Advocacy in action blog

The administration’s final rules on short-term, limited-duration health insurance (STLDI) plans will restrict access to these policies that serve crucial needs of many American consumers. The plans, which have existed since the introduction of HIPAA-based rules nearly two decades ago, are designed to bridge the gap between comprehensive coverage options. They can be a great fit for those looking for individual coverage, waiting for the start of group plan enrollment, having gaps between different employment opportunities, or waiting for their next open enrollment opportunity.

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 & Medicaid Services (CMS) introduced new regulations in the Notice of Benefit and Payment Parameters for Plan Year 2024 that all agents, brokers, and web-brokers must follow before helping consumers complete and submit their Marketplace application. To ensure that agents and brokers understand the specific guidelines of these new regulations, CMS recently published several frequently asked questions (FAQs) that answer common questions about these new requirements.

Short-term limited duration insurance (STLDI) is very important to many American families and individuals looking to fill gaps in their health insurance coverage and unable to access the individual health insurance marketplace. A current proposal by the administration would reduce the maximum allowable STLDI coverage period from 12 months to three months with a possible one-month renewal. People would be able to purchase a new STLDI policy from a different carrier, but would not be allowed to "stack" a new policy from the same carrier on an expiring policy.

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.

NAIFA-MA is celebrating a major advocacy win after a very close call. During the last three days of the legislative session which concluded July 31, the General Court introduced H. 5123 which would have implemented a two-year pilot program to extend eligibility for premium assistance payments on point of service cost-sharing subsidies for certain health insurance applicants. In short, this legislation would have implemented a pilot single-payer health coverage program, thus having a catastrophic impact on employer-sponsored health plans.

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.  

The Partnership for America’s Health Care Future recently published results from a nationwide poll showing that the push for transforming the American health care system through a public option, Medicare-for-All or other government interventions in the market is losing traction with American voters.

On September 21, 2021, Reps. Mike Thompson (D-CA) and Adrian Smith (R-NE) introduced H.R. 5318. This bipartisan bill will provide much-needed relief for employers seeking to comply with the reporting requirements under Section 6055 and 6056 for enforcement of the ACA's individual and employer mandates. NAIFA believes the passage of this legislation would greatly assist in addressing new challenges employers face under the health-reform law.

On Monday, July 26, NAIFA and our industry partners, The Council of Insurance Agents & Brokers and the Independent Insurance Agents & Brokers of America, sent a letter to the U.S. Department of Labor requesting an initial non-enforcement period for Section 202 of the No Surprises Act.