Here’s what brokers need to know about the Centers for Medicare & Medicaid Services’ (CMS) guidelines on referral and finder’s fees (Medicare Marketing Guidelines, Section 110.6.3).
What Is the Maximum Paid for Referral and Finder’s Fees?
Carriers can pay brokers up to $100 for referral or finder’s fees. That payment decreased to $25 for prescription drug plans. These fee compensation amounts are kept relatively low by CMS to prevent any financial incentive for brokers to enroll beneficiaries in unsuitable plans.
Fees and Fair Market Value (FMV)
Referral and finder’s fees paid to brokers are counted toward total compensation. The amount paid for referral fees, finder’s fees, and compensation cannot exceed Fair Market Value (FMV) for that contract year. For 2018, the FMVs for initial enrollment for the following products are as follows.
|Product||National||Connecticut, Pennsylvania, DC||California, New Jersey||Puerto Rico, US Virgin Islands|
|Medicare Advantage and Section 1876 Cost Plans||$455||$511||$567||$312|
|Prescription Drug Plans||$72||$72||$72||$72|
Other Ways to Increase Revenue
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