Medicare Advantage Commissions Increased for 2018 Enrollments
This memorandum provides contract year (CY) 2018 compensation limits for agents and brokers, directions for submitting amounts into the Health Plan Management System (HPMS), as well as training and testing requirements.
Compensation Rate Adjustment for CY 2018
As provided in 42 C.F.R. §§422.2274(b)(1) and 423.2274(b), the compensation amount paid to an independent agent or broker for an enrollment must be at or below the fair market value (FMV) cutoff amounts published yearly by CMS.
The CY 2018 FMV cut-off amounts for all organizations are as follows:
(2.7% increase ($12 / $6) to the writing agent for 2018 Medicare Advantage enrollments.)
NOTE: The FMV amounts for CY 2018 are rounded to the nearest dollar. The Initial Year amount is the maximum allowable to be paid for enrollments during compensation cycle-year 1. The renewal amount is the maximum allowable to be paid for enrollments during compensation cycle-years 2 and beyond.
Compensation Rate Submission for CY 2018
As in past years, all organizations must inform CMS via HPMS whether they are using employed, captive, or independent agents. Organizations that use independent agents must provide the initial 2 and renewal compensation amount or range of amounts paid to these agents. Additionally, if an organization pays referral fees, the organization must disclose the referral fee amount. CMS has provided instructions for data entry in the HPMS Marketing Module User Guide.
Organizations may submit their agent/broker information in the HPMS Marketing Module from
CMS expects organizations to keep full records documenting that they are updating compensation schedules and paying agents and brokers according to CMS requirements.
Please note that the CY 2018 compensation information submitted will be made available for the public to view on www.cms.gov prior to the annual election period for CY 2018.