ATTENTION AGENTS!
Plan Year 2025 Policy & Technical Changes to Medicare Advantage Plans
As an insurance agent, you are compensated by carriers to provide a service to members. Agents are the heart of distribution for carriers and a gateway of understanding to consumers. As an FMO, we believe that providing agents the support they need is a necessary component of how Medicare Advantage plans are transacted.
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There are proposed changes to the Medicare Advantage program for the year 2025 that are very likely to impact insurance agents, agencies and FMO’s. Below is an outline:
- Limitation on Agent and Broker Compensation: The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would cap the compensation that agents and brokers can receive for enrolling Medicare beneficiaries into Medicare Advantage plans. Specifically, commissions would be capped at $632, starting with the 2025 plan year. This change is a significant shift from the current structure and could impact the earnings of agents and brokers.
- Changes in Broker Support Services Payments: CMS has proposed eliminating the current administrative support services payments and replacing them with a different structure. This could affect the way General Agencies that service brokers and agents are compensated for their administrative and support services, including marketing assistance, reimbursements and coop.
- Stricter Marketing Rules: Medicare Advantage insurers are facing new regulations governing marketing, which could impact how agents and brokers promote these plans.
- Concerns Over Circumvention of Payment Rules: CMS has expressed concerns that some Medicare Advantage plans might be compensating agents and brokers in ways that may circumvent existing payment rules. This could lead to stricter enforcement and potential changes in compensation models.
- Overall Policy and Technical Changes: The proposed rule for Contract Year 2025 includes various policy and technical changes to the Medicare Advantage program, which could have broader implications for how agents and brokers operate within this space.
Limitation on Agent and Broker Compensation: The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would cap the compensation that agents and brokers can receive for enrolling Medicare beneficiaries into Medicare Advantage plans. Specifically, commissions would be capped at $632, starting with the 2025 plan year. This change is a significant shift from the current structure and could impact the earnings of agents and brokers.
Changes in Broker Support Services Payments: CMS has proposed eliminating the current administrative support services payments and replacing them with a different structure. This could affect the way General Agencies that service brokers and agents are compensated for their administrative and support services, including marketing assistance, reimbursements and coop.
Stricter Marketing Rules: Medicare Advantage insurers are facing new regulations governing marketing, which could impact how agents and brokers promote these plans.
Concerns Over Circumvention of Payment Rules: CMS has expressed concerns that some Medicare Advantage plans might be compensating agents and brokers in ways that may circumvent existing payment rules. This could lead to stricter enforcement and potential changes in compensation models.
Overall Policy and Technical Changes: The proposed rule for Contract Year 2025 includes various policy and technical changes to the Medicare Advantage program, which could have broader implications for how agents and brokers operate within this space.
