Inside the Industry Health Insurance Video Podcast

How the 2027 CMS Rule Changes Impact Field Agents & Seniors

In this episode, Allison Babberl and Mariangel Martinez discuss the recent CMS Final Rule 2027, exploring its impact on Medicare agents, key regulatory changes, and strategies for adapting to new compliance regulations. They discuss practical tips for field agents, the importance of credible information sources, and how to leverage technology, like AI and transcripts, to improve client interactions.

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Inside the Industry: How the 2027 CMS Rule Changes Impact Field Agents & Seniors

Inside the Industry is a monthly video podcast hosted by AgencyBloc to take an insider's look at the health, group benefits, and senior insurance industry. Learn more about what's happening right now, what it means for your agency, and how your team can stay ahead of these changes.

Transcript for the Episode

Note: AB denotes Allison Babberl, MM denotes Mariangel (Mari) Martinez

Allison Babberl: Welcome, everyone. We are back for another edition of Inside the Industry. As always, I'm Allison Babberl, Content Marketing Manager here at AgencyBloc, and I'm joined by another awesome guest, Mariangel Martinez, owner of North Star Insurance. So good to have you today, Mari.

Mariangel Martinez: I appreciate you reaching out to me and inviting me on your podcast. It's a great opportunity and I'm super excited to chat with you.

AB: Yeah, and just for anyone listening, Mari did give me full authority to call her Mari. So that's what the cool kids do. So in case you run into her, and you just got back from Medicarians and probably a whirlwind of a time.

MM: Of course. I did. I did. Yeah, it was a lot of fun and loved seeing so many people that I only knew virtually and so working on some content after the event just to give some information.

AB: I'm sure. I'm so jealous. It is on my bucket list. One of these years, it's going to line up in all the stars and all the schedules so that I can go out to Vegas with you all, too. Because gosh, I think it was like 5,000 people or something. I mean.

MM: It was there's a lot of people and I think maybe it's because you only see or not only, but you see a lot of the people from your market. I'm here in Houston and it just seemed like there was Houston people everywhere. But I feel like that's probably what everybody thinks, regardless of where they're from.

AB: Definitely. It's kind of like when you go to a lot of those conferences, you kind of see that same person over and over and you're like, we should just be friends at this point because we keep running into each other.

MM: Yeah, it was really fun. It was a lot of fun.

AB: Awesome. And I know for me, I'm coming also off of, we just had our BlocBuilder event, which is our event here at AgencyBloc, and we were in Fort Lauderdale a couple of weeks ago. So it's just been a crazy couple of weeks. It is definitely event season. So I appreciate you taking time out of your day to do this podcast with me.

MM: Thank you for the invitation. I'm happy to be here.

AB: Well, we do have some really great stuff to get into today. As you know, as I know, about a month ago, CMS launched the Final Rule 2027. We've all been anxiously awaiting it. I know I talked with a different guest back in January about this coming out and what it was looking like during the proposed time. No longer proposed. Everything is going into effect. Let's kind of dive in, Mari. What are some of the key changes in this rule and the big themes coming out?

MM: Yeah, I think that the best way to look at the changes is separating them between the ones that are going to be affecting the agent operation, the day to day, and then the ones that are going to be affecting or having an impact on our clients and the seniors. And so there's probably like nine in total, I think, that are worth noting, divided between those two sections. And so, of course, the ones that affect the agent day-to-day, of course, are:

The 48-hour rule on the scope
The timeframe on keeping the recordings, which is going to free up so much of our iCloud storage.
The educational events and actually that one is one of the ones that, at least for North Star, for our agency, is going to be the most impactful because we are heavy on educational events. We do those constantly. Our agents are always, always in front of a crowd, educating seniors. And so that one's going to be, at least for us, the one that's going to impact our day to day the most.

AB: And when you say you can do SOAs there. What do you mean by that, just for the people who haven't read through the rule yet?

MM: Great question. So the fact that it used to be where we couldn't do an appointment or a sales appointment or even a sales event after an educational event, we had to wait. You couldn't be in the same building or even an adjacent building. And I think we had to wait like 12 hours, if I'm not mistaken, before we could do a sales appointment.

