Compliance Bulletins
Aetna Exits ACA: What It Means for Agents
ave you heard the big news in the healthcare space? CVS Health has announced that Aetna will exit the ACA individual insurance market, effective in 2026, impacting approximately 1 million members across 17 states. But no need to worry — your ACA guru is here (via JC’s...
CMS Finalizes Major Rule to Lower Individual Health Insurance Premiums for Americans
Rule Cracks Down on Improper ACA Enrollments, Protects Patient and Taxpayer Dollars, and Restores Marketplace Integrity The Centers for Medicare & Medicaid Services (CMS) is finalizing a major rule that will lower individual health insurance premiums by...
KFF Health Tracking Poll: The Public’s Views on the ACA
Enacted in 2010, the Affordable Care Act became more popular amid Republicans’ unsuccessful efforts to repeal it during the Trump administration, though there remain deep partisan divisions. Click below to examine how specific groups feel about the law and how those...
NAIFA Denounces UnitedHealthcare’s Decision to Cut Agent Commissions
The National Association of Insurance and Financial Advisors (NAIFA) strongly objects to UnitedHealthcare’s decision to cut agent commissions on more than 100 Medicare Advantage plans across over 20 states. This action undermines the value of professional guidance at...
Chronic SNPs: A growth opportunity during Medicare slow season
When Medicare’s annual enrollment period ends and the calendar flips into the lock-in phase, many agents feel their sales momentum has stopped. However, Medicare (Original Medicare and Medicare Advantage) health insurance opportunities don’t vanish after AEP; they...
3 Ways for Agents to Increase the Lifetime Value of MA Plans
As an agent or broker, it’s essential to understand the lifetime value (LTV) of Medicare Advantage plans, and to maximize every available opportunity for long-term client relationships and renewal income. The LTV is calculated based on the duration of the enrollee’s...
How Will the 2025 Reconciliation Bill Affect the Uninsured Rate in Each State? Allocating CBO’s Estimates of Coverage Loss
House Republicans have passed a reconciliation package (the “One Big Beautiful Bill Act”) that would make significant changes to Medicaid and the Affordable Care Act (ACA) Marketplaces. The Congressional Budget Office (CBO) estimates that the bill would increase the...
Chasing Big Money with the Health-Care Hustlers of South Florida
The ads were deceptive, but they weren't trying to con people out of their money--at least not directly. The goal was to sign them up for actual goverment-subsidized health-insurance plans, whether they wanted them or not. People responding to the ads were routed...
EnrollHere and SunFire Announce Strategic Partnership to Deliver Seamless, End-to-End Medicare Enrollment Technology
Under this new agreement, SunFire's gold-standard enrollment technology will be embedded directly into EnrollHere's intelligent dialer environment—creating a fully integrated solution that allows users to manage the entire consumer journey from initial outreach to...
Consumer Profile: Who Is the Ideal Medicare Supplement Client?
As we navigate the ever-evolving landscape of healthcare, understanding the characteristics of our target audience becomes crucial in effectively serving our clients and achieving our sales goals. Let’s explore the five key factors that define the ideal Medicare...
Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces
The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This brief explains what these...
The Sleeper Provision in the Reconciliation Bill That Could Hobble the ACA Marketplaces
In summary, there are two proposals that would impact millions of enrollees this OEP. Eliminating Passive Reenrollment – 10.8 million consumers passively reenrolled last OEP Eliminating Provisional Eligibility – Consumers would have to pay their premium until DMI...
Boosting Your Medigap Knowledge for More Holistic Service
Medicare Advantage (MA) plans are subject to change every year, requiring licensed agents to guide beneficiaries through the maze of options. While Medicare Advantage plans often attract attention and continue to grow in market share, it’s essential not to overlook...
From Products To Purpose: Leading Through Change In The Health Insurance Industry
Health insurance leaders must move beyond selling products and instead focus on delivering real value—both to customers and the communities they serve. The industry is shifting toward purpose-driven strategies: improving customer experiences, driving innovation, and...
