As insurance carriers face increased financial pressures, they are looking for ways to lower costs for 2026. Some MA and PDP carriers have responded by limiting enrollment in their least profitable plans. Here’s how these efforts could impact you and what you should do.
Understanding Key Definitions
There are two situations that you may encounter:
- Eliminating Commissions: Many carriers have announced they will no longer be paying commissions on less profitable plans such as $0 premium plans and PPOs, both of which tend to be less cost-effective.
- Plan Suppression: Another way to reduce enrollment in some plans is to suppress them. Carriers will remove the plans from their online enrollment platforms, making enrollment possible only with paper applications. In some cases, a carrier might suppress a particular plan mid-AEP once they have determined they have reached their desired number of enrollees.
Eliminating commissions and suppressing plans are two ways carriers help alleviate increased financial pressures. As a Medicare agent who earns their income from commissions, these changes are concerning. How do you protect your earnings as well as the best interests of your clients?
Put Your Clients Needs First
You have built your business and reputation on honesty and with integrity. Your clients trust you to analyze their needs and present the plan options that best fit their needs. This could mean enrolling them in a plan for which you receive no commission. While this may not benefit you in the short term, it will certainly benefit you over the long run. When your clients see that you are putting their best interests first, you strengthen your relationship and increase the probability of retaining them as clients and earning their referrals.
Check Your Errors and Omissions Policy
Before enrolling a client into a non-commissionable plan, check your Errors and Omissions (E&O) policy to confirm that you are covered if you advise a client on or enroll them in a non-commissionable plan. Some E&O policies will only cover you if you receive a fee or commission for your professional service, while other policies are less specific, only stating that you must be contracted to provide a professional service.
What should you do if a non-commissionable plan is the best option for a client, but your E&O policy offers no coverage? Your best course of action is to reach out to your carrier’s agency broker support team for guidance, especially since this is a complex issue. Remember to always prioritize your client’s best interests and keep a detailed record of all communications, no matter if you earn a commission. This approach will help you handle the situation effectively and professionally.
Review Your Portfolio
To maximize your commission potential, review, update, and add to your portfolio regularly. Strive to offer a one-stop shopping experience for existing clients and to improve prospecting opportunities with new clients. This helps you diversify your book of business and create year-round sales opportunities and a steady flow of income.
Medigap and PDP Plans
Consider adding new commissionable plans to your portfolio, including Medigap plans and PDPs. Many MA plan enrollees are unhappy with the changes to their plans for 2026, and some might be good candidates for a Medigap plan.
Cross-Selling Ancillary Products
Consider adding any of these products to your portfolio:
- Life insurance
- Annuities
- Hospital indemnity
- Critical illness
- Final expense
- Long-term and short-term care
- Stand-alone vision, dental, and hearing
To stay compliant with CMS regulations, schedule a separate meeting to discuss non-health related products such as life insurance and annuities, if your client expresses an interest in discussing them.
Stay Focused on the Big Picture
While changes to commission structures can be unsettling, focus on the big picture. Stay engaged with your clients throughout the year, with an emphasis on retention, cross-selling and referral generation. Always express your appreciation and follow up with a thank you note. If you have questions, the dedicated team at Western Asset Protection is here to help. Contact us today.