My mission really, Allison, as an immigrant in this country is to spread the Medicare gospel in the language that people are most comfortable listening to. And I know that we don't have a whole lot of time and I'm really talkative. So you're going to have to keep me on on topic. But there, you know, I went through a specific experience coming into the country when I was 16 years old and going to high school and not understanding a lot of the instructions that some of my teachers were giving and just how tough that can be. And these were instructions like just simple instructions, not something like the Medicare system. And so because of my experience, you know, like I said, my passion is, my mission is explaining Medicare to seniors in whatever language they're most comfortable in. And so that's why we do a lot of educational events constantly. We use social media marketing to advertise these educational events and then we spread the Medicare gospel, like I said, in multiple languages. And so it used to be a little bit more difficult because there are seniors that would want to take care of the issue or whatever situation they were dealing with with their healthcare right there and then. And so I think sometimes I understand where these rules come from, particularly, in my opinion, the telesales agent where a lot of things happen that shouldn't happen, but it is always the field agents that are most affected. And it's the seniors that need that field agent, especially in the immigrant community. You cannot duplicate that connection that you build with someone that is from your country or, you know, I mean, one of my agents speaks American Sign Language. And it's awesome. Her name is Jessica and she's just absolutely wonderful. She speaks English, Spanish, and American Sign Language fluently.

AB: That's really cool.

MM: And so she is someone that, I mean, the stories that she has, know, she, anyway, I don't want to get, you know, go on another topic, but we serve these seniors that could never receive the same amount of care and attention and just quality guidance that they get from someone like Jessica. And so they're making an effort to go to these educational events. And then, you know, they wanna take care of the issue, the reason why they came from, and we couldn't. We had to set up an appointment for another time, another day, another place, and then have them either, you know, meet us somewhere else, or, cause sometimes they don't wanna invite you to their home.

AB: Right, and I think, you know, coming back. I like to think, and you know, there will be mixed opinions on this, but I like to think they came from good intentions, right? Good intentions to create that space. But it is hard for working communities to take off time to make it to this thing and then make it again in two days, four days, a week, or whatever. And I think those two are, those two have been the two I've heard the most, the reduction or those three that you mentioned, the reduction of the 48-hour, or termination of that, the no appointment setting out at educational events. And

MM: The recording, the 10 years got reduced to six. And then also the not having to say the disclosure right in the first 60 seconds. Because I mean, sometimes even though we're field agents, we have to make some calls and do some appointments telephonically. Some seniors rather do that. And it was just so difficult because you have to create a connection with the person that you're talking with so that there's that trust and when you're having to hit them with a disclosure in those first 60 seconds, like you said, it's a good intentions, but it's tough.

AB: It's like let me read this out loud to you really quick. Then we'll talk like we're actual humans. And I think you're right. Those are some of the key pieces. That's four of them. I think you said you had seven. Did you have three others? It's a big bill, a big rule. And I know a lot of the agents I've talked to are most excited about the reduction. I know last year I talked to Calvin Bagley and discussing the potential of what was coming in this final rule and saying, hey, again, these things came from, let's say they came from good intentions. We all hope that, right?

But at the end of the day, there are bad actors and the bad actors are not getting the consequences. It is the agents like yourself and all the people that were just that Medicarians that are being impacted that have to follow these rules. Giving more leniency gives everyone just a bit more space to breathe and ability to do their job well instead of trying to do their job. And also follow XYZ/ABC all of the time, which can feel really overwhelming and can feel really weird to your clients.

MM: Right, right. And think about a brand new agent, you know, because like if you've been in the industry for a long time, you know that these rules change because CMS has to, this is the tricky part. They can't set a rule, test it out for a little bit and then say, you know what, it's really not working out. It's not doing what we were intending it to do. So let's switch it back. These are changes that have to, at minimum, stay in place for a year. And so a new agent, you know, comes into the industry and they don't know the business. They don't know that these rules change and how everything works. There's so much information in this industry that it's really hard to get an agent fully knowledgeable in a matter of like less than a year. And so they're coming in, hearing all these rules, they think like, I mean, I see it all the time where they're like, I don't want to like, I don't want to get in trouble. I don't want to get it like because the compliance rule sometimes can seem like you can't do anything.

