CMS is disenrolling over 760,000 current ACA enrollees due to concerns about fraud in these enrollments. CMS is also announcing a temporary order prohibiting new brokers from registering and selling in the 2027 ACA Marketplace.
CMS also intends to terminate another 200 brokers and agents from selling ACA marketplace plans that “failed to comply with enrollment standards for the ACA’s marketplaces.” This action follows notices to terminate 569 ACA agents and brokers, sent this summer to agents who submitted enrollments missing key pieces of client information.
These steps are part of CMS’s efforts to reduce fraud in the ACA program. Right now, it’s not clear how long the temporary ban on new broker registrations will last.
The Impact on ACA Agents
As soon as ACA agents receive notice of a client’s disenrollment from this action, contact them to discuss other available health coverage options. If the client can’t enroll in another ACA plan in their area, ACA-alternative plans, catastrophic plans, and ancillary policy options available there are available.
With the CMS focus on fraud and enrollment documentation for premium tax credits and cost-share reduction eligibility, ACA brokers and agencies need to ensure their proofreading of enrollment forms and all documents is as accurate as possible. Any illegible data or missing numbers on a required form that’s submitted can cost an enrollment and may trigger additional compliance and enforcement action against the agent or agency.
CMS ACA compliance will be critical in the Marketplace moving forward to achieve ACA success. There’s still time to act to address any gaps in this area, so please reach out to us for immediate help with questions and concerns using the contact information below.
The Agility Difference
As the insurance market changes, Agility helps agents stand out by sharing updates and offering our team’s expertise to help you grow. If you have questions or want to talk to our ACA, Medicare, CHOICE, Group, life, or ancillary experts, reach out to our dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com.
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