Advocacy in action blog

Here we go again! Two more insurance companies, Aetna and Anthem, have informed agents that they will no longer pay commissions on new enrollments to some Medicare Advantage plans. These announcements follow similar ones by insurers earlier this year. The most recent decisions are particularly jarring because they come in the middle of the Medicare Annual Enrollment Period, when many agents are deep into the planning process with clients.

While MarketWatch columnist Brett Arends raises legitimate concerns about the complexities surrounding Medicare enrollment and the insurance brokers who assist beneficiaries (“The Medicare scandal hiding in plain sight,” Oct. 16), he unfairly paints a broad picture of financial professionals as profit-driven actors without considering the critical role brokers play helping consumers navigate the Medicare Advantage marketplace, which now accounts for more than half of all eligible Medicare beneficiaries. Agents and brokers educate consumers on how Medicare works, both broadly and in conjunction with other products such as Part D prescription drug plans, to simplify a complex decision-making process.

NAIFA has submitted a letter by NAIFA CEO Kevin Mayeux, CAE, to the Centers for Medicare and Medicaid Services regarding a decision by certain health insurance companies to discontinue Medicare prescription drug (Part D) compensation for health insurance agents. The changes will have a detrimental impact on American consumers who will potentially lose access to the personalized guidance that agents provide. Agents also will be restricted from receiving compensation for both new business and renewals when assisting clients with prescription drug plan enrollment.

In the letter, Mayeux said Medicare Part D plans “are sophisticated products that can be difficult for many Medicare beneficiaries to fully understand. NAIFA members spend a considerable amount of time each year, especially during the Annual Enrollment Period, matching beneficiaries to the prescription drug plan that best fits their specific needs.” Mayeux also makes the following points:

• Because Medicare can be much more complex than commercial insurance, many consumers need assistance throughout the year as they move through the various phases of coverage, cost determinations, and new prescriptions, all of which are services that agents provide on a continual basis.
• Eliminating agent compensation for these plans creates a risky precedent that may lead to consumers being left without personalized assistance as the agent cannot help with any issues that may arise. 
• Without professional agent assistance, consumers will be confused and left to contact calls centers unfamiliar with their unique situations. Frustrated consumers are more likely to submit their complaints and concerns directly to Medicare, placing added stress on CMS’s ability to deal with calls and inquiries in a timely fashion.  

Mayeux added that NAIFA plans to continue the conversation with the Centers for Medicare and Medicaid Services to communicate the impact this decision will have on protecting our most vulnerable citizens. 

National Association of Insurance and Financial Advisors (NAIFA) CEO Kevin Mayeux, CAE, issued the following statement on the decision by some health plans to cease new and renewal commissions for Medicare prescription drug (Part D) plans and terminating existing marketing service agreements:

The U.S. District Court for the Northern District of Texas has issued a stay preventing the Centers for Medicare and Medicaid Services (CMS) from implementing a new rule changing compensation rules for professionals providing products and services related to Medicare Advantage and Medicare Part D programs. NAIFA is not a party to the lawsuits, Americans for Beneficiary Choice et al. v. the U.S. Department of Health and Human Services et al. and The Council for Medicare Choice et al. v. HHS et al., but has been an outspoken critic of the rule since it was first proposed.

NAIFA strongly urges the Centers for Medicare & Medicaid Services (CMS) to reconsider a proposal that would change the compensation rules for professionals providing products and services related to Medicare Advantage and Medicare Part D programs.

NAIFA members help millions of individuals and employers administer and utilize Medicare plan options as well as other health plans. They are a vital part of the plan-selection process and serve as expert resources for consumers considering their Medicare plan options or looking for specific drugs and services to be covered. Agents and brokers educate clients on how Medicare works, research physician networks and prescription formularies for the plans to ensure a suitable health and drug plan is recommended, and review plan-comparison and enrollment changes annually.

The Centers for Medicare and Medicaid Services (CMS) has published its final marketing rule for Medicare Advantage (MA) and Medicare Part D (Part D) plans. Below you can read about key changes that will most impact NAIFA members, as well as some of NAIFA’s concerns that were addressed by CMS.

A NAIFA comment letter to the Centers for Medicare & Medicaid Services (CMS) submitted comments suggesting changes to the CMS proposed rule titled ”2024 Notice of Benefits and Payment Parameters,” published in the Federal Register on December 21, 2022.  

This proposed rule includes proposed payment parameters and provisions related to the HHS-operated risk adjustment and risk adjustment data validation programs, as well as proposed 2024 user fee rates for issuers offering qualified health plans (QHPs) through Federally-facilitated Exchanges (FFEs) and State-based Exchanges on the Federal platform (SBE-FPs).

In May, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule which revises the Medicare Advantage (Part C) program and the Medicare Prescription Drug Benefit (Part D) program regulations to implement changes related to marketing and communications, past performance, Star Ratings, network adequacy, medical loss ratio reporting, special requirements during disasters or public emergencies, and pharmacy price concessions.

A NAIFA Action Alert asks agents and advisors to contact their members of Congress and express concerns over a new Medicare marketing rule and request that lawmakers ask the Department of Health and Human Services for a delay of six to twelve months, during which the Centers for Medicare & Medicaid Services can work with stakeholders to improve the rule.