Though the company asks its sales force to pay travel expenses and an enrollment fee, it picks up the rest of the tab for the convention.

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An annual enrollment fee not only provides a significant incremental stream of revenues to the pharmacy chain but also ensures consumer loyalty for the duration of the plan.

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It will only charge them the small enrollment fee.

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Yet for the past several years enrollment has climbed at an 8% to 10% clip annually, versus 3% for normal fee-for-service Medicare.

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Ms. Ott, an enrollment-benefits manager for an insurance company, entered her credit-card number online, and was charged the fee upfront.

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