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REMINDER: You are required to comply with all Marketplace regulations and requirements. As an agent or broker, you play a pivotal role in maintaining program integrity and supporting a sustainable Marketplace.
By following these helpful reminders for compliant Marketplace activities below, you can ensure you’re consistently delivering a positive consumer experience.
Prior to assisting consumers with enrollment activities, you are required to obtain and document the consumer’s consent. Your consumer must produce documentation demonstrating their consent, which must contain, at a minimum, the following information:
- A description of what actions on the part of the agent or broker the consent covers (and its limitations), the purpose, and duration of the consent provided by the consumer or their authorized representative;
- The date the consent was given;
- The name of the consumer or their authorized representative;
- The name of the agent, broker, or agency being granted consent;
- A process through which the consumer or their authorized representative may rescind the consent.
In addition, prior to submission of any new enrollments or updates to enrollments, you are required to obtain and document that the consumer or their authorized representative has reviewed and confirmed the accuracy of the information the consumer provided in their Marketplace eligibility application. Your consumer must produce documentation demonstrating they have reviewed and confirmed the accuracy of this information, which must contain, at a minimum, the following information:
- The date the information was reviewed;
- The name of the consumer or their authorized representative;
- An explanation of the attestations at the end of the eligibility applications;
- The name of the assisting agent, broker or web-broker.
You must maintain this documentation for a minimum of 10 years and provide it to CMS upon request.
As an agent or broker, you are required to abide by appropriate marketing guidelines and privacy and security agreements in accordance with all applicable Marketplace regulations and guidance. You can be subject to enforcement action for non-compliant practices. Here are some key reminders for compliant advertising and marketing practices.
DO:
- Provide accurate information on Marketplace plans, benefits, and savings, if applicable.
- Tell consumers you are a state licensed Marketplace-registered agent or broker selling Marketplace plans.
- Ensure potential pricing of health plans and plan benefits is accurately represented in advertisements.
- Tell consumers they may qualify for Marketplace coverage and help them get a quote or eligibility determination from the Marketplace.
DON’T:
- Say you represent or are employed by CMS, the Marketplace, HealthCare.gov, or an issuer, or misrepresent your role with an issuer.
- Mislead consumers about rewards or discounts for enrolling in Marketplace coverage without accurately describing the qualifications for such incentives.
- Guarantee free or low-cost plans to all consumers.
- Engage in misleading or coercive marketing.
- If you’re using a third party, confirm their marketing and advertising is not misleading or coercive.
For more information on compliant Marketplace activities, view this resource.
Have questions? For additional assistance, contact the Agent/Broker Email Help Desk via email at FFMProducer-AssisterHelpDesk@cms.hhs.gov.
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