On October 5, the Centers for Medicare and Medicaid Services (CMS) released its proposed rules for Affordable Care Act (ACA) health insurance for 2026. The rules cover agent/broker practices.

The CMS proposal includes “ways to prevent unauthorized marketplace activity by agents and brokers,” the agency said. According to the CMS fact sheet that accompanied the proposed rules, “The CMS proposes to expand its authority to suspend an agent or broker’s ability to transact information with the marketplace if we discover circumstances that pose an unacceptable risk to the accuracy of Marketplace eligibility determinations, operations, applicants, and or enrollees.” It goes on, “The proposal is designed to improve marketplace security and integrity and reduce unauthorized changes to coverage.

“The proposal would also update the consumer consent form used by agents and brokers when assisting people with their marketplace enrollments and eligibility applications. The expanded form would better document “that a consumer or their authorized representative reviewed and confirmed the accuracy of their eligibility application information before their application was submitted to the Marketplace,” the fact sheet said.

Comments on the proposal are due November 12, 2024. NAIFA is currently reviewing the proposed rules.

Prospects: There will be intense back-and-forth (likely to include Congress) about the impact of these proposed rules prior to CMS finalizing them. NAIFA will, as always, advocate vigorously for rules that permit fair treatment for the crucial advice provided by professional agents, brokers and advisors.

NAIFA Staff Contact: Michael Hedge – Senior Director – Government Relations, at mhedge@naifa.org.