Street-level Medicare contracts, explained

What street level means

In Medicare Advantage, “street level” usually means the agent is paid the carrier’s full agent compensation for each enrollment, as set in the carrier agreement. With us, your Medicare Advantage contracts pay at each carrier’s full agent level, and your level never depends on recruiting.

CMS sets the ceiling

Federal rules limit what Medicare Advantage organizations can pay agents and brokers. CMS defines a fair market value amount for an enrollment, and plans may pay at or below that amount for an initial enrollment year and for renewal years. Starting in 2025, compensation also includes payments for administrative work that used to be paid separately (42 CFR 422.2274). The exact amounts change each year and are set in each carrier’s agreement.

Initial year vs. renewal

An initial enrollment year is the first year a person is enrolled in a plan. Renewal years are the years after that in the same plan or a plan of the same type (42 CFR 422.2274). Ask how each carrier pays both, and when.

When compensation is recovered

If a client changes plans within the first three months of enrollment, called rapid disenrollment, the carrier must recover the full compensation, with some exceptions. Plans also recover a prorated amount for months a person was not enrolled (42 CFR 422.2274). Try our rapid disenrollment checker.

Questions to ask any agency

• Are my Medicare Advantage contracts at the carrier’s full agent level?
• Do I have to recruit to keep my level or get paid?
• Who owns my book of business?
• Do I get enrollment and compliance tools, and what do they cost?
• What happens if I want to move my contracts later?