State insurance regulators are issuing warnings around what they describe as unfair practices by Medicare Advantage insurers to restrict enrollment.
Amid rising costs and increased regulatory pressures, insurers have been adjusting their broker commission structures this year as many look to shrink their national MA footprint. In response, at least four states have issued warnings or emergency orders to prevent insurers from limiting access to MA plans, restricting broker commissions, and engaging in other market manipulation tactics that could harm beneficiaries’ ability to choose coverage.
The Idaho Department of Insurance issued emergency orders in late October, demanding UnitedHealthcare and PacificSource Health Plans cease practices that limit access to MA plans and alter broker compensation. The department alleged that both insurers discouraged brokers from selling certain plans and removed enrollment applications from public platforms during open enrollment.
Delaware’s Department of Insurance released a bulletin in late October, clarifying that actions such as removing enrollment applications, altering producer compensation, or steering consumers away from approved plans violate both state law and federal Medicare protections. The state noted that such actions hinder consumer access to Medicare products and could lead to enforcement action.
The New Hampshire Insurance Department issued a bulletin in November, warning insurers against manipulating broker compensation or withholding access to approved MA and Medicare supplement plans. The bulletin said that altering commissions mid-year could violate state law and negatively impact seniors’ access to necessary coverage options.
North Dakota’s Insurance Department issued a warning in November against practices that restrict access to Medicare products or manipulate compensation structures. The department said it is important to maintain transparency and fair competition in the marketplace to ensure seniors have full access to Medicare Advantage and supplement plans.
