unique in a competitive marketplace?
Define your value, culture, and brand. This helps attract the right successor and retain clients through the transition.
4. When will clients and staff be introduced to the successor?
Phased introductions build trust. Consider joint meetings, co-branded communications, and a clearly communicated transition timeline.
5. How will relationships be transferred and protected? Create systems for continuity, including a documented client service model, operational SOPs, and a clear hand-off structure.
Be prepared for the possibility that your first successor candidate may not be the right fit. Even when a match seems strong, a “trial period” is wise. Relationships, especially in the financial services profession, are nuanced and personal.
The Role of Mentoring and Coaching
One of the most overlooked components of succession planning is ongoing coaching and mentorship. Transitioning a practice is not just about compliance and contracts, it’s about transferring trust.
Senior advisors can support successors through shadowing opportunities, coaching conversations, and modeling how to navigate the interpersonal aspects of client service. Consider bringing in a certified business coach to help the successor refine leadership presence, communication skills, and client onboarding strategies. This coaching investment often accelerates confidence, fosters cultural integration, and enhances long-term retention.
Just as you’ve helped clients plan their futures, coaching helps the next generation plan, and succeed, in theirs.
A Living, Breathing Plan
Succession planning isn’t a “set it and forget it” task. Your vision, market conditions, and client expectations may evolve. Treat your plan as a living document and revisit it. Ask yourself: Is my successor still the right fit?
Are clients responding well to the transition? Do operational or financial details need adjustment? Is the valuation aligned with current market benchmarks?
It’s never too early, and never too late, to begin.
Legacy Beyond the Numbers
Ultimately, succession planning is not just about valuation or exit timing. It’s about the enduring impact of your work. The relationships you’ve nurtured. The lives you’ve changed. The trust you’ve earned over the years.
When you approach your succession with the same care, intentionality, and leadership that built your business, you do more than create an exit. You create a future that’s grounded in service, stewardship, and significance.
And that future is truly worth leading.
Dr. Daralee Barbera : EdD CFP® CMFC® CLF® ChFC® CEPA® CPBL® CPMBC® is a Certified Master Business Coach, international speaker, professor, author, and consultant,she has over three decades of financial servicesand leadership experience. She is President of DPC, Diversified Professional Coaching, LLC, serves as Program Director of Graduate Leadership at The American College of Financial Services, holds the Joseph-Liddy Chairin Practice Management & Leadership, and is Assistant Professor of Leadership. Dr. Barbera is the 70th recipient of the Will G. Farrell Award, presented by NAIFALA, and she is Past President of the GAMA International Board of Directors. daralee@divprocoach.com
The health insurance industry is undergoing a significant transformation as Baby Boomer brokers approach retirement age, creating an unprecedented opportunity for succession planning and business growth. In a recent webinar, Phil Calhoun and David Ethington delved into their proven "Preferred Buyer and Successor" program, designed to help brokers protect, grow, and eventually sell their health insurance commissions. This article synthesizes the key points, strategies, and real-life stories shared during the session, offering a comprehensive guide for brokers seeking to secure their legacy and expand their business.
The Growing Demand for Commission Planning
Phil Calhoun opened the webinar by highlighting the urgent need for commission planning among active health insurance brokers. “With Baby Boomers owning a vast majority of small businesses in the U.S., including health insurance agencies, the market for succession planning huge. In California alone, there are over 170,000 resident licensed health and life insurance professionals, many of whom will be seeking exit strategies in the coming decade.” Brokers must take action to protect their commissions, as those without a plan leave their commissions at risk of total loss. Ethington states “We help brokers protect their hard-earned health commissions with a plan that moves the threat from active to controlled. Our goal is to eliminate the risk of lost commissions through education on the importance of proactive planning for all brokers.
Regardless of the retirement timeline, having commissions unprotected will result in total loss when an unexpected life event occurs to the active broker.
With so many active brokers working in the industry, the need for an effective solution to protect commissions is huge. Education is necessary, but action must follow. For over ten years, we have provided our experience with commission planning.