Four Changes to Medicare in the One Big Beautiful Bill Act
Medicare provides health care for 68.5 million beneficiaries. The One Big Beautiful Bill, passed by the House and in debate in the Senate, contains several provisions that would impact Medicare, including cuts to several programs. The cost of the pending legislation...
Maximizing Healthcare Value: The Superior Benefits of D-SNPs
Dual-Eligible Special Needs Plans (D-SNPs) — a type of Medicare Advantage plan specifically designed for individuals eligible for both Medicare and Medicaid — offer consumers more for less, especially compared to traditional MA plans. D-SNPs can provide greater...
From Products To Purpose: Leading Through Change In The Health Insurance Industry
Angela Palo is COO of Pinnacle Financial Services, a leading National Medicare Brokerage, and member of the NABIP Medicare FMO Council. Health insurance costs are rising—again. Between 2022 and 2025, average premiums for private health insurance plans—including those...
Marketplace Enrollees with Unpredictable Incomes Could Face Bigger Penalties Under House Reconciliation Bill Provision
Key Findings Many Americans experience high income volatility, in particular potential ACA Marketplace shoppers. One in five people aged 19-64 were in families that saw more than a 20% difference in their income, split approximately equally between people who ended up...
4 Ways Congress May Soon Change the Medicare Program
Medicare touches the lives of just about every American senior. The nation’s retirement health insurance program currently has 68.5 million enrollees. So, when Medicare changes are proposed, millions of retirees take notice. Recently, the U.S. House of...
Empowering Medicare Advantage Enrollees with Hospital Indemnity Plans
Medicare Advantage (MA) enrollees now account for nearly half of all inpatient hospital stays. This shift not only affects the dynamics of how these patients receive healthcare, but it also opens up new avenues to guide consumers to more holistic coverage. It’s...
Could Prescription Drug Costs Change for Medicare Users? Experts Weigh In
As President Donald Trump signed an executive order Monday that promises to drastically lower prescription drug prices in the U.S., Newsweek spoke with experts to find out what the new order will mean for those on Medicare. The executive order is aimed at a...
ACA: Status of State Medicaid Expansion Decisions
The Affordable Care Act’s (ACA) Medicaid expansion expanded Medicaid coverage to nearly all adults with incomes up to 138% of the Federal Poverty Level ($21,597 for an individual in 2025) and provided states with an enhanced federal matching rate (FMAP) for their...
Medicare Is a Natural Fit for Life Insurance
Integrating Medicare, Medicare Advantage plans and Medicare Supplement products into your life insurance practice is about offering a complete, client-focused solution that meets your clients’ evolving health and financial needs. As the senior market grows, especially...
Agents as Advocates: Using Medigap and MSP to Combat the ‘Medicare Cliff’
Licensed agents who work with Medicare products are on the front lines of a significant shift in healthcare coverage affecting our most vulnerable consumers. Recent data reveals a troubling trend: lower-income older adults transitioning from Medicaid to Medicare face...
When it comes to Social Security and Medicare, this is what the nation’s top experts on aging worry about
There was a sliver of good news about Social Security, which turns 90 in August: None of the experts I heard from believe benefits will be cut any time soon for current beneficiaries or people close to claiming Social Security. Nor did they think the president and...
IUL comparison: Mastering the basics
Indexed universal life products have gained momentum in the life insurance industry for good reason. With built-in flexible premiums, tax-advantaged and tax-free growth potential, and design flexibility, IULs can serve both protection and accumulation goals, making...
CVS Plans to Exit Obamacare in 2026, Impacting 1 million Aetna Members
CVS Health plans to exit the individual health insurance business also known as Obamacare next year, leaving about 1 million Aetna members in 17 states looking for new coverage in 2026. The decision, disclosed Thursday, a day when CVS reported nearly $1.8 billion in...
Bend the Healthcare Cost Curve: Exploring Reforms to Address Rising Federal Spending
While the debate around reform is complex, it presents both challenges and opportunities for all sectors of the healthcare space, including licensed insurance agents and professionals. ARTICLE
Medicare Advantage Insurers Often Use Rewards and Incentives to Encourage Enrollees to Complete Health Risk Assessments (HRAs)
Completing a health risk assessment (HRA) is one of the activities for which insurers may provide a reward or incentive. HRAs are used to collect information about enrollees’ characteristics and health status. They may be conducted in the home, at a physician’s...
