2021 State of the Senior Market: In Review

Craig Ritter, CEO of Ritter Insurance Marketing, recently gave his annual State of the Senior Market address to 412 agents, who attended from all across the U.S.

This year, Craig’s address was split into three informative videos: The Year in Review, Enrollment Stats for 2021, and Medicare Regulation & Legislation and Major Industry Trends.

We’ll provide the highlights here, but you can watch the presentations in their entirety by following the link below. (You must register for a ticket to watch the recordings.)

Check Out the State of the Senior Market

The Year in Review

In the first session, Craig discussed what’s new at Ritter and some numbers from the Medicare market. It’s safe to say this past year was like nothing we’ve ever experienced, for our employees and agents alike. While COVID-19 restrictions forced us to make some adjustments, we all still managed to make the most of an unpredictable situation.

2020 in Numbers

In 2020, our agents produced $30,396,018 in Medicare Supplement premium. It was a great year for Medicare Advantage enrollments, with 86,505 in 2020 — a 37 percent increase from last year! Medicare Part D enrollments came in at 69,539, which was down by 12 percent from 2019, likely due to changes to the products in the market.

2020 in Numbers

Our Annual Enrollment Period numbers were down a bit, possibly due to COVID-19 and 2020 being an election year, which made it difficult for marketing. We had 35,140 Medicare Advantage enrollments during AEP, which was a 25 percent decrease from last year’s AEP, but we had 36,137 Part D AEP enrollments, which was a 15 percent jump from the same period in 2019.*

Over the course of the year, we added three key business relationships in 2020, including Secure Benefits Alliance, Quick Insured Brokerage, and HTA Financial Services. We also added nine new Medicare contracts, and our existing MA/PDP parent relationships increased to 39.

Additionally, Ritter gained 10 new employees, putting us at a total of 230 full-time team members. Our home office remains in Harrisburg, Pennsylvania, with regional offices in Arizona, Nebraska, and New York. This year, we added Ritter presence in Maryland, Indiana, Georgia, and Ohio.

*Excludes three acquisitions


Meet Shop & Enroll — For the 2024 AEP, we rebranded Medicareful to Shop & Enroll. It’s the same great tool, with the same great features, just a new look and feel. Learn about the rebrand

Our premier quoting and enrollment platform, Medicareful, now has partnerships with five PDP and 23 MA carriers. We saw a 30 percent year-over-year growth in new Medicareful pages, a 50 percent year-over-year growth in first-time users, and a 78 percent year-over-year growth in applications. It’s all thanks to agents like you who keep Medicareful thriving!

We saw a 30 percent year-over-year growth in new Medicareful pages, a 50 percent year-over-year growth in first-time users, and a 78 percent year-over-year growth in applications.

The graph below shows the year-over-year growth in the number of Medicareful enrollments. Our total number of applications for 2020 was more than the combined total of apps from all prior years. Great job to our Medicareful agents!

Year-Over-Year Growth in Medicareful Enrollments

We made some improvements to Medicareful, as well. Our agents can now complete prescription drug quotes through our Platform CRM and Medicareful and email or text their clients prefilled Medicareful applications. We also launched Medicareful Help, a video series you can share with your clients to show them how to use the Medicareful platform.

Additional Improvements

We redesigned our Medicareful Living blog, which saw a 33 percent increase in visitors in 2020. Our Agent Survival Guide did quite well this year, too. We had more than 4,500 downloads of eBooks in 2020 and released five new guides: Developing an Agency — Your Guide to Getting Started, The Complete Guide to Client Loyalty and Retention, Modern Medicare Marketing for Today’s Agents, The Complete Guide on How to Sell Medicare Advantage Plans, and A Quick Guide to Cross-Selling Ancillary Insurance with Medicare Products.

Our future plans for 2021 include enhancements to Medicareful and our CRM and improvements to the contracting and enrollment processes. Stay tuned to see what 2021 has in store!

Medicare Enrollment Stats for 2021

In the second session of the State of the Senior Market, Craig took a look at enrollment stats for the 2021-2022 AEP, the top growth states, and what these numbers mean for the year ahead!

Annual Medicare Market Growth

Individual Medicare Advantage products saw an 11 percent increase in enrollments, while PDP enrollments went down by three percent. This makes 2021 the second consecutive year of double-digit growth in the MA space! Employer plans saw no increase or decrease in enrollments.

UnitedHealthcare ranked number one for individual MA enrollments in 2021, with Humana, CVS/Aetna, and Anthem following closely behind. Traditional HMO enrollments were up seven percent from 2020, while local PPOs saw a significant increase of 24.5 percent. For prescription drug plans, CVS/Aetna ranked number one, with WellCare, UnitedHealthcare, and Humana ranking second, third, and fourth, respectively. You can see a full breakdown of carrier ranks, enrollments, and changes in enrollments during AEP and year-over-year by watching the full session.

