Compliance Bulletins

IUL Illustration Complication: Helping Clients See Past the Hype

Indexed universal life (IUL) insurance has surged in popularity over the past decade, but regulators warn that the way these products are illustrated often sets clients up with unrealistic expectations. For years, regulators, actuaries, and consumer advocates have...

Why Affordability Must Be Our North Star

This is a pivotal year for our nation’s healthcare system, and one theme rises above the rest: affordability. Millions of older adults depend on Medicare Advantage for stability, simplicity, and support. ARTICLE

Keeping Retirement Timelines on Track for the Peak 65 Generation

Every day, more than 11,000 Americans turn 65 — the most significant wave of retirees in U.S. history. But instead of celebrating, many are hitting pause. Nearly one-third of Peak 65 consumers (ages 61-65) say they’re considering delaying retirement due to worries...

Exclusive: House panel subpoenas 8 health insurers

House Judiciary Committee Republicans have subpoenaed eight Affordable Care Act health insurers for documents as part of a widening investigation of potential fraud surrounding the use of premium subsidies in the individual market, Axios has learned. Highlights:...

CMS Issues ACA 2027 Proposed Rules

The Centers for Medicare & Medicaid Services Feb. 9 released its 2027 proposed standards for the health insurance marketplaces, including the issuers and brokers who assist marketplace enrollees. Notably, the proposed rule would allow CMS to certify non-network...

Texas sees more enrolled in Affordable Care Act insurance

Almost 4.2 million Texans enrolled in Affordable Care Act health insurance for 2026, a more than 5% increase from last year, per federal data. The big picture: Around 23 million Americans enrolled for a health insurance plan through the ACA for this year, a roughly...

Medicare Advantage shifts focus to quality

Medicare Advantage plans face pressure to be profitable, so carriers are shifting their focus to quality. “The entire MA ecosystem is for the benefit of seniors and we must remember that,” said Steve Kaplan, chief legal, compliance and privacy officer at...

Keeping Retirement Timelines on Track for the Peak 65 Generation

Every day, more than 11,000 Americans turn 65 — the most significant wave of retirees in U.S. history. But instead of celebrating, many are hitting pause. Nearly one-third of Peak 65 consumers (ages 61-65) say they’re considering delaying retirement due to worries...

As federal ACA subsidies lapse, blue states offer their own

Some states are stepping in to blunt the financial fallout of lapsed federal subsidies for Affordable Care Act health insurance premiums. California, Colorado, Connecticut, Maryland, Massachusetts and New Mexico have all started offering additional state-funded...

ACA Marketplace 2026 OEP Report: National Snapshot

The Centers for Medicare & Medicaid Services (CMS) reports that 22.8 million consumers have signed up for 2026 individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period (OEP) on November 1,...

Turbulence in the ACA Marketplace: Fraud Crackdowns and Rising Costs

A convergence of legislative changes and market integrity initiatives is reshaping the Affordable Care Act (ACA) Marketplace landscape. For the more than 24 million Americans who rely on the ACA Marketplaces for their coverage and the insurance professionals who serve...

Contract Year 2027 Medicare Advantage and Part D Proposed Rule

On November 25, 2025, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would revise the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), and Medicare Cost Plan Program. The Contract Year (CY) 2027...

Medicare premium hike will cut into 2026 Social Security checks

“That’s the second-highest Part B premium increase in program history,” Mary Johnson, a Social Security and Medicare policy analyst, told Yahoo Finance. It hits just as seniors are coming to terms with the modest 2.8% cost-of-living adjustment (COLA) increase in the...

States warn payers not to restrict Medicare Advantage access 

State insurance regulators are issuing warnings around what they describe as unfair practices by Medicare Advantage insurers to restrict enrollment.  Amid rising costs and increased regulatory pressures, insurers have been adjusting their broker commission structures...

2026 Medicare Parts A & B Premiums and Deductibles

The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,736 in 2026, an increase of $60 from $1,676 in 2025. Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of...

Dems accept shutdown deal without ACA guarantee

Enough Senate Democrats are poised to accept a deal to reopen the government without a concrete agreement to extend Affordable Care Act subsidies — but with the promise of a showdown vote on the assistance next month. Why it matters: If a bill to temporarily fund the...