A Medicaid Per Capita Cap on the ACA Expansion Population: State by State Estimates
The estimated effects of a per capita cap depend highly on what assumptions are made about policy specifications, future growth in Medicaid spending, and states’ responses to federal cuts. This analysis is designed to illustrate the magnitude of the impact of a per...
Mastering the Intersection: How SSDI Benefits Open the Door to Medicare
New research from 2024 has examined the connection between Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and access to health coverage. The data revealed that approximately 13 million people under the age of 65 were receiving income...
Dispute involving Affordable Care Act’s preventive care coverage faces Supreme Court
Washington — The Supreme Court on Monday considered a case that could impact whether Americans have to pay out-of-pocket for preventive-care services such as diabetes screenings, HIV-prevention drugs and statins, which are currently provided to patients at no cost...
How Indexing Can Fuel Life Insurance and Annuity Success
Indexed annuities and universal life (IUL) insurance propel the industry to the forefront of retirement strategies. As Americans are gravitating toward financial products that offer the potential for gains without the accompanying risk of market losses, there’s an...
Growth Rate for Medicare Advantage Plans Slowed in 2025
Now that the 2025 Medicare Open Enrollment season is finished, over half, 51.5%, of people eligible for Medicare have decided on Medicare Advantage plans (MA), up from 50.8% in March of 2024. Based on the Centers for Medicare & Medicaid Services (CMS) enrollment...
CMS proposes 2.4% bump to inpatient pay in fiscal 2026, calls for deregulation, MAHA suggestions
The 2.4% effective pay increase would be below both the 2.6% rate CMS proposed last year and the 2.9% final rate it later landed on. Both were characterized by the hospital industry as inadequate in light of rising expenses. Independent advisors have suggested...
2026 Medicare Advantage and Part D Rate Announcement
In the CY 2026 MA and Part D Advance Notice, CMS proposed updates to payment factors for CY 2026 and received a wide variety of comments on our proposals. CMS appreciates the submitted comments. We considered applicable comments as we finalized the policies contained...
Enrollment in ACA Exchanges has Exploded in Recent Years
In states that currently have not expanded Medicaid, Marketplace enrollment grew 188% from 2020 to 2025, compared with the 65% growth in expansion states. In states where uninsured rates for children and adults under 65 were at least 10% in 2019, ACA Marketplace...
Medicare Advantage is covering more and more Americans − some because they don’t get to choose
Since the mid-2000s, the Medicare system has dramatically transformed. Enrollment in Medicare Advantage – the private alternative to the traditional Medicare program administered by the government – has more than quadrupled. It now accounts for the majority of...
Enrollment Growth in the ACA Marketplaces
CA Marketplace enrollment has reached a record-high for a fourth year in a row, totaling 24.3 million people in 2025. Much of this growth can be attributed to the enhanced subsidies first made available by the American Rescue Plan Act (ARPA) in 2021 and later extended...
Pennsylvania House Moves to Protect Affordable Care Act Protections
The Pennsylvania House of Representatives has taken bold action to safeguard the Affordable Care Act (ACA) protections, passing a set of four bills with bipartisan support to enshrine health care rights into state law. The four bills passed by the House are designed...
Medicare Advantage Growth Continues Despite Headwinds
The Medicare Advantage (MA) market grew to 34.5 million in 2024 despite significant challenges, according to a new report from HealthScape Advisors and Chartis. This signifies that 51% of the U.S. Medicare population is enrolled in an MA plan, reflecting a growth of...
OEP Answers: Helping Clients with Common Medicare Advantage Questions
The Medicare Advantage Open Enrollment Period (OEP) from January 1 to March 31 is your chance to be their go-to resource. People enrolled in an MA plan can switch to a different one or return to Original Medicare (with the option to add Part D prescription drug...
Medicare Telehealth Coverage Extended for Six Months
Just weeks before expanded telehealth services for Medicare beneficiaries were set to expire, a new announcement extends the program for an additional six months. The new expiration date for telehealth flexibilities in Medicare is now Sept. 30, 2025. This extension...
