B.

Ronnell Nolan, HIA 225-921-6711 ~ (Phone)

President/CEO 225-387-0100 ~ (Fax)
P. O. Box 65128 Ronnell@HAFAmerica.org
Baton Rouge, LA 70896 www.HAFAmerica.org

The Crucial Role of FMOs in Medicare Advantage

A White Paper by Health Agents for America, Inc. (HAFA)
Executive Summary:
Health Agents for America, Inc. (HAFA) is a nonprofit trade association that represents agents and brokers across the
United States, with members advocating for over a million consumers in all insurance markets. This white paper
addresses the significant concerns arising from CMS's proposed rules affecting Agents/Brokers and their FMOs &
GAs. The proposed rules, particularly those eliminating marketing dollars, pose a threat to the vital support FMOs
provide to Medicare agents.
Introduction:
The landscape of Medicare Advantage Plans involves a complex network of Agents, Brokers, and Field Marketing
Organizations (FMOs) that play a crucial role in facilitating the process for both insurance carriers and consumers.
Challenges Faced by Agents and Brokers:
Agents and Brokers face challenges due to CMS's proposed rules, particularly the elimination of marketing dollars. It
is essential to highlight that Agents and Brokers are typically unable to sell Medicare Advantage Plans directly
without involving an FMO or GA.
The Invaluable Role of FMOs:
FMOs serve as indispensable partners to Medicare agents, providing essential back-office support. This support
includes:
Licensing and Contracting Support: FMOs streamline the licensing and contracting process for all represented
companies, reducing administrative burden.
Administration for Paper Applications: FMOs assist in handling paper applications, catering to clients without
computer access or in areas with limited internet service.
CMS Compliance Alerts: Timely alerts from FMOs ensure agents stay informed about CMS compliance changes,
compensating for potential delays from insurance companies.
Comparative Rating Software: FMOs offer sophisticated software that aids in comparing Medicare plans, acting
as CRM software to manage client information efficiently.
Software Programming Requirements: FMOs collaborate with vendors to ensure accurate and compliant
software, aligning with CMS rule changes and insurance carriers' product updates.
Product and Compliance Training: FMOs provide ongoing training to agents, enhancing their knowledge and
ensuring compliance with industry standards.
Clarification on Medicare Eligibility: FMOs offer insights into specific situations not covered in standard courses,
addressing nuances in Medicare eligibility.
Troubleshooting with Insurance Companies: FMOs leverage their contacts within insurance companies to resolve
issues related to members' applications, that agents do not typically have access to.
If FMOs cease to be adequately compensated for their crucial role in supporting carriers' marketing efforts, the ripple
effect will be detrimental. The inability of FMOs to function effectively would directly impact agents and,
consequently, Medicare members who rely on their expertise and support.
Health Agents for America, Inc. urges stakeholders to recognize the pivotal role FMOs play in the Medicare Advantage
landscape. Preserving their compensation is not just a matter of business interest; it is a critical step in ensuring the
continued provision of high-quality support to agents and, ultimately, safeguarding the interests of Medicare
members.
Health Agents for America, Inc. (HAFA) faces a significant challenge with the timing of CMS's proposed rules, which
coincide with the crucial 45-day open enrollment period. The comment period for these rules, unfortunately,
concludes in the middle of the open enrollment window. HAFA acknowledges the importance of providing
constructive feedback to ensure the effectiveness and fairness of regulations that impact agents, brokers, and,
ultimately, the consumers they serve. However, the timing of these proposed rules raises a fundamental question: If
our feedback is deemed invaluable, why would CMS choose a time frame that limits our ability to thoroughly assess
and provide input during this critical open enrollment period? HAFA urges CMS to reconsider the timing of such
proposals to allow for a more comprehensive and thoughtful collaboration between industry stakeholders and
regulatory bodies.

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