Agent groups urge feds to stabilize MA as another carrier cuts commissions

Medicare Annual Enrollment Period begins Wednesday and Humana announced late last week that it will not use agents to sell its prescription drug plans.

Effective Nov. 9, all Humana prescription drug plans will be removed from enrollment tools, except for Humana.com and Medicare.org for beneficiary self-service, the company told agents in a statement.

“We are confident in your ability to deliver exceptional results with the sale of Humana’s Medicare Advantage plans, Medicare Advantage prescription drug plans and Medicare Supplement plans,” the company’s statement said.

This is the latest move by a carrier to eliminate agents or stop paying agent commissions on Medicare products. Most recently, United Healthcare announced in June it would eliminate agent commissions on 100 Medicare Advantage products in 20 states.

The National Association of Benefit and Insurance Professionals is conducting an online survey to give its agent members an opportunity to voice their concerns about the challenges they are facing in light of numerous policy and market changes in Medicare. The association is conducting an additional survey to collect testimonials from clients and Medicare beneficiaries about the role their agents played in helping them obtain coverage or solve a Medicare-related problem.

“Legislators need to hear more from consumers about your experience navigating health insurance coverage and hearing the role an agent has or has not played in this journey,” NABIP said on its website.

Agent organizations urge CMS to stabilize Medicare Advantage

Meanwhile, a coalition of insurance and financial organizations sent a joint letter last week to the Centers for Medicare & Medicaid Services urging immediate action to protect Medicare beneficiaries and stabilize the nation’s Medicare Advantage and Part D markets. The full letter, addressed to CMS Administrator Dr. Mehmet Oz, can be viewed here.

“The Medicare program faces a convergence of pressures that directly undermine beneficiaries’ stability,” the letter said.  “Post-pandemic utilization spikes and unintended regulatory consequences, such as from the Inflation Reduction Act, have placed heavy inflationary cost pressures on carriers. In response, many have developed different approaches to restrict sales of long-term, newly nonviable products. In Medicare Advantage, we now see actual retraction rather than growth: plan exits, service area reductions, and the loss of PPO options that are especially critical in rural areas.

"In Medicare Supplement, new state ‘birthday rule’ regulations have forced smaller carriers out, resulting in fewer consumer choices and steep premium hikes. And in Part D, only a handful of carriers remain in the market. Across Medicare Advantage and Part D, many carriers are no longer paying agents fair-market new and renewal compensation and limiting plan options available on enhanced direct enrollment platforms.”

The letter was co-signed by NABIP, Health Agents for America, Independent Insurance Agents & Brokers of America and the National Association of Insurance and Financial Advisors.

“With more than half of all Medicare beneficiaries now enrolled in Medicare Advantage, immediate action is needed to protect seniors from losing the coverage and guidance they depend on,” said NABIP CEO Jessica Brooks-Woods in a news release. “Across the country, we are seeing plan exits, reduced options in rural areas and rising premiums. These trends are leaving seniors confused, anxious, and at risk.”

The coalition represents hundreds of thousands of licensed professionals who help more than 33 million Americans navigate their Medicare coverage. It warns that rising utilization and unintended regulatory impacts are destabilizing the market. Carriers are exiting regions, narrowing plan options, and reducing fair-market compensation for licensed agents who ensure Medicare beneficiaries can choose and maintain the right coverage.

“These recommendations are not about protecting agents— they’re about protecting seniors,” said Brooks-Woods. “Licensed agents and field marketing organizations are the front line for beneficiary education, problem resolution and fraud prevention. When these professionals are constrained, it’s seniors who suffer.”

Five urgent reforms

To restore stability, uphold program integrity, and protect beneficiaries, the coalition outlined five urgent reforms CMS can implement immediately.

• Stabilizing agent support: Prohibit post-Oct.1 commission changes and ensure lifetime renewals are honored, so seniors are not left without help during the AEP.
• Reducing privacy risks: Cut the 10-year call recording retention requirement to three years to better protect seniors’ personal information.
• Ensuring timely help: Establish a safe harbor from the 48-hour scope-of-appointment rule so beneficiaries can receive assistance when plans exit or networks change.
• Clarifying third party marketing organization regulations: Exclude licensed agents and regulated FMOs from TPMO definitions to distinguish them from unregulated telemarketers.
• Streamlining training: Create a single, CMS-approved certification recognized across all carriers to reduce redundant requirements while maintaining strong consumer protections.

The coalition calls on CMS to work collaboratively with industry experts to realign regulations, restore stability, and ensure oversight targets fraud, not the licensed professionals safeguarding beneficiaries.

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Susan Rupe is editor in chief, magazine, for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].