In this episode, we break down the CMS Final Rule for the 2025 Marketplace and what it means for agents, insurers, and consumers.

Key highlights include:

• Past-due premium enforcement: Carriers may require payment of prior premiums before activating new coverage, with flexibility for state-specific rules.

• Standardized Open Enrollment: → 2026: Nov 1 – Jan 15 → 2027 and beyond: Federal deadline of Dec 15

• Tighter eligibility verification: 75% of applications will be randomly selected for verification.

• DACA exclusion: DACA recipients will no longer be eligible for Marketplace coverage.

• Financial impact: CMS estimates $12 billion in savings and an average 5% premium reduction due to increased oversight and fraud prevention.

This final rule is a major step toward greater compliance, reduced fraud, and a more stable Marketplace.

Learn more about partnering with The Brokerage Inc. by visiting our website, www.thebrokerageinc.com.

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