NABIP Oregon Statement on Medicare Advantage & Part D Policy Changes: Protecting Consumer Access, Fair Competition, and the Role of Licensed Agents & Brokers

To Insurance Agents & Brokers, Insurance Carriers, and the General Public

Across Oregon and the nation, licensed health insurance agents and brokers have long served as trusted advocates—helping Medicare beneficiaries understand, select, and maintain coverage that meets their needs.

Today, however, the integrity of that advisory role is being undermined by troubling practices within the Medicare Advantage (Part C) and Medicare Prescription Drug (Part D) markets.

A Growing and Concerning Trend

In recent months, NABIP Oregon has observed a series of carrier actions that threaten both consumer access and the stability of the industry:

• Unannounced commission schedule changes, often taking effect midyear or without prior notice to appointed agents.
• Removal or restriction of access to plan applications for agents and brokers who are otherwise fully contracted and in good standing—again, without advance notice.
• Targeted suppression of plan marketing, intentionally discouraging or disincentivizing the sale of certain products to steer business toward plans that carriers financially prefer.

These actions are not isolated administrative decisions. They undermine fair competition, manipulate the market, restrict consumer access, and erode the essential role that licensed independent agents and brokers play in helping Americans navigate an increasingly complex Medicare marketplace.

The Role of the Licensed Agent or Broker

Licensed Medicare Insurance Agents and Brokers are highly trained and federally regulated professionals—not casual intermediaries. To participate in the Medicare market, every agent must:

• Hold an active state insurance license and complete required continuing education to maintain it.
• Pass annual Medicare-specific certification and compliance training, such as the AHIP or NAHU Medicare certification, covering CMS rules, consumer protections, and marketing ethics.
• Complete carrier-specific training and testing for each company they represent, ensuring they understand the plan’s details, benefits, and compliance standards before assisting a single client.

These requirements are extensive and renewed every year, reflecting both the complexity of Medicare and the seriousness of the agent’s duty to provide accurate, compliant, and ethical guidance. Independent agents are subject to strict oversight, monitoring, and auditing—ensuring consumers receive professional, unbiased advice that aligns with CMS standards and their individual needs.

When these professionals are restricted, bypassed, or financially disincentivized, the result is not greater efficiency—it is less accountability, less education, and less protection for the consumer.

The Real-World Impact

When independent agents are blocked, sidelined, or undercut, beneficiaries lose access to unbiased guidance.
These are not mere “salespeople”—they are certified professionals who:

• Compare coverage options across multiple carriers and plans.
• Explain formularies, provider networks, and cost structures.
• Ensure enrollees understand the implications of their choices.
• Provide year-round service and advocacy when issues arise.

Removing or disincentivizing these professionals leaves consumer—many with chronic health conditions, fixed incomes, or limited digital literacy—to navigate Medicare’s intricate rules and plan options alone.

A Call to Carriers

NABIP Oregon recognizes the pressures of evolving regulation and market competition, but partnership requires transparency and respect.
Changes to commissions, contracting, or plan access should never occur without reasonable notice or communication. Carriers and agents have historically worked side-by-side to support compliance, educate consumers, and sustain trust in the Medicare system. That partnership must be protected—not quietly dismantled.

A Call to Agents & Brokers

Your work is critical. Every conversation you have with a beneficiary represents a safeguard against confusion, misinformation, and coverage errors. NABIP Oregon will continue to advocate for your right to operate in a fair, transparent marketplace that values professionalism, ethics, and service.

A Call to the Public

If you or someone you love has ever relied on a trusted Insurance Agent or Broker to help understand Medicare, compare options, or solve enrollment issues, the support you received depends on a system that values independent expertise. That system is now at risk. Limiting agent participation doesn’t simplify Medicare—it silences the advocates who ensure seniors are protected and informed.

Our Commitment

NABIP Oregon calls for:

1. Fair, transparent, and stable commission structures for Medicare Advantage and Part D plans.
2. Full and consistent access to plan applications for properly appointed and certified agents and brokers.
3. An end to selective suppression or disincentivizing of plan marketing that distorts consumer choice.
4. Renewed collaboration between carriers, regulators, and the advisory community to preserve a marketplace grounded in fairness, integrity, and consumer protection.

Independent agents and brokers are not barriers to efficiency—they are the bridge between complex programs and the people they were designed to serve.
NABIP Oregon remains steadfast in its commitment to consumer advocacy and to defending the professionals who dedicate their careers to helping Oregonians make confident, informed Medicare decisions.

Robert Mulcare, RSSA®, REBC®, FPQP™
President, Oregon Chapter
National Association of Benefits and Insurance Professionals