Agent/Broker Training and Compensation

August 5, 2014

Agent/Broker Training

To continue participation in the Federally Facilitated Marketplace (FFM) for the individual market for the remainder of the 2014 plan year and the 2015 plan year, agents and brokers must complete an annual registration renewal process that includes completion of required training and execution of the Agent/Broker FFM Agreements for the individual market and/or SHOP. Existing registration will expire Sept. 30, 2014. In order for an agent or broker to continue to assist with October through December 2014 Marketplace special enrollment periods, the agent or broker must ensure he/she has completed the registration renewal process before the 2014 registration expires.

Agents and brokers participating in the FFM for the first time must:

  • Create an account on the Medicare Learning Network (MLN);
  • Complete required training based on participation in the individual FFM, SHOP, or both;
  • Sign the FFM Agent/Broker FFM agreement; and
  • Create an FFM user account and complete identity proofing on the CMS enterprise portal.

Agents and brokers renewing with the FFM must:

  • Login to MLN using their existing MLN user ID;
  • Utilize their existing FFML user account on the CMS enterprise portal;
  • Complete required training based on participation in the individual FFM, SHOP, or both; and
  • Sign the FFM Agent/Broker FFM agreement.

Agent/Broker Compensation

Agents and brokers are compensated directly by Qualified Health Plan (QHP) issuers as per the terms of their QHP issuer contracts for assisting consumers to enroll in QHPs through the FFM.

Compensation includes commissions, fees, or other incentives as established in the relevant contract between a QHP issuer and an agent or broker.

QHP issuers are required to pay the same compensation to agents and brokers for enrollment in QHPs through the Marketplaces as for enrollment in similar health plans offered outside the Marketplaces.

Unless otherwise required under state law, a QHP issuer is not obligated to compensate an agent or broker with whom the QHP issuer is not affiliated, even if the agent or broker assists a consumer in enrolling in the issuer’s QHP through the Marketplace.

The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.