We personally and professionally seek to help colleagues with commission planning. Our articles, webinars, videos on our website (www.commission.solutions) lead to a free 15-minute, 1:1 call where a broker can receive answers to their planning questions. With the number of brokers still without a plan to protect their commissions, we have recently started an effort to grow our team of Preferred Successor Buyers interested in working with brokers who need a plan.
Introducing the Preferred Buyer and Successor Program
The "Preferred Successor - Buyer" program brings local health insurance professionals up to speed on our commission planning approach. This program equips brokers with the information needed to arrange a 15-minute appointment. During these appointments with our Preferred Successor – Buyer and their broker lead, we reinforce the need for planning and the value of a Preferred Successor – Buyer. When the broker agrees, next steps include:
• Access to our essential tools and agreements we use to help develop a written plan.
• Guidance on identifying and approaching more Baby Boomer brokers for succession planning.
• Support through the entire process, from initial discussions to legal agreements and client retention strategies.
• Eligibility for more work, Preferred Successor –Buyers become part of our team after completing the training. We promote them to California Brokers and connect them to brokers looking for a Successor or Buyer.
With a decade of experience, Phil and David are preparing for the huge number of Baby Boomers who need education and the tools to complete their commission protection agreements. The goal is to ensure buyers and sellers benefit from a fair, vetted, and effective process.
The Planning Process: Steps to Success
Our four-step process for commission and client protection process always begins with:
1. Be the Successor for an Active Health Insurance Broker: Present as a licensed, certified Successor and line out the specific criteria you provide with our team to ensure a proven commission protection plan is provided.
2. Complete a Successor Agreement: With our team leading the process, Successor and Active Broker work to clearly define the terms of succession, including payment structures and responsibilities.
3. Establish a Purchase Agreement: We lead the way through the planning process which includes purchase price and payout period terms.
4. Implement a Client Retention Plan: Another step in the planning process is the development of a client retention plan which is critical in the process.
Our agreements lead the industry, as over years of collaboration with hundreds of attorneys, CPAs, and industry advisors, we can confidently state we met the goal to ensure all parties have the protection needed.
Training and Support for Preferred Successor Buyers
The program offers a comprehensive two-hour training session, after which participants earn the "Preferred Successor Buyer" designation. This status links Preferred Successor Buyers with our team and opens doors to new business opportunities, provides access to expert support, and enables brokers to participate in a network of professionals dedicated to best practices in commission planning.
Key benefits of the training include:
• In-depth education on commission protection, acquisition processes, and client retention.
• Access to legal tools and advisory support for navigating complex transactions.
• Ongoing marketing and lead-matching to connect buyers with brokers seeking succession solutions.
The training fee is a modest investment compared to the potential growth and security it offers. Additionally, participants gain access to annual reviews, updated carrier transfer forms, and continued advisory support to address evolving needs.
Why This Matters: Protecting Legacies and Growing Businesses
Phil and David’s approach is rooted in a genuine passion for helping brokers secure their financial futures and protect their families. By educating the industry on the risks of unplanned succession and providing a proven roadmap for transition, they aim to shift the narrative from loss and uncertainty to empowerment and growth.
Brokers who engage in commission planning not only safeguard their own interests but also position themselves as trusted advisors and problem-solvers for their peers. The program’s collaborative, team-based model ensures that even complex cases involving estate planning, tax considerations, or unique business structures are handled with expertise and care.
READ FULL ARTICLE →
Next Steps: How to Get Involved
For brokers interested in becoming a Preferred Successor - Buyer, the process is straightforward:
Attend the training session to gain the necessary knowledge and designation.
To learn more about commission planning options go to: www.commission.solutions
Engage with the program’s Subject Matter Experts in commission planning and identify active brokers in need of succession planning.
Arrange the First Planning Call which connects your active broker with our team to get answers to planning questions.
Phil Calhoun is the owner and publisher of California Broker Media, and he owns Integrity Advisors, a health insurance agency. Phil started Commission.Solutions to provide coaching for health insurance professionals on how to protect, grow and sell health commissions. Phil is an active member of several insurance associations including the California Association of Health Insurance Professionals (CAHIP) and local chapters in Orange County, Los Angeles, San Diego and Inland Empire Health Insurance Professionals. He serves on board for the Exit Planning Insitute.
