Health Affairs  |  June 17, 2022

Read the Publication

On June 7, 2022, the Centers for Medicare and Medicaid Services (CMS) issued new guidance confirming that insurers cannot vary compensation for agents or brokers based on whether the person they are helping enrolls during the open enrollment period (OEP) or a special enrollment period (SEP). Arrangements that reduce or eliminate commissions (and other forms of compensation) for agents and brokers for SEP enrollment violate the Affordable Care Act’s (ACA’s) guaranteed issue requirement under Section 2702 of the Public Health Service Act. Insurers might additionally violate federal nondiscrimination standards if these arrangements discourage agents and brokers from marketing to and enrolling consumers with significant health needs.

Read more here.

Related Initiatives

Health Policy and the Law

Latest publications See All