Broker Payment Transparency Rule May Trigger Policy Changes

So far this month, in addition to allocating hundreds of millions of dollars in federal funding to augment various aspects of the Affordable Care Act marketplaces, the Biden administration has also proposed a regulation that would increase transparency about how brokers are compensated for selling certain health plans. Health policy experts say that while those new requirements may not be particularly helpful for consumers, they could eventually trigger policymaking that alters some insurers’ broker payment practices.

The broker compensation provisions appear in a notice of proposed rulemaking (NPRM) issued jointly by HHS, the Labor and Treasury departments and the Office of Personnel Management — a large portion of which is devoted to establishing new data-reporting requirements for air ambulance services (which historically were a frequent source of surprise medical bills). In addition to those provisions, the NPRM proposes to require issuers offering individual health insurance coverage or short-term, limited duration insurance (STLDI) to “disclose to policyholders, before finalizing plan selection as well as on documentation confirming the individual’s enrollment, commission rates and compensation structure for other direct and indirect compensation provided by the issuer to an agent or broker associated with enrolling those individuals.”

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