Every Medicare agency and FMO loses commission it is owed — to chargebacks, to payments that never match an enrollment, and to hours spent reconciling carrier statements by hand. Enter your numbers. See an estimated annual range. No login to start.
Where the money leaks, your benchmark percentile, and the methodology — sent to your inbox.
Commission leakage is the gap between the commission a Medicare agency or FMO is contractually owed and what it actually keeps. It is rarely one large miss. It is the slow accumulation of small ones: a chargeback on a member who disenrolled inside the clawback window, a payment that arrives but never matches an enrollment in your system, and the staff hours spent reconciling carrier statements that could have gone to production. Individually each is minor. Across a full book and a full year, they compound into a number worth measuring.
A chargeback occurs when a carrier reclaims commission it already paid — typically because a member disenrolled or was retroactively termed inside the period the carrier is allowed to recover. Rapid disenrollments, retroactive effective-date changes, and eligibility corrections are the most common triggers in Medicare Advantage and Part D. Because the reversal often lands months after the original payment, it is easy to miss without a system that ties each payment back to a specific enrollment and its status.
Every carrier reports commission on its own schedule, in its own format, using its own identifiers. The more carriers pay you, the more distinct formats your team has to normalize — and the more payments slip through unmatched. A payment that cannot be tied to an enrollment is a payment nobody notices is missing. This is why the number of carrier statements you reconcile is a direct input into leakage: statement complexity, not book size alone, is what turns owed commission into uncollected commission.
| Dimension | Manual reconciliation | Automated matching |
|---|---|---|
| Statement intake | Re-keyed or copy-pasted from each carrier's format | Every carrier format normalized into one schema on ingest |
| Payment matching | Eyeballed against enrollments; unmatched rows quietly dropped | Each payment tied to an enrollment with source lineage |
| Chargeback detection | Found late, if at all, when totals look off | Flagged as reversals post against the original enrollment |
| Cost to scale a bigger book | More statements means more staff hours, linearly | Marginal — the same pipeline handles more volume |
This is a factual process comparison, not a claim about any specific vendor or carrier. Your actual results depend on your book, your carrier mix, and your current process.
The calculator applies documented, versioned model coefficients (leakage-model-v1) to the business aggregates you enter — book size, blended commission, chargeback rate, carrier count, and reconciliation hours. It returns a range rather than a single figure because the underlying rates vary by operation. The coefficients are honest priors that will be recalibrated as more agencies and FMOs run the tool. Treat the output as a directional estimate to size the opportunity, not an audited number.