This October marks the start of what is likely to be the most disruptive year in recent memory for Medicare Advantage sales. With an estimated 7% of the Medicare Advantage population losing coverage due Service Area Reductions (SARS) or plan exits, this Annual Election Period (AEP), its more important than ever that Health plans, agents, and agencies are laser-focused on maximizing these next six weeks. The stakes are even higher with regulatory changes and an election year adding complexity. Here’s what to expect and how our products can help you navigate this intense selling season.
Key Focus Areas for Health Plans:
1. Lead Generation & Distribution
Generating and distributing leads efficiently is essential to Medicare Advantage success. This year, competition is especially fierce, and agencies will be looking to recapture and protect their books of business for members that are losing their coverage. This takes focus and attention off of finding new business, making the need for health plans to be especially agile about lead distribution and management this AEP. Expect to regularly reassign leads, calls, and appointments to brokers who are actively writing your plans and have availability to work new appointments rather than chasing existing rewrites.
2. Enrollment Processing & Reporting
With AEP comes increased activity, and efficient enrollment processing is key to staying organized. Health plans must have reliable systems to handle high volumes while keeping reporting timely. In Medicare Advantage, the last application wins for AEP enrollment, and many plans may experience a slow start to application submissions only to see volume explode after the election on November 5th and moving into the end of AEP on December 7th. Ensuring the timely submission, processing and triage of applications will be crucial to winning agent and broker business this year while also staying on plan for sales goals.
3. Compliance
In years with serious disruption like this one, Health plans also see that agencies and agents may feel pressured to cut corners, skirt standard sales processes, or disregard new regulations in order to grab and/or protect as much business as they can. Health plans need to remain vigilant and dedicated to their compliance program, identify outliers in the data that may indicate a need for corrective action and focus on business with the right partners who reduce regulatory risk in times of turmoil.
4. Sales Support & Materials
Hand in hand with compliance comes training and delivery of required sales materials to brokers. With the 2025 Star Ratings release just around the corner and paper sales materials still holding a valuable place in the sales channel, ensuring brokers are presenting accurate information about your products, to the right prospect at the right time this AEP will not only reduce your compliance risk but drive broker satisfaction and overall plan growth. Make your materials and specific training available on demand so agents and agencies feel its easy to do business with you over your competitors.
Why This Year Is Different:
Regulatory Changes
The 2025 AEP brings significant shifts due to new rules governing marketing, sales practices, and agent compensation. These changes create a dynamic market with plenty of opportunities, but they also require tighter compliance. When 7% of the market is forced to find new coverage due to plan exits or SARS, its feast or famine for many Health Plans and agencies. When your operations are streamlined to be the signal in the noise for your partners, you’ll outperform in this disruptive market.
Election Year Disruption
With the 2024 Presidential Election looming, marketing campaigns will be competing for attention, and mail campaigns could see delays. This adds another layer of complexity to an already intense AEP and makes your agents and agencies all the more important as they engage their clients and centers of influence to stop gap losses and drive new plan growth. Make sure you are ready for the avalanche of activity that you should be anticipating post November 5th this year.
How Our Products Help You Succeed:
In a market experiencing major disruption, know that you don’t have to go it alone. EvolveNXT tailormade suite of Health Plan solutions is here to support our current Health Plan partners in a marketplace that demands agility and timely execution from your vendors. Here are a few ways we help our partners today tackle this exciting and tumultuous year.
- Broker Contracting & Certification: Streamlines producer credentialing and relationship management, ensuring agents are fully certified and “ready to sell” by the start of AEP.
- Broker Services: Centralizes producer workflows, simplifying enrollment processing, agent training, and sales material distribution to keep agents efficient and productive.
- Sales Execution: Improves producer lead management and enrollment by enhancing lead distribution and tracking, helping your team stay agile in a competitive environment.
- Commission Payments: Ensures accurate, efficient, and compliant commission payments, keeping agents motivated with timely compensation.
Tips for Navigating AEP 2025:
- Stay Compliant: Use Broker Contracting & Certification to ensure agents adhere to new regulations, keeping your sales operations safe from penalties.
- Maximize Lead Generation: Leverage Sales Execution to distribute leads effectively and seize new business opportunities.
- Focus on Reporting: Use Broker Services and Commission Payments to streamline enrollment and commission reporting, minimizing administrative hurdles.
As AEP approaches, the right tools can be the difference between success and chaos. By staying compliant, streamlining your sales operations processes, and focusing on sales execution, you can make this Medicare Advantage season your most successful yet. Let us help you navigate the challenges and come out ahead! Reach out to info@evolvenxt.com for help today.
