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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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

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...

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,...

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

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