CLICK HERE to arrange a no obligation 15-minute coach session Phil@commissions.solutions 714-664-0311
With Questions answered, the next step is to engage with you and your active broker to develop the specific terms of your agreement with you as the active broker’s Successor – Buyer. Complete our comprehensive three-part agreement. We provide all of the tools, the legal agreements, the commission transfer process, and the client retention plan. We support you and your active broker and facilitate your successful plan.
Phil and David also offer free 15-minute consultations for those seeking more information or personalized advice. Their goal is to build a statewide network of qualified successors, ensuring that every broker in California has access to effective commission protection and transition solutions.
David Ethington is VP of the Medicare Division and director of Broker Relations with Commission Solutions, part of Integrity Advisors. His work has excelled due to his commitment to providing the best service to both health clients and health brokers. David respects the hard work it takes to build a book of business and enjoys working with retiring brokers and their families. David has participated in the commission protection process for seven years. He’s also involved in acquisitions, especially in the broker relationship transfer of commissions. David lives in Orange County with his wife and their cats. He is an avid runner and completes several long-distance events annually.
David@commission.solutions 714-664-0605
The Preferred Successor - Buyer program presented by Phil Calhoun and David Ethington represents a bestpractice approach to one of the most pressing challenges facing health insurance brokers today. By combining education, legal expertise, and a supportive professional
THE PREFERRED SUCCESSORBUYER TEAM
Meet the teaM that can help you protect your coMMissions:
These health insurance professionals completed our required training to earn the designation of a Preferred Successor – Buyer. They are now part of the team at Commission Solutions. Our team helps active health brokers get their planning questions answered. Active Brokers need to learn about Commission Planning, how to protect, grow, and eventually sell their health commissions, which is important to understand. These Preferred Successor – Buyers are part of our planning team, and they look for health brokers who need a plan to protect their commissions. The training we provide enables them to help educate brokers that they find in their networks.
The first step in the planning process is to set a FREE 15-minute phone call. During the call you will get your health commission questions answered by our team. David Ethington and Phil Calhoun lead the team, and they have ten years of experience educating brokers on commission planning and developing customized plans for Active Brokers. All Active Brokers need a plan to protect their commissions, and they need to work with a Successor Broker to implement their plan. Our Preferred Successor – Buyers are a great option. If you already have a partner, colleague, or family member who can be your Successor, then you still need our agreement and expertise to build out your personalized plan. If you need a trusted person who will commit to protecting your commissions while you remain active, you can select one of our Preferred Successor – Buyer brokers or call us to learn more about the planning process. Phil Calhoun phil@commission.solutions 714-612-0306
Reach out today.
Elliott Martin is an independent insurance agent based in Irvine, California, at his family’s firm, Martin & Associates Insurance Services, Inc. He specializes in helping clients navigate Medicare and fill coverage gaps with private insurance plans. Known for his clear guidance and client-focused approach, Elliott helps individuals access flexible, nationwide healthcare options with confidence.
www.martinassociatesmedicare.com
Michelle has been a licensed health insurance agent since 1992, with broad experience in the employee benefits field. She has supported a wide range of brokers, businesses, individuals, and seniors through roles in sales, management, and by founding her own agency to better serve clients and partners. She helps agents navigate business transitions, protect commissions, and maintain client loyalty. Michelle also assists brokers in creating succession plans that ensure stability and peace of mind. Based in Clovis, California, she works with clients statewide and stays busy raising her four children.
559-287-3407 cell www.brokertransitionsolutions.com/protect Connect with me on LinkedIn
I began my career in health insurance in 2002 and currently operate under the Tim Proctor Insurance Agency, with a primary focus on the Individual and Family Plan (IFP) market. I have extensive expertise in Covered California health insurance and currently manage a portfolio of over 700 active policies. My agency serves clients throughout the entire state of California and is supported by a dedicated team of five employees.
I am actively seeking opportunities to acquire additional IFP business. Please feel free to contact me at 800-771-7653
