< Agent Blog
Jun
02
,
2021

CMS: Compensation Rates and Referral/Finder’s Fees for CY 2022

June 2, 2021
CMS News Releases

As provided in 42 C.F.R. §§422.2274(d)(2) and 423.2274(d)(2), the compensation amount an organization pays to an independent agent or broker for an enrollment must be at or below the fair market value (FMV) cut-off amounts published yearly by the Center for Medicare and Medicaid Services (CMS). 42 C.F.R. §§422.2274(d)(3) and 423.2274(d)(3) limit renewal compensation to a maximum of 50% of the FMV. 42 C.F.R. §§422.2274(f) and 423.2274(f) limit the amount an organization may pay for referrals.

Each year, the CMS publishes the FMV amounts for initial an renewal compensation as well as referral fees. These amounts are as follows:

NOTE: The FMV amounts for CY 2022 may be up rounded to the nearest dollar. The Initial Year amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-year 1. The renewal amount is the maximum allowable amount that organizations may pay for enrollments during compensation cycle-years 2 and beyond.

Compensation Rate Submission for CY 2022

As in past years, all organizations must inform CMS via HPMS whether they are using employed, captive, or independent agents. Organizations that use independent agents must provide the initial and renewal compensation amount or range of amounts paid to these agents. Additionally, if an organization pays referral/finder’s fees, the organization must disclose the amount. CMS has provided instructions for data entry in the HPMS Marketing Module User Guide.

Organizations must submit their agent/broker information in the HPMS Marketing Module between June 1, 2021 and July 25, 2021, 11:59 pm EST. Please note that CMS does not consider the submission process complete until the organization’s CEO, COO, or CFO has completed the attestation in HPMS. Organizations that fail to submit and attest to their agent and broker compensation data by July 25, 2021 will be out of compliance with CMS requirements. Organizations will not be able to make changes to those submissions after the July 25, 2021 deadline.

CMS expects organizations to keep full records documenting that they are updating compensation schedules and paying agents and brokers according to CMS requirements.

Please note that CMS will make the CY 2022 organization-submitted compensation information available for the public to view on www.cms.gov prior to the annual election period for CY 2022.

Curricula for Training and Testing Agents and Brokers for CY 2022
Regulations at 42 C.F.R. §§422.2274 and 423.2274 require that organizations train and test all agents and brokers selling Medicare products, including employees, subcontractors, downstream entities, and/or delegated entities annually on Medicare Parts A, B, C, D, and plan specific information. CMS further requires that all agents and brokers obtain an 85% passing rate on the test.

In order to ensure the quality of agent and broker training and testing programs, CMS annually provides minimum training and testing requirements to organizations. Organizations should review these requirements before developing their own agent and broker training and testing programs to ensure compliance with CMS requirements. CMS permits and encourages organizations and third-party training and testing vendors to include other relevant topics, in addition to the minimum required elements.

CMS has made the CY 2022 CMS training and testing requirements available here.

View Details >View Details >

Questions? Call us at 855-888-8326.

Don't have a MedicareValue page yet?

Get Your FREE Site >

Posts you may be interested in...

Read More

Use GTL's Text-to-Sign Feature for Even Faster Submissions!

November 21, 2022
Agent Blog Icon - Indicates this is a blog article.

Save time and bypass the Voice Verification Call! Text-to-Sign is available on the Agent Portal only

Read More

Compare The Benefits Today! See How The Difference is Clear with Clear Spring!

November 16, 2022
Agent Blog Icon - Indicates this is a blog article.

Help your clients meet life where it is at, secure and confident with Clear Spring Health!

Read More

See how Aetna is making it easier for members to stay informed

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

An enhanced member experience is coming in 2023

Read More

Excellus BCBS Medicare Broker News - Vol. 4 No. 10

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

Final Reminders For AEP | Medicare Supplement Update

Read More

Important updates to Humana’s Rx Calculator and Humana.com

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

It was recently discovered that Humana’s Rx Calculator and Humana.com were incorrectly quoting the $0 Rx Copay Benefit Model incorrectly for DSNP plans.

Read More

Wellcare Increased Payments and Network Additions!

November 15, 2022
Agent Blog Icon - Indicates this is a blog article.

Your Wellcare NY Sales team wanted to remind you of an increase to the payment amounts for our Health Risk Assessment's (HRA's) and inform you of two important NY network additions.

Who we are & what we do.

Choosing an FMO to work with is not just about having access to top insurance products and commissions, it’s about finding a one-on-one agent service that is prepared to meet your needs.  

Get to know us, and see how we can help you take your business to the next level.

Learn More

Helpful Links

New Here?

We love meeting new people! Fill out the form below, and one of our sales directors will get in touch with you shortly.

Thank you! Your form has been received!
Oops! Something went wrong while submitting the form