CMS Announces System Changes to Stop Unauthorized Agent and Broker Marketplace Activity

The Centers for Medicare & Medicaid Services (CMS) recently issued a press release stating "...The Centers for Medicare & Medicaid Services (CMS) is committed to protecting consumers from bad actors and ensuring the program integrity of the Federally-facilitated Marketplace (FFM)... Starting July 19, 2024, CMS will block an agent or broker from making changes to a consumer’s FFM enrollment unless the agent is already associated with the consumer’s enrollment..."

CMS’ has worked to protect consumers insured through the FFM by suspending and terminating agents and brokers who participate in unauthorized Marketplace activity. 

The Department continuously receives reports of false applications, unauthorized changes, and access to consumer accounts without their knowledge or consent and is aggressively pursuing licensees who participate in this activity.

Read the CMS press statement here...

Fraudulent Appointments

The Department continues to receive many complaints from licensees reporting that their license has been appointed by insurers without their knowledge or consent. Some licensees have found their MyProfile account has been accessed and changes have been made to their demographic information.

As we previously reported, some unauthorized appointments were made after the agent discussed possible association with an agency or other entity, but later chose not to contract with or be associated with them. In some cases, a license and appointment has been used to produce insurance business without the knowledge or consent of the licensee.

Because appointments are made by authorized appointing entities through the Bureau of Licensing's eAppoint electronic appointment application, we have no way to monitor appointments or otherwise "flag" an agent's license to reject an appointment or monitor appointments when asked to do so by a licensee. The Department is working on methods to monitor suspicious activity conducted through licensees' MyProfile accounts.

Anyone can appoint a licensee if they know the information from our Licensee Search page on the internet.

The best way for licensees to check their appointment status is through our Licensee Search to verify the appointments listed are known to the licensee. If you are representing an entity but there is no corresponding appointment, you should contact that entity to correct it, as the Florida Statutes require a licensee be appointed to represent an insurer. (See s. 626.112(2), F.S.)

If an appointment is found for an insurer or entity you do not represent,  you can cancel that appointment through your MyProfile account. You should also contact AskDFS@MyFloridaCFO.com so we can verify the appointment was made in error and not as part of a fraudulent transaction.

We recommend licensees review their MyProfile account at least monthly to check for unauthorized appointments, or changes in your demographic information including your date of birth, addresses, etc. The Department recently found a situation where a licensee's MyProfile account was modified by an unauthorized party who had somehow obtained the licensee's Social Security number and date of birth. Those facts are not available from MyProfile, so it is suspected the information was obtained from the licensee during a job search or via other means. Other resources you can contact to report apparent fraudulent activity:

• the Federal Trade Commission (FTC) at ReportFraud.ftc.gov
• your State Attorney General
• your local consumer affairs office

The methods used to gain access to licensee appointment and licensing information continue to grow. We are actively working to roll out additional security measures, work with industry partners including insurers, and coordinate with law enforcement to deter and end this unlawful practice.

DO NOT share your MyProfile credentials with anyone!!

Citizens - Agent Appointment Requirement Statute Change