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CMS to require new identity-proofing and agent authorization for enhanced direct enrollment
Summary
CMS announced new identity-proofing and agent/broker authorization requirements for enhanced direct enrollment websites and said verification activities will move outside the marketplace call center to strengthen program integrity and speed service for compliant agents.
Peter Nelson, a deputy administrator at the Centers for Medicare & Medicaid Services (CMS) and director of the office that oversees the Health Insurance Marketplace, told agents and brokers that CMS is making program-integrity changes ahead of plan year 2027.
"When working on enhanced direct enrollment websites this open enrollment, you will experience new identity proofing and agent broker authorization requirements," Nelson said, outlining a policy change intended to tighten online enrollment security. He added that "these more streamlined measures move verification and other activities outside of the marketplace call center."
Nelson framed the changes as both consumer protection and an efficiency measure: "The goal is to better protect consumers while making the process faster and less burdensome for agents and brokers who are doing everything right." The training did not provide implementation dates or technical specifications for the new identity-proofing or authorization steps; those details were "not specified."