Obama calls to expand Obamacare ‘with everything going on right now’
Former President Barack Obama said that his signature legislation, the Affordable Care Act, should be expanded in future years, arguing that the ACA should be seen as a “first step” to better healthcare. “We’re not finished yet,” Obama said in a video promoting the...
The Cigna Group Completes Sale of Medicare Businesses to HCSC
"We are proud of the positive impact we have made in people's lives and the unique value provided through our Medicare businesses and are confident that HCSC will continue the meaningful work that we have done for these customers. We remain committed to serving...
UnitedHealth Sees Coming Fight Over Medicare Advantage
What they're saying: “We're excited to have a conversation" about whether to continue the push for value-based care or to "stay stuck in fee-for-service, which is volume-based and which is doing nothing to actually improve people's health," a UnitedHealth Group...
2026 CMS Final Rule: What Agents Need to Know Now
The proposed 2026 CMS Final Rule has the potential to reshape the Medicare landscape, and as licensed agents, you need to prepare now for what may be implemented. A key change that may impact your daily operations is a new mandate requiring pre-approval...
ACA: 2025 Marketplace Integrity and Affordability Proposed Rule
Today, the Centers for Medicare & Medicaid Services (CMS) issued the “Marketplace Integrity and Affordability Proposed Rule” that proposes standards for the Health Insurance Marketplaces, as well as for health insurance issuers, brokers, and agents who connect...
Trump Health Care Proposal Billed as Consumer Protection but Adds Enrollment Hoops
The Trump administration said in a statement Monday that the new regulations include “critical and necessary steps to protect people from being enrolled in Marketplace coverage without their knowledge or consent, promote stable and affordable health insurance markets,...
Is Medicare Stopping Telehealth in 2025? All About the Extended Waivers and Possible Exceptions
With Medicare telehealth services expanding significantly during the COVID-19 pandemic, many Americans are now asking: Is Medicare ending telehealth in 2025? While some temporary policies will expire, Congress has extended key provisions that ensure continued access...
10 Things to Know About Medicaid
Medicaid is the primary program providing comprehensive coverage of health and long-term care to 83 million low-income people in the United States. Medicaid accounts for one-fifth of health care spending, more than half of spending for long-term care, and a large...
What Forced CMS to Terminate the MA Value-Based Insurance Design Model?
In December, the Centers for Medicare & Medicaid Services (CMS) announced it was terminating the Medicare Advantage Value-Based Insurance Design (VBID) model at the end of 2025 due to the model’s “substantial and unmitigable costs to the Medicare Trust Funds.”...
Medicare Statistics and Facts In 2025
Medicare Statistics at a Glance As of April 2024, approximately 67.3 million U.S. adults are enrolled in Medicare coverage, according to the Centers for Medicare and Medicaid services. Approximately 50.4% of beneficiaries are enrolled in a Medicare Advantage plan...
Trump administration slashes funding for ObamaCare outreach program
The Centers for Medicare and Medicaid Services (CMS) on Friday announced health insurance navigators will receive just $10 million per year over the next four years. Navigators received $98 million in 2024. CMS said the cut will allow the exchanges to focus on more...
Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?
Enhanced Affordable Care Act (ACA) subsidies were first made available as part of the American Rescue Plan Act in 2021 and were extended through the end of 2025 by the Inflation Reduction Act. The enhanced subsidies build on the ACA’s original tax credits by...
UPDATE: 11th Circuit Vacates FCC’s One-to-One TCPA Consent Rule
While Monday was the original compliance deadline for the Federal Communications Commission’s (FCC or Commission) new one-to-one consent requirement under its Telephone Consumer Protection Act (TCPA) regulations, a decision late last week has put that rule on hold...
How Does the Affordable Care Act Affect Medicare?
The Affordable Care Act (ACA) set out to make healthcare more affordable. It had various effects on Medicare, such as improving coverage and eliminating the drug coverage gap (also called the donut hole). More than 68 million people in the United States are enrolled...
Trump rescinds Biden-era supplemental health benefits notice requirement
President Donald Trump gave issuers of critical illness insurance, hospital indemnity insurance and other forms of fixed-indemnity health insurance benefits a boost Monday. The new Trump administration undercut an effort by President Joe Biden to rein in...
