Molina Healthcare won’t pay commissions on new ACA business

Molina Healthcare announced it will not pay agent commissions on new business on the Affordable Care Act marketplaces. The carrier will not pay commissions on new ACA business written in Florida, New Mexico, Texas, South Carolina, Illinois, Michigan, Wisconsin, Connecticut, Washington and Ohio. However, the carrier will pay agents renewals and bonuses. In addition, Molina is accepting business directly from consumers.

“That says to me they’re going to steer those folks who might be unhealthy to not buy Molina,” said Ronnell Nolan, president and CEO of Health Agents for America, in a statement today. “They are trying to steer, in my opinion, people away from buying Molina for the 2026 year. And they do not believe that we are worthy of commissions.”

Molina Healthcare provides managed healthcare services under the Medicaid and Medicare programs, and through the ACA marketplace. The company has three business segments: Medicaid, Medicare, and Marketplace.

Molina legal troubles lead to stock plunge

Molina is facing legal and financial troubles, including a class action lawsuit alleging securities fraud. These issues have led to a significant drop in the company's stock price.

A class action lawsuit alleged that Molina made false and misleading statements about its financial guidance and medical cost trends. The suit claims the company knew about increasing medical costs but downplayed the risks to investors, which contributed to a stock price drop after the company revised its 2025 earnings per share guidance in July 2025.

The lawsuit alleges that on July 23, Molina Healthcare reported its financial results for the second quarter ended June 30,  and further slashing its full-year 2025 earnings guidance.  In doing so, the class action alleges Molina Healthcare revealed that “GAAP net income was $4.75 per diluted share for the second quarter of 2025, a decrease of 8% year over year” and it “now expects its full year 2025 adjusted earnings to be no less than $19.00 per diluted share.”  Molina Healthcare attributed its results and full year outlook to a “challenging medical cost trend environment,” including “utilization of behavioral health, pharmacy, and inpatient and outpatient services.”  On this news, the price of Molina Healthcare stock fell nearly 17%, according to the complaint.

In 2024, Washington State Insurance Commissioner Mike Kreidler fined Molina Healthcare of Washington $100,000 for errors in the company’s enrollment and billing system.

Kreidler’s office opened a review of Molina’s enrollment and billing system in 2021 after a significant increase in consumer complaints against the company. That included two complaints about claims for pre-authorized services being denied after Molina transitioned to a third-party enrollment and premium billing platform in April 2021.

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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 susan.rupe@innfeedback.com.