Stabilize the Medicare Advantage marketplace, Idaho director tells NAIC

Medicare marketplace challenges have left one agents' association leader frustrated.

“I feel like I’m living in the wild, wild West. Carriers are doing things that have never been done before and no one is stopping them.”

That was a comment from Ronnell Nolan, president and CEO of Health Agents for America, who spoke on her observations of the Medicare market during the National Association of Insurance Commissioners Fall Meeting.

“Medicare is very complex and complicated, and seniors deserve to choose an agent, should they want,” she said during a meeting of the NAIC Senior Issues Task Force.

She was especially critical of carriers that decided to eliminate agent commissions during the current enrollment period.

Nolan told the task force members that in 44 years working in the industry, “I have never seen anything like what’s happening in the market today.

“The day before open enrollment, after insurance agents have prepared to take care of seniors, an insurance company will say, ‘We’ve decided not to pay you.’ When your client calls and needs help, you’re going to help them because that’s what agents and brokers do. We have no choice. We have many agents across the nation who are working for free. They worked for free through the entire open enrollment … Seniors deserve assistance and calling the 1-800 numbers and things like that will not help them.”

Medicare Advantage marketplace shifts in Idaho

Nolan’s remarks came after the task force heard from Idaho Department of Insurance Director Dean Cameron, who described his state’s actions against unfair trade practices regarding Medicare Advantage plans.

“Up until two years ago, the Medicare Advantage marketplace was reasonably healthy” in Idaho, Cameron said. “I remember when I took this job 10 years ago, we had 10 counties that did not have Medicare Advantage plans and we gradually worked to get all but one of them to have Medicare Advantage plans. The challenge was not the carriers, but the providers.”

Cameron said some of those counties didn’t have hospitals or access to providers. His department, working with the Centers for Medicare and Medicaid Services, were able to work with the carriers to build out a provider network.

But the market dynamics in Idaho began to shift in 2024, Cameron said.

“We had some carriers that struggled to get their contracts with providers. We had other carriers that threatened to pull out of the marketplace. We had one carrier who took their applications off their website and another carrier who discontinued commissions. After conversations with them, both of those carriers restored their previous actions.”

Cameron said 2025 “showed a different landscape.”

“All of a sudden, some of the carriers that were struggling decided not to play in the marketplace. Some of those carriers that were struggling before with contracts also began struggling. We started the number of carriers and plans available in every county diminish. Then we saw the unfortunate situation where - after open enrollment, after broker meetings, after they had spent hundreds of thousands of dollars, developing the product, pricing the product, submitting it to CMS, getting approval from CMS - we started seeing the carriers take actions that we felt were inappropriate and harming Idaho seniors.”

Cameron said carriers withdrew applications from their websites and also withdrew paper applications.

“Agents would have to call and plead with the regional manager in order to get a paper application,” he said. “Agents were being put in an awkward position because we drum into them that they must do what's in the best interest of the consumer. Many of the agents have done that in spite of the fact that they're no longer going to be paid commissions.”

Cameron said his department also saw carriers who had priced agent commission into their rate development and who were charging consumers for a commission, then decided to quit paying the commission. “We felt those were inappropriate actions,” he said.

He said Idaho also saw a number of carriers change their plans or withdraw them from the market, requiring consumers to change to different plans.

Taking legal action

Cameron said his department believed carriers acted inappropriately, so it issued a bulletin to state that this fell under Idaho’s Unfair Trade Practices Act.

“We felt very strongly that the carriers should have to make their applications available easily for a consumer to be able to enroll, and we felt that the carrier should not be engaged in steering or pushing enrollees to another competitor,” he said.

Cameron said that after his department received pushback from carriers, it issued two cease and desist orders to carriers. He called on regulators to take action to stabilize the Medicare Advantage marketplace.

“Somebody must be able to protect the seniors against unfair trade issues, and that’s our role and our responsibility,” he said.

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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].