Medicare lifecycle

For Medicare books (Medicare Advantage, MAPD, and Part D), CommissionSight adds two forward-looking views that a month-over-month statement can’t show on its own: a rapid-disenrollment (RDE) clawback radar for the downside, and a renewal & book-value forecast for your recurring income. Open them from the account menu (top-right) → Medicare lifecycle.

Both read only your loaded statements — there’s nothing to configure to get started, though setting your Medicare product line and contracted rates makes the dollar figures exact (see Product lines & commission rates).

Note

Medicare lifecycle is enabled per account — it’s built for Medicare Advantage / Part D books, so it’s off by default. If you run a Medicare book and don’t see it in your account menu, ask us to turn it on.

Rapid-disenrollment (RDE) radar

Medicare commission is advanced and then earned: the carrier pays you the year’s commission up front, but if the member disenrolls in the first few months (a rapid disenrollment), CMS rules claw the whole advance back. The radar surfaces that risk in two numbers:

• Realized — members who already rapidly disenrolled and show a clawback (negative commission) this period. Money you’ve lost.
• Exposure — active members still inside the rapid-disenrollment window (their coverage started recently). This is the see-it-coming figure: commission you’d have to give back if these members left today.

Alongside those you get the rapid-disenroll rate and breakdowns by plan and by writing agent, so you can tell whether the churn is concentrated in one plan or one producer.

Note

If your carrier reports a term / disenrollment date, the radar uses it directly. Many carriers (e.g. UHC) don’t — so when a date is absent, CommissionSight infers the disenrollment from the member timeline: a member who was on the statement and then drops off is treated as disenrolled the month after their last appearance, and effective → last-seen is their enrolled window. Inferred disenrollments are labeled as such, so you always know which came from a carrier date vs. a timeline drop. Records missing an effective date are counted toward coverage but never guessed.

Renewal & book-value forecast

The forecast projects the next 12 months of renewal commission across your active book. Each active member renews once a year on their enrollment-anniversary month at the CMS renewal rate, so the total is your book’s annual recurring renewal income — a practical measure of what the book is worth.

• It uses your configured Medicare rate schedule when you’ve set one. If you haven’t, it falls back to the built-in CMS maximum rates and marks the result as an estimate — set your contracted rate to make it exact (carriers may pay below the CMS cap).
• The forecast assumes members are retained. Pair it with the RDE radar above, which is the complementary downside — retention risk on the newest members.

Getting the most out of it

• Set each Medicare carrier’s product line to Medicare so the CMS engine runs (Major medical is the default and won’t compute renewal/RDE figures).
• Enter your contracted CMS rates for exact dollars; otherwise you’ll see CMS-maximum estimates.
• Make sure your statements carry effective and term dates — they power the RDE radar.