Top Medicare Advantage Growth States

Texas was the top growth state for Medicare Advantage, with 77,454 new enrollments in AEP, from December 1, 2020 to January 1, 2021. Florida, California, North Carolina, and Michigan followed. In Texas, UnitedHealthcare accounted for 45 percent of that growth, Humana for 26 percent, Centene for 11 percent, Anthem for six percent, and CVS/Aetna for one percent. For a more in-depth look at the breakdown of state enrollments by carrier, check out the full second session of the State of the Senior Market Address.

Texas was the top growth state for Medicare Advantage, with 77,454 new enrollments in AEP, from December 1, 2020 to January 1, 2021.

Some carriers in a handful of states of states even saw greater than 100 percent of growth in 2020, due to some other carriers’ plans shrinking or leaving the market. Those plans were UnitedHealthcare in Missouri with 109 percent growth, UnitedHealthcare in Kansas with 103 percent growth, and Humana and Presbyterian Healthcare in New Mexico, with 298 percent and 249 percent growth, respectively.

#1 Plan Generates > 100% Growth

In his third and final session, Craig covered Medicare legislation updates, as well as major trends in the Medicare market.

MACRA, 21st Century Cures Act, and 2021 Advance Notice

First and foremost, the new Medicare Beneficiary Identification Number (MBI) fully replaced the HICN, which was retired as of January 1, 2020. Due to MACRA, Plan F became unavailable to newly eligible Medicare beneficiaries as of January 1, 2020, and Plan G became guaranteed issue for these individuals. Additionally, the 21st Century Cures Act removed the Medicare Advantage Disenrollment Period (MADP) and added the new Medicare Advantage Open Enrollment Period (OEP). This act also allowed people with End-Stage Renal Disease to enroll in Medicare Advantage plans for 2021. Moreover, the 2021 Advance Notice indicated the voluntary maximum out-of-pocket (MOOP) limit was changing from $3,400 to $3,450, while the mandatory MOOP changed from $6,700 to $7,550. This was primarily due to the ESRD changes.

Changes from CMS

The Centers for Medicare and Medicaid Services (CMS) “upped the bar” for 4-star plans. For 2021 and future years, CMS is putting more focus on the patient experience. They’re doubling the weight on patients’ experiences (CAHPS Survey), complaints, and access measures in 2021, and quadrupling it in 2023. CMS is also looking to increase health care access in rural areas to give beneficiaries better coverage, so look for more Medicare Advantage plans in rural markets! By 2022, CMS will not renew D-SNP look-a-like plans (non-SNPs that target the D-SNP population), unless there is no other true D-SNP alternative available in the state or other plan authorized by CMS (e.g., MMPs).

The Centers for Medicare and Medicaid Services (CMS) “upped the bar” for 4-star plans. For 2021 and future years, CMS is putting more focus on the patient experience.

CMS made some technical changes as well. They will no longer issue a Call Letter, but instead codify the bidding process through Advance Notice and Rule Making process. Also, prescription drug plans will have access to a sixth tier for “preferred specialty drugs.” CMS is requiring a real-time beneficiary tool to view formulary information, including lower-cost alternatives. They’re requiring Part D plans to disclose quality measures they use to evaluate pharmacy performance in their network agreements as well.

In the PDP market, the top six carriers control 92 percent of the market (down from 94 percent), whereas in the Medicare Advantage market, the big four plans control 58 percent. The big four Medicare Advantage plans grew by 1,571,217 enrollments, whereas the bottom 295 plans grew by 201,276. There’s even talk of improving MA plan designs, with reimbursement gains, the repeal of the health insurer fee, and segmented designs (e.g. ESRD). In the Medicare Supplement market, we may see higher household discounts coming, as well as high-speed underwriting. Keep an eye out for easier telephonic enrollment and more aggressive pricing on Plan F.

Craig also discusses claims, such as the “asset” value of an agent’s book of Medicare business increasing by 30 to 50 percent on the same dollar of revenue in the past three years. Additionally, he covers claims that the retail market for Medicare business is getting more competitive, which could lead to higher acquisition costs and lower retention, and that Medicare products are getting harder to compare. Check out session three in its entirety for the support and implications of these claims!

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Thank you for staying committed to Ritter, even during times that are as unpredictable as 2020. Our hardworking agents continue to help us grow and succeed. We’re looking forward to a bright and successful — and hopefully not as socially distanced — 2021!

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