Medicare finalizes controversial cut to specialty care next year

Medicare has locked in a controversial pay cut for specialty doctors next year, normalizing reimbursement between specialists and primary care doctors and curbing the influence of a powerful physician association in setting rates. The CMS finalized the 2026 Medicare...

Plan Year 2026 Marketplace Plans and Prices Fact Sheet

The Health Insurance Marketplace® Open Enrollment Period for plan year 2026 begins on November 1, 2025, and runs until January 15, 2026. In plan year 2026, most enrollees on Healthcare.gov will have access to plans with premiums at or below $50 per month, after the...

What to know about ACA open enrollment

Beginning Saturday, Americans will be able to log into the federal Affordable Care Act exchange and choose their insurance plans for next year. Nov. 1. has been a key date in the shutdown fight, as Democrats have long argued that if the enhanced federal subsidies...

Scammers now targeting Medicare open enrollment

With open enrollment for Medicare currently available the Better Business Bureau reports scammers are trying to take advantage of those adding or changing their coverage. The Quincy BBB regional director, Don O’Brien, said scammers often like to take advantage of...

Dealing with Disruption: How to Navigate This Year’s AEP Challenges

With Medicare Advantage (MA) now covering more than half of all Medicare beneficiaries, its dominance in the senior health coverage space is only growing. However, this growth doesn’t necessarily mean stability. This year’s Annual Enrollment Period (AEP) is expected...

What to Do About These Three Medicare Changes During Open Enrollment

When the Medicare open-enrollment season for 2026 starts on October 15, brace yourself for some big, and potentially costly, changes. Premium hikes for both medical and drug coverage, shrinking benefits on some private insurers' Medicare Advantage plans and a few rule...

5 Things to Know About the Health Care Fight Behind the Shutdown

  The tax credits that make ACA health care premiums affordable for many Americans don't expire until December, as Republican lawmakers note. But Democratic lawmakers want to see them extended before enrollment begins Nov. 1, and they have made that a condition of...

Winners and Losers from 2026 Medicare Advantage Star Ratings

 The CMS quietly released highly anticipated 2026 star ratings for MA insurers on Thursday evening. The agency normally issues a press release on the results, but has yet to do so. Operations may be hampered by the government shutdown — the HHS said communication...

Bulletin 2025-07: Arizona Licensed Insurance Producers

Solicitation and Sale of Health Insurance ProductsPursuant to Arizona Revised Statutes (“A.R.S.”) §§ 41-1001(24) and 41-1091, the Arizona Department of Insurance and Financial Institutions (“Department”) issues this Substantive Policy Statement (“Bulletin”) to provide...

Where ACA enhanced subsidies stand: 10 updates

The federal government has shut down for the first time since 2019 after lawmakers failed to reach a funding deal, with the fate of enhanced ACA subsidies, set to expire at year’s end, hanging in the balance. Premium tax credits were originally available for enrollees...

Medicare’s best-kept secret: The licensed agent

We’ve all heard of Peak 65 — more than 11,000 Americans will celebrate their 65th birthday each day this year. That reality isn’t only a demographic headline; it’s transforming the client base. As clients a ge, Medicare becomes a key factor in their pre- and...

Gold Kidney Sanction

On September 12, 2025, the Florida Office of Insurance Regulation (FL OIR) and Gold Kidney entered into a consent order which stated that Gold Kidney’s “authority to enroll new subscribers for plan year 2025 shall be suspended through December 15, 2025”. However, Gold...

How an ACA Premium Spike Will Affect Family Budgets, and Voters

If the enhanced ACA tax credits are not extended, premium payments will increase by more than 100% for many of the 24 million Americans who buy their own coverage (as forthcoming KFF research will show), and that’s on top of rising food and housing costs among other...

Health Insurance Premiums Could Rise More Than 80% Next Year

Americans' health insurance premiums are on track to surge next year, due to the imminent expiration of enhanced Affordable Care Act (ACA) tax credits introduced in response to the COVID-19 pandemic. According to a recent analysis by the Peterson Center on Healthcare...

Zacks Industry Outlook Highlights Cigna and Humana

The U.S. health insurance industry, referred to as Health Maintenance Organization (HMO), is poised to benefit from expanding commercial plans suite, which offers higher margins and reduced regulatory risk, while also leveraging favorable financing conditions from...

