CMS increases MA broker compensation for 2026

The Centers for Medicare and Medicaid Services is adjusting agent compensation for Medicare Advantage upward, a move that one agent association CEO described as “a meaningful step in the right direction.”

The CMS adjustment represents the largest MA increase in broker compensation in years.

Here are the 2026 MA compensation rates by state/region:

• For Connecticut, Pennsylvania and the District of Columbia, initial Medicare Advantage compensation will increase from $705 per member per year to $781 per member per year, a 10.8% change year over year. Renewal compensation will increase from $353 per member per year to $391 per member per year, a 10.8% change YOY.
• For California and New Jersey, 2026 initial MA compensation will increase from $780 per member per year to $864 per member per year, a 10.8% change YOY. Renewal compensation will increase from $390 per member per year to $432 per member per year, a 10.8% change YOY.
• For Puerto Rico and the U.S. Virgin Islands, 2026 initial MA compensation will increase from $428 per member per year to $474 per member per year, a 10.7% change YOY. Renewal compensation will increase from $214 per member per year to $237 per member per year, a 10.7% change YOY.
• In all other states, initial MA compensation will increase from $626 per member per year to $694 per member per year, a 10.9% change YOY. Renewal compensation will increase from $313 per member per year to $347 per member per year, a 10.9% change YOY.

For Part D plans, initial compensation will increase from $109 per member per year to $114 per member per year, a 4.6% increase YOY. Renewal compensation will increase from $55 per member per year to $57 per member per year, a 3.6% increase YOY.

CMS move 'reflects growing recognition' of brokers

Kevin Mayeux, CEO of the National Association of Insurance and Financial Advisors, said the CMS move “reflects growing recognition of the critical role licensed insurance professionals play in guiding Medicare beneficiaries through a complex and often confusing system.

"Insurance agents are highly trained professionals who provide personalized, informed guidance to help individuals choose the plans best suited to their needs. Their support doesn’t end with enrollment. Agents are on the front lines year-round helping clients navigate the challenges that arise after a plan is selected."

Mayeux said NAIFA wants to continue a dialogue with CMS to further improve the beneficiaries’ experience especially by revising the Compensation Rate Submission to require plans to report the specific rate they intend to pay independent agents. The current allowance of a reported range has resulted in shifts from being paid for service to no compensation during the plan year, he said.

CMS’ move to adjust agent compensation comes on the heels of United Healthcare’s recent decision to eliminate agent commissions across more than 100 Medicare Advantage plans in more 20 states. Professional associations representing the agent community – NAIFA, the National Association of Benefits and Insurance Professionals and Health Agents for America – condemned United Healthcare’s actions.

HAFA urges congressional action on commissions

HAFA sent letters to Congress last week, urging lawmakers to investigate how CMS allowed United Healthcare to eliminate commissions after the company had already finalized its MA contracts with CMS. HAFA also wants Congress “to demand accountability from United Healthcare, other carriers and CMS and to take immediate action to ensure that agents are treated fairly and that consumer access to experienced assistance is not eroded.”

United Healthcare instituted a midyear cut to agent commissions after rates and benefits were finalized and approved by CMS, agent contracts were executed, and enrollment and renewal outreach efforts were completed. HAFA described this move as “a bait-and switch.”

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Susan Rupe is managing editor 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].