How Healthcare Leaders Reacted to the 15 Additional Drugs Selected for Medicare Negotiation Program
The U.S. Department of Health and Human Services unveiled 15 additional drugs chosen for the Medicare Drug Price Negotiation Program on Friday. Many healthcare leaders are applauding the list of selected drugs, while drug manufacturers are coming out against it. Under...
As Congress Looks to Reduce Federal Spending, Medicare and Medicaid Remain Broadly Popular, and At Least Twice as Many People Want to Increase Spending Rather Than Cut It
About eight in 10 Americans overall view Medicare (82%) and Medicaid (77%) favorably. This includes majorities across partisans, including most Republicans (75% view Medicare favorably and 63% view Medicaid favorably). About half (46%) of the public say the federal...
New Federal Rule Promises Fairer Medigap Access: What Agents Need to Know
Medicare Supplement (Medigap) plans have long been a popular choice for Medicare beneficiaries looking to manage healthcare costs. Yet they’ve lacked critical federal consumer protections, leading to discriminatory practices from insurers based on age, disability, and...
Clover Health Reports 27% Growth in Medicare Advantage Membership, Surpassing 100,000 Lives After Strong Annual Election Period
Robust plan benefits powered member growth, mainly driven by switchers from other plans Company will focus on balancing profitability with strategic investments in growth and technology to take advantage of strong market opportunity ~95% of Clover’s January 1, 2025...
Capstone: Medicare Advantage Quick Take: 2026 Advance Notice Beats Expectations With 2.23% Payment Lift, No Major Reforms; Win for Humana, UnitedHealth
Capstone believes the 2026 Medicare Advantage (MA) Advance Notice is a win for insurers in the program, including Humana Inc. (HUM) and UnitedHealth Group Inc. (UNH). The Centers for Medicare and Medicaid Services (CMS) released the higher-than-expected 2.23% payment...
Unhappy with Your Medicare Advantage Choice? You have One More Chance to Change Your Mind.
Good news — you can make changes during the Medicare Advantage enrollment period running from Jan. 1 to March 31, which allows you to: Switch to another Medicare Advantage plan, with or without drug coverage. Drop your Medicare Advantage plan and return to original...
Why Republicans Are Warming to Extending Obamacare Subsidies
Republican members of Congress who once opposed expanding – and even wanted to repeal – the Affordable Care Act are coming around to extending subsidies that allow more Americans to buy individual coverage, also known as Obamacare. Veteran U.S. Sen. Lisa Murkowski, a...
HealthCare.gov Breaks New Record with 16.6 million Consumers Signing Up for Coverage—the Highest Ever for January 1 Coverage
The Centers for Medicare & Medicaid Services (CMS) is committed to a robust Marketplace Open Enrollment process for consumers so they can easily purchase high-quality, affordable health care coverage. CMS reports that a record 16.6 million[1] consumers signed up...
Aetna ACA: 2025 IFP- Broker Bonus program
About the program Brokers can qualify through new business in all participating states and retained business in specific counties • Includes members sold or renewed with January 1, 2025 effective date Qualifying brokers are eligible for additional credits for dental...
Medicare Special Needs Plans Are Booming in Popularity. Are You Missing Out?
In 2025, SNP enrollment is expected to soar to 7.2 million people, or 28% of Medicare Advantage enrollees—the vast majority of them in plans for people in Medicare and Medicaid. The number of SNP plans has risen to about 47,000 nationwide, which is a quarter of all...
CMS releases details on Medicare premiums, deductibles for 2025
The Medicare Part A deductible for inpatient hospital services will increase by $44 in calendar year 2025 to $1,676, the Centers for Medicare & Medicaid Services announced Nov. 8. The Part A daily coinsurance amounts will be $419 for days 61-90 of hospitalization...
Cigna Healthcare, Infirmary Health Reach Medicare Advantage Agreement
The agreement includes value-based aspects that are focused on improving customer health, lowering costs and achieving high-quality ratings. Infirmary Health is the largest nonprofit, non-governmental healthcare provider in Alabama. Based...
