CMS’s Center for Consumer Information and Insurance Oversight released guidance urging Qualified Health Plan issuers on the Federally-facilitated Exchange to step up their oversight of appointed agents and brokers, saying many issuers have been slow to monitor and act against noncompliant producers, including by suspending commissions or terminating appointments. 

The guidance focuses on two areas. First, starting with 2027 Open Enrollment, CMS will send issuers a recurring file listing PY2027 policies with open Data Matching Issues alongside the associated broker’s NPN. Beginning November 1, CMS recommends issuers review enrollment records monthly for signs of misconduct, act against noncompliant brokers generally within a month, and report investigation status to CMS monthly. CMS ties the urgency to timing: the Working Families Tax Cut law requires pre-enrollment eligibility verification for premium tax credits, but not until PY2028, leaving PY2027 under a weaker process.

Second, borrowing from Medicare Advantage practice, CMS recommends issuers have appointed brokers record calls covering plan comparison, enrollment, and sales and marketing. Brokers who enrolled at least 100 PY2026 policies with a parent organization should start by November 1, 2026; smaller producers by March 1, 2027, or once they hit 100 PY2027 policies, whichever comes first. CMS also frames recordings as a way for brokers to document consumer review and consent ahead of the HHS-approved consent form requirements taking effect in PY2028. 

Read the full CMS release HERE.