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Medical Growth Bonus example: An agency has 1,700 enrolled medical employees in eligible cases on
January 1, 2017 and five eligible cases with 2,100 enrolled employees (1,200 fully insured and 900 self-funded
with specific stop-loss and prescription drug coverage) on January 1, 2018. They also sell five Specialty Benefits
(two dental and three vision) lines of coverage in groups with 100 to 3,000 eligible employees during the
period from January 2, 2017 to January 1, 2018. The agency has met the requirements of the bonus, and would
receive a bonus calculated as follows:
Net Change Factor Calculation.
January 1, 2017 Enrolled Medical January 1, 2018 Enrolled Medical Net Change Net Change
Employee Count in Eligible Groups Employee Count in Eligible Groups Percent Factor
1,700 2,100 123.5% 1.3
Bonus Payment Calculation.
Funding Type Capped Employee Bonus Rate per Initial Bonus Amount
Count*
Employee
Fully Insured 1,200 $35 $42,000
Self-Funded with Specific Stop-Loss 900 $6 $5,400
and Drug Coverage
Self-Funded without Specific Stop-Loss 0 $3 $0
or Drug Coverage
Total Initial Bonus $47,400
Net Change Factor 1.3
Specialty Benefits Factor (for Five Lines of Coverage from Table) 1.0
Net Bonus Payable (Initial Bonus Multiplied by Net Change Factor and $61,620
Specialty Benefits Factor):
* Note: The maximum number of employees used in the payment tier determination and the calculation of the bonus payment for any case or
affiliated cases is 1,000.
Groups that change funding type during the bonus period will be classified according to the funding type in place as of the last day of the
bonus period. All bonus compensation will be reported as required for regulatory requirements. Classification of a group with “100 to 3,000
eligible employees” is determined by us considering a number of factors. Please see Case Size Designations on page 7 for details. Only agents
in the area indicated on page 7 are eligible for this bonus.
Special rules apply to payment of bonuses for non-commissionable customers. Non-commissionable governmental entity cases are not eligible
for any bonus program. We require written customer acknowledgment and approval before paying bonuses on other non-commissionable
customers, and on commissionable governmental entity customers. Refer to Producer Compensation Policies and Practices in this guide for
additional policies and more information.
MISSOURI AND SOUTHERN ILLINOIS 2017 Producer Performance Guide 15
January 1, 2017 and five eligible cases with 2,100 enrolled employees (1,200 fully insured and 900 self-funded
with specific stop-loss and prescription drug coverage) on January 1, 2018. They also sell five Specialty Benefits
(two dental and three vision) lines of coverage in groups with 100 to 3,000 eligible employees during the
period from January 2, 2017 to January 1, 2018. The agency has met the requirements of the bonus, and would
receive a bonus calculated as follows:
Net Change Factor Calculation.
January 1, 2017 Enrolled Medical January 1, 2018 Enrolled Medical Net Change Net Change
Employee Count in Eligible Groups Employee Count in Eligible Groups Percent Factor
1,700 2,100 123.5% 1.3
Bonus Payment Calculation.
Funding Type Capped Employee Bonus Rate per Initial Bonus Amount
Count*
Employee
Fully Insured 1,200 $35 $42,000
Self-Funded with Specific Stop-Loss 900 $6 $5,400
and Drug Coverage
Self-Funded without Specific Stop-Loss 0 $3 $0
or Drug Coverage
Total Initial Bonus $47,400
Net Change Factor 1.3
Specialty Benefits Factor (for Five Lines of Coverage from Table) 1.0
Net Bonus Payable (Initial Bonus Multiplied by Net Change Factor and $61,620
Specialty Benefits Factor):
* Note: The maximum number of employees used in the payment tier determination and the calculation of the bonus payment for any case or
affiliated cases is 1,000.
Groups that change funding type during the bonus period will be classified according to the funding type in place as of the last day of the
bonus period. All bonus compensation will be reported as required for regulatory requirements. Classification of a group with “100 to 3,000
eligible employees” is determined by us considering a number of factors. Please see Case Size Designations on page 7 for details. Only agents
in the area indicated on page 7 are eligible for this bonus.
Special rules apply to payment of bonuses for non-commissionable customers. Non-commissionable governmental entity cases are not eligible
for any bonus program. We require written customer acknowledgment and approval before paying bonuses on other non-commissionable
customers, and on commissionable governmental entity customers. Refer to Producer Compensation Policies and Practices in this guide for
additional policies and more information.
MISSOURI AND SOUTHERN ILLINOIS 2017 Producer Performance Guide 15