ACA Open Enrollment for 2025: What You Need to Know
Each year, CMS tweaks its Affordable Care Act open enrollment strategy to streamline the consumer experience and improve access to care and coverage. This year, CMS shared its approach to ACA open enrollment for the 2025 enrollment season and how any adjustments aim...
Correcting Cost Misconceptions Can Bridge the Life Insurance Gap
Despite a broad understanding of life insurance basics, there’s still a significant gap in coverage among Americans, primarily because of cost misconceptions. A startling 72% of individuals overestimate the expense of basic term life insurance, with only about 11% of...
How to use Medicare star ratings wisely during open enrollment
During this Medicare open-enrollment season, people selecting options for 2025 can often choose among a dizzying number of Part D drug plans and private insurers’ Medicare Advantage plans. Medicare’s star ratings can help you narrow down choices—if you understand what...
Medicare Mastery: The Importance of Offering MA and Medigap Options
Medicare Advantage (MA) plans currently serve over half of all Medicare-eligible individuals. Despite this dominance, the demand for Medicare Supplement (also known as Medigap) plans is on the rise, with recent projections showing an increase from 14.3 million to 17...
Medicare Advantage 2025 Plan Competition and Market Insights
It’s that time of year! Medicare Advantage (MA) plans have prepared their Medicare products in anticipation of the 2025 Annual Election Period (AEP), which is upon us once again! The MA market is comprised of national health plans, Blue Cross Blue Shield...
Key Facts About Medigap Enrollment and Premiums for Medicare Beneficiaries
This brief presents facts about Medigap, including the characteristics of Medicare beneficiaries with a Medigap policy, variation in Medigap enrollment by state, and Medigap premiums. This analysis is based on data from the National Association of Insurance...
Medicare Advantage growth persists ahead of open enrollment
Medicare Advantage growth has been rapid. The share of Medicare-eligible individuals in Medicare Advantage plans escalated from 31.5% to 48.2% over the past eight years. Half of this population is now enrolled in Medicare in 2024. This trend is expected to continue....
Marketing Rules for Health Plans Updated
People representing Medicare plans aren't allowed to: Ask for your personal information (like bank account or credit card numbers) over the phone unless it’s needed to process an enrollment request. Plans don't need your personal information to give a quote. Come to...
2025 Medicare Advantage and Part D Star Ratings
Medicare Advantage Prescription Drug (MA-PD) contracts are rated on up to 40 unique quality and performance measures; MA-only contracts (without Part D coverage) are rated on up to 30 measures; and PDP contracts are rated on up to 12 measures. For each measure, CMS...
ACA: HHS Notice of Benefit and Payment Parameters for 2026 Proposed Rule
The Affordable Care Act (ACA) is more popular than ever: A new report shows that nearly 50 million people – or one in seven Americans – have had ACA Marketplace coverage at some point. The Department of Health and Human Services (HHS), Centers for Medicare &...
Value-based Care: Transforming Medicare for the Better
Value-based care (VBC) is a health care payment model that shifts the focus from the volume of services provided to the quality of care delivered. This paradigm shift aims to improve patient outcomes, reduce costs, and enhance the overall efficiency of the health care...
AgencyBloc and SunFire to Forge New Integration that Empowers Insurance Agencies
The #1 recommended provider of insurance growth enablement solutions for the health, senior and benefits industries, and SunFire, the leading Medicare quoting and enrollment platform, are excited to announce an upcoming integration designed to streamline Medicare...
Marketing Rules for health plans
People representing Medicare plans aren't allowed to: During the meeting, Medicare plans and people who work with Medicare can't: Charge you a fee to process your enrollment into a plan. Steer you into a particular plan. Communicate incorrect information about their...
Are You Ready to Sell Your Life Insurance Book of Business?
You’ve built a successful career helping clients navigate the world of life insurance. Now, you might be contemplating the next chapter. Selling your book of business can be a strategic move, but it’s crucial to understand your readiness before embarking on the sales...