Reversing the Rise in Avoidable Deaths: Examining the Role of Agents

The U.S. is facing a public health failure that most people don’t even know about. Between 2009 and 2019, the average rate of avoidable deaths — those that could have been prevented or effectively treated with proper care — increased by 33 per 100,000 people across...

Mastering SEPs in the ACA Marketplace

With ACA enrollment hitting a record 24 million in 2024 — 15% higher than the previous year — the demand for quality healthcare remains strong. While Open Enrollment for Affordable Care Act (ACA) plans in most states may have closed on January 15, millions may still...

HHS Expands Access to Affordable Health Insurance

WASHINGTON — The U.S. Department of Health and Human Services (HHS) announced today it is implementing important measures to expand access to more affordable catastrophic health coverage through HHS’ new hardship exemption guidance. This guidance streamlines access to...

Always Be Marketing: The Mindset Shift Licensed Agents Need in 2025

Let’s get this out of the way upfront: “Always Be Closing” “ABC’s” of Sales still has its place. Asking for the sale is part of the job, and a critical one at that. Whether you’re helping someone enroll in a Medicare plan or choose the right life insurance...

A Checklist For Success In Medicare AEP

The Medicare annual enrollment period is approaching, and you’ve likely been gearing up for this critical time when your clients can enroll in or make changes to their Medicare Advantage and Part D prescription drug plans. But in this flurry of activity, it’s easy for...

Why Young Americans Dread Turning 26: Health Insurance Chaos

Amid the challenges of adulthood, one rite of passage is unique to the United States: the need to find your own health insurance by the time you turn 26. That is the age at which the Affordable Care Act declares that young adults generally must get off their family’s...

As payers stumble, hospitals eye their Medicare Advantage members

Despite the national pullbacks, total Medicare Advantage enrollment is still growing, though at a slower rate. Between 2024 and 2025, enrollment grew 4%, compared to 7% the year before. In 2025, 34 million Medicare beneficiaries, or 54% of the eligible population, are...

IUL or FIAs: Which is the Best Option?

Indexed universal life (IUL) and fixed indexed annuities (FIAs) both stand out as powerful yet distinct tools, with their camps of defenders. Some of the more dedicated proponents may even suggest that their preferred product is objectively better than others....

How much and why ACA Marketplace premiums are going up in 2026

Health insurers submit rate filings annually to state regulators detailing expectations and rate changes for Affordable Care Act (ACA)-regulated health plans for the coming year. A relatively small, but growing, share of the population is enrolled in these plans...

The SEP Advantage: Boost Your Medicare Business Year-Round

Licensed agents in the Medicare space are well-versed in the rhythm of the Annual Enrollment Period (AEP) and the Medicare Advantage Open Enrollment Period (MA OEP). The busy months from October through March are often a whirlwind of enrollments, client meetings, and...

Medicare Advantage in 2025: Enrollment Update and Key Trends

Highlights for 2025: More than half (54%) of eligible Medicare beneficiaries are enrolled in Medicare Advantage in 2025. While a growing share of Medicare beneficiaries are enrolled in a Medicare Advantage plan, the pace of the increase in enrollment slowed in 2025....

Health agents Must Start Now to Keep Clients from Losing ACA Coverage

Health insurance agents who work in the Affordable Care Act market need to begin working with clients now to help them prepare for new regulations that will impact their eligibility for coverage. The “One Big Beautiful Bill” along with new regulations from the Centers...

Medicare Advantage legislation in Congress: 7 bills to know

Federal lawmakers have introduced a handful of bills aimed at speeding up prior authorization and cracking down on upcoding in Medicare Advantage. None of the introduced bills have been heard in committee. Here are seven proposals introduced in 2025 to know: ARTICLE

Prior Authorization Coming to Traditional Medicare Starting in 2026

Traditional Medicare, also known as Original Medicare, has historically required little in the way of pre-authorization for beneficiaries seeking services; pre-authorization was typically the domain of Medicare Advantage. But that's about to change, as the Centers for...

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...

What Medicare beneficiaries really want in AEP

Medicare beneficiaries’ priorities have clearly shifted. Factors beyond cost are significantly influencing consumer decision-making, presenting new challenges and opportunities for carriers and advisors. Consumer confusion drives plan switching, while consumers place...

Compliance Bulletin Videos

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