Key Update: HHS Implements New Consent Policy for ACA Plan Enrollments

The Department of Health and Human Services (HHS) - the regulatory authority overseeing Individual and Family Plans (IFP), also known as ACA plans - has issued its annual policy updates. A significant change taking effect on June 18, 2023, impacts how agents, brokers, and web-brokers operate when enrolling consumers in health coverage through Federally Facilitated Exchanges (FFEs) or State-Based Exchanges (SBEs), and when assisting with applications for Advanced Premium Tax Credits (APTC) and Cost-Sharing Reductions (CSRs) for Qualified Health Plans (QHPs).

What’s Changing?

While consumer consent has always been a requirement, starting June 18, 2023, all registered agents and brokers must now document consumer consent before accessing or updating any Marketplace account information.

The Centers for Medicare & Medicaid Services (CMS) does not dictate a specific format for recording consent. Instead, agents and brokers may use a variety of methods, including:

• Recorded phone calls
• Text messages
• Emails
• Signed electronic documents
• Hardcopy forms with handwritten signatures

Required Elements of Consent Documentation:

To be valid, the documentation must clearly include:

• The date consent was given
• The full name of the consumer or their authorized representative
• The name of the agent, broker, web-broker, or agency receiving consent
• A description outlining the purpose, scope, and duration of the consent
• Instructions for how the consumer can revoke their consent

A sample consent form provided by CMS/HHS is available for download to assist with compliance.

Why This Policy Is Being Implemented:

This update is designed to:

• Prevent unauthorized access and modifications to consumer accounts
• Ensure transparency about who is managing a consumer’s enrollment
• Address increasing concerns about Agent of Record disputes
• Reduce incidents of fraudulent enrollments, which waste federal and state funding

This new requirement emphasizes the importance of consumer awareness and participation in the enrollment process and reinforces ethical conduct among agents and brokers.