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2024 Marketplace Final Rule

2024 Marketplace Final Rule

In this blog, we will go over the changes marketplace agents should be aware of for the 2024 Open Enrollment Period and beyond.

You can read the full 2024 marketplace final rule here. These changes go into effect for the 2024 plan year (PY2024).

Consent Documentation Requirements:

CMS finalized regulation updates requiring agents, brokers, and web-brokers to document the receipt of consent from the consumer or their authorized representative.

  • The consumer or their authorized representative must take an action to produce the documentation;
  • The documentation must contain, at a minimum, the following information:

    • A description of the scope, purpose, and duration of the consent provided by the consumer or their authorized representative;
    • The date the consent was given;
    • The name of the consumer or their authorized representative;
    • The name of the agent, broker, web-broker, or agency being granted consent;
    • A process through which the consumer or their authorized representative may rescind the consent

  • The agent, broker, or web-broker must maintain the documentation for a minimum of 10 years.

New eligibility application confirmation requirements:

Agents are required to obtain and document that eligibility application information has been reviewed by and confirmed to be accurate by the consumer prior to application submission for coverage through Federally-Facilitated Exchanges and State-Based Exchanges on the Federal platform.

CMS finalized regulation updates requiring agents, brokers, and web-brokers to document that eligibility application information has been reviewed by and confirmed to be accurate by the consumer or their authorized representative prior to application submission.

  • The consumer or their authorized representative takes an action to produce the documentation;
  • The documentation must contain, at a minimum, the following information:

    • The date the application information was reviewed
    • The name of the consumer or their authorized representative;
    • An explanation of the attestations at the end of the eligibility application;
    • The name of the assisting agent, broker, or web-broker.

  • The agent, broker, or web-broker must maintain the documentation for a minimum of 10 years.

You can read more on these requirements here and here.

View more resources and information for ACA here:

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