Managed Care Marketing Agent Broker Compensation
Guidance for compensation paid to independent agents/brokers to sell Medicare drug and health plans.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 27, 2019
Below is a link to a file containing the amounts that companies pay independent agents/brokers to sell their Medicare drug and health plans. Companies that contract with Medicare to provide health care coverage or prescription drugs typically use agents/brokers to sell their Medicare plans to Medicare beneficiaries. Sometimes these agents/brokers are employees of the contracted company. In other situations, the companies hire independent agents/brokers who are not employees to sell the companies' Medicare plans.
Generally, agents/brokers receive an initial payment in the first year of the policy (or when there is an “unlike plan type” enrollment change) and half as much for years two (2) and beyond if the member remains enrolled in the plan or make a “like plan type” enrollment change.
Agents/brokers must be licensed in the State in which they do business, annually complete training and pass a test on their knowledge of Medicare and health and prescription drug plans, and follow all Medicare marketing rules. Agents/brokers are subject to rigorous oversight by their contracted health or drug plans and face the risk of loss of licensure with their State and termination with their contracted health or drug plans if they don't comply with strict rules related to selling to and enrolling Medicare beneficiaries in Medicare plans.
The information contained in this file has columns for each Medicare plan with the following information: State, county, company name, plan name, whether the company uses independent agents or not, the amount(s) paid to independent agents for selling the plan in the first year of enrollment following the sale, other plan identification numbers, and whether the plan information displayed requires correction. The information within the various columns can be sorted to more easily find compensation information about the plan or plans you are interested in.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.