Affordable Care Act Tax Credits Work Despite Fraud and Should be Expanded
Official data show an 88 percent increase in individuals signing up for Marketplace coverage between 2020 and 2024. The nonpartisan Congressional Budget Office projects an average of 6.9 million more enrollees due to this policy over the next decade. ARTICLE
Medicare Supplement Open Enrollment: What to Know
If you miss open enrollment, underwriters will review the state of your health when you try buying a Medigap plan. Based on their assessments, you could: Pay higher premiums Face a coverage waiting period for preexisting conditions Be denied a plan altogether...
Humana Exiting Medicare Advantage in 13 Markets
Humana reaffirmed its full-year guidance but is leaving 13 Medicare Advantage (MA) markets next year, Chief Financial Officer Susan Diamond said during the Wells Fargo Healthcare Conference on Wednesday. Other members will have fewer plans to choose from in certain...
Medicare Statistics and Facts In 2024
From Original Medicare to Medicare Advantage to Medicare Supplement, different plan options abound. Below, we explore a variety of Medicare facts and statistics that reveal the choices older adults are making to cover the costs of their health care. ARTICLE
New Medicare Part D Out-Of-Pocket Spending Cap is an Important Improvement for Enrollees Facing High Prescription Drug Costs
Under the Medicare Part D benefit, which provides prescription drug coverage for nearly 56 million Medicare beneficiaries, many enrollees were originally required to pay 5 percent of their prescription drug costs, with no limit, even after their out-of-pocket spending...
Centene is said to be ending broker commissions for Medicare Part D
Being the largest Part D player, the move is expected to save hundreds of millions of dollars for Centene (CNC). Many brokers believe the new strategy aims to drive members towards Medicare Advantage plans, which also offer Part D coverage and draw higher funding from...
6 Milestones and How They Might Change Your Life Insurance Needs
Life is full of life-changing moments. Moving to a different city, starting a new job, becoming a first-time parent (or grandparent). But it’s also full of uncertainty — and how long we have left to enjoy life’s many milestones is one of those uncertainties. That’s...
Why this year’s Medicare Annual Notice of Change will be vital reading for beneficiaries
If you’re on Medicare, you’ll be getting one or two Annual Notice of Change letters in your mail or email this September about your 2025 coverage and costs. You may be tempted to ignore what looks like junk, as nearly a third of recipients do, according to an eHealth...
Unleash Market Potential: ACA Cuts Uninsured Rates, Expands Opportunities
Since its inception in 2010, the Affordable Care Act (ACA) has been a catalyst for reducing uninsured rates among U.S. minority groups, creating significant market opportunities for licensed sales agents. From 2010 to 2022, the uninsured rate among Black Americans was...
Lower Drug Prices Announced Under Medicare Negotiation Program
CMS today announced the agreed-upon lower prices for all 10 drugs selected for price negotiations under the Inflation Reduction Act (IRA). These drugs are considered some of the most expensive and frequently dispensed throughout the Medicare program. According to CMS,...
Medicare Advantage in 2024: Enrollment Update and Key Trends
Medicare Advantage enrollment has been on a steady climb for the past two decades following changes in policy designed to encourage a robust role for private plan options in Medicare. After a period of some instability in terms of plan participation and enrollment,...
Medicare Advantage in 2024: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
In 2024, three quarters (75%) of enrollees in individual Medicare Advantage plans with prescription drug coverage pay no premium other than the Medicare Part B premium, which is a big selling point for beneficiaries, particularly those living on modest incomes and...
Top Life Insurance Statistics for 2024
The state of the life insurance industry is continuously evolving, and understanding trends and changes can help you choose the right policy. Life insurance offers financial support for your dependents after you pass away, helping them cover your final expenses and...
How much and why ACA Marketplace premiums are going up in 2025
For 2025, across 324 insurers participating in the 50 states and DC, this analysis shows a median proposed premium increase of 7%, which is similar to last year. Based on a more detailed analysis of publicly available documents from insurers in 10 states and DC,...
Registration and Training for Marketplace Agents and Brokers
Agents and brokers who are new to the Marketplace this year, or who did not complete plan year 2024 registration and training, will be required to take the full Individual Marketplace training for plan year 2025. New agents and brokers can take Individual Marketplace...
Compliance Bulletin Videos
