In the health insurance industry, Open Enrollment Period (OEP) is one of the most important times of the year. It’s when agents and brokers have the opportunity to assist their clients in selecting or renewing coverage. However, success during this season depends not only on your skills as an agent but also on your ability to stay updated and comply with established regulations.
To this end, CMS (Centers for Medicare & Medicaid Services) offers a variety of resources and guidelines to help agents and brokers perform their roles efficiently, compliantly, and with a client-centered approach. This blog breaks down the key resources CMS provides and strategies to make the most of them.
Reporting Phishing Attempts
One of the biggest risks in today’s digital environment is phishing—a tactic used to obtain sensitive information through fraudulent emails or messages. Health insurance agents and brokers are potential targets due to the personal and financial data they handle for their clients.
If you detect any phishing attempts, CMS provides a clear protocol for reporting them:
- Email cms_it_service_desk@cms.hhs.gov.
- Call 1-800-562-1963 or 410-786-2580.
Why It’s Important:
Protecting your clients’ data is not only an ethical obligation but also a way to build trust and ensure compliance with regulations. By reporting such attempts, you contribute to a safer ecosystem for all stakeholders in the insurance market.
Practical Tips:
- Training: Ensure you and your team are trained to recognize phishing signs, such as suspicious email addresses or unsafe links.
- Internal Protocols: Establish clear procedures to handle potential phishing attempts and guarantee a swift response.
- Participate in Public Consultation: 2026 Benefit and Payment Parameters
Each year, CMS makes adjustments to benefit and payment parameters to ensure the health insurance system remains efficient and equitable. For the 2026 cycle, agents and brokers have the opportunity to actively participate by submitting comments on proposed changes.
You can submit your feedback here before the 11:59 PM ET deadline.
Why It’s Important:
Participating in this process allows you to influence policy designs that directly impact your work and your clients. Additionally, it gives you an early understanding of potential regulations, enabling you to plan more effectively.
How to Participate:
- Stay Informed: Carefully review CMS’s proposals before submitting your feedback.
- Be Specific: Provide clear examples and concrete data to support your opinions or suggestions.
- Engage Your Peers: Participating as part of an agent community can lead to stronger and more representative feedback.
Stay Informed with REGTAP Webinars
CMS hosts webinars through REGTAP (Registration for Technical Assistance Portal), designed to provide key updates and practical guidance for agents and brokers.
You can register for these webinars here and gain direct insights from CMS experts on relevant topics for Open Enrollment.
Why It’s Important:
These webinars not only keep you updated on the latest regulations but also offer a space to resolve specific doubts and learn from other professionals in the field.
Common Webinar Topics:
- Changes in marketplace parameters.
- Updates on Open Enrollment and Special Enrollment Periods.
- Strategies to enhance customer experience.
Maximize Your Webinar Experience:
- Schedule Time: Ensure you reserve time on your calendar to attend.
- Take Notes: Record key ideas and review how to apply them in your daily work.
- Ask Questions: Actively participate to clarify doubts and gather additional information.
Adhere to Advertising and Marketing Guidelines
Advertising and marketing are essential tools for reaching new clients and keeping current ones informed. However, in the health insurance sector, these activities are subject to strict CMS regulations.
To ensure your materials comply with these regulations, CMS provides an updated guide on advertising and marketing, available here.
Why It’s Important:
Non-compliance with these regulations can result in penalties, loss of licenses, or damage to your agency’s reputation. Following the guidelines not only protects your business but also demonstrates professionalism to your clients.
Practical Tips for Compliance with CMS:
- Pre-Launch Review: Before launching any advertising campaign, thoroughly review the materials to ensure they comply with the regulations.
- Clear and Accurate Language: Avoid exaggerated or misleading claims about the products you offer.
- Transparency: Always include complete information about costs, benefits, and policy limitations.
Access General Resources for Agents and Brokers
CMS provides a wide range of resources specifically designed for agents and brokers working in the Marketplace. These include guides, training tools, and regular updates. You can access these resources here.
Why It’s Important:
These resources help you stay prepared, deepen your knowledge of the market, and deliver exceptional service to your clients. Additionally, having a robust toolkit makes problem-solving easier and positions you as a reliable expert in the field.
Notable Resources:
- Step-by-step Open Enrollment guides.
- Updates on CMS policy changes.
- Tools for calculating subsidies and comparing plans.
How These Tools Impact Your Work
By leveraging these resources and guidelines, you’ll be better equipped to face the challenges of Open Enrollment and improve your clients’ experiences. Here are some key benefits:
- Guaranteed Compliance
Staying compliant with CMS is non-negotiable, but with the right tools, it’s much more manageable.
- Enhanced Customer Experience
When you’re well-informed, you can answer client questions more quickly and accurately, building trust and loyalty.
- Operational Efficiency
Resources like REGTAP webinars or CMS guides save you time by providing clear and accessible information.
Open Enrollment is a critical time for health insurance agents and brokers. Taking advantage of CMS resources not only simplifies your daily work but also strengthens relationships with your clients and ensures compliance with current regulations.
Take the time to explore and utilize the tools mentioned. Whether it’s reporting phishing attempts, participating in public consultations, attending webinars, or reviewing your marketing campaigns, every action contributes to more professional and efficient performance.
