May 28, 2024
CMS has released the Medicare Advantage (MA) and Medicare Prescription Drug Benefit Programs Final Rule, which outlined the following changes to agent/broker compensation for 2025:
- The regulatory definition of compensation has been finalized to include all activities associated with sales to and enrollment of an individual into an MA or Part D plan, including payments for activities previously excluded under the definition of compensation (e.g., administrative payments).
- Reporting requirements have been removed, since agents/brokers would be paid the same compensation rate in a given year.
- The final national agent/broker fixed compensation amount for initial enrollments into a MA or Part D plan has increased by $100.
- Contract terms between MA/Part D sponsors and third-party marketing organizations in various capacities are prohibited, including any provisions offering volume-based bonuses for enrollment into certain plans.
Compliance with the updated standards in the Final Rule starts Oct. 1, 2024, when marketing activities begin for the 2025 plan year.
Questions? Contact your Medicare broker manager.