And so like when for the tell I know that it was to to alleviate the bad actors in the in the telephonic sales, but it was easier for them to say like, hey, you know what? I can't do this because I called you but I can hang up right now and then you call me back and then we don't have to wait the 48 hours. And while it's a tough thing to explain to seniors, it could happen. They could hang up. The senior calls back and it gets done immediately. But what do you do when you are an agent that goes home-to-home. Like if you have a storefront like we do here at North Star, well, that's also easier because someone's walking in and you could write that application right there and then. But what happens to an agent that is going to all these homes? Like, what do you say? Like, well, you know what? Let's have the appointment in my car. And then you just like walk into my like it was just the agent that was mostly affected by some of these rules were the ones that are out in the field serving people.

And so it's just, it is great news. definitely was some of these was a win. Like I said, for us, the educational event, the sales appointment or sales event right after an educational, is going to be just a game changer for the way that we operate. And I did say that I had a few more, some of them are affecting more of the seniors like the Part D redesign and all that stuff.

AB: And I think it would also affect agents that work in multiple states. I know you're mainly in the Houston area, but I know a lot of Medicare agents that have multiple states. Like I know Medicare agents here in Iowa who serve Iowa and Nebraska and Missouri and like, although they're not that far away, it's still a drive. And if you're meeting with those people in person, you have to drive and then you're there a few days. It's a lot of pre-planning, and I know you and I were just talking about, it's hard to memorize everything in this rule, but I think this rule is also giving a lot more space for agents to work instead of always being on compliance, always focusing on "oh, am I acting right? Am I doing right? Am I gonna get slapped on the hand?" And I think it also opens the opportunity for new agents to enter the field. We've kind of been in a reduction lately of agents getting out because it's getting too complicated, right? You have to have the right tools. I come from the software side and keeping up with all of these compliance to make sure you can play that recording, that you can store your recordings, that you have the SOA, you can do the 48-hour. Those are all things we put into place to stay up to date, but you have to have all of that.

And that's extra things to think about each day on top of the compliance you have to think about. And then also memorize the plans and the changes and everything. Like you just mentioned the Part D redesign. That's a really critical piece to know when you're talking to your agents. you know, that's one reason I wanted to have you on, Mari. I know you're great with other languages, but even translating it from CMS government speak into, hey, this is what this means as a human to a human, right?

My parents are Medicare-aged aged and I don't call them and read them the CMS guidelines. They would probably go to sleep. You know, take it, you look at it, you ingest it, you've redeliver it in a way that makes sense. And I think that's really cool. And this rule gives agents and agencies across the nation that ability to just act more human, which is really critical now with all this AI coming out and the changes with technology. You're so up to date on all of this, Mari. What are some of the places you really go to? What are your go-to sources to get some of this information that you can then internalize and then translate back to your community, whether that is in Spanish, ASL, or just like, hey, this is what this actually means speak.

MM: Right. So like we said, we were at Medicarians and I ran into a good friend of mine from the industry. he was like, he said, you're a total nerd. So let me ask you. And he was like, I mean that like as a compliment. I told him, I only take that as a compliment. So thank you. I have an obsession, but I am always researching and trying to read and asking and trying to find and I think it is an obsession. But I use multiple sources. With AI nowadays, it's just so wonderful to find different sources for credible information.

Of course, the Wall Street Journal is one of them. The Kaiser Foundation, I follow a lot of what they do as well. Milliman is one of my favorites because there's, I love statistical data and numbers and trends. I love seeing trends. And so they do a lot of that kind of research. So I read a lot about the things that they post. LinkedIn is a great source as well. And just finding those people that, as I'm reading articles or someone that reported something really interesting, then I go and I follow. It's like that rabbit trail, I think is what they call it. English is not my first language, so sometimes sayings, I say them completely wrong and people, I guess, find it funny or maybe endearing, I don't know. But I follow the trail. so, yeah.

AB: Yeah, like a rabbit trail. I'm going to start using that. And honestly, LinkedIn is where I found you. You were posting about some of the different changes and I started following you. I know I follow a lot of different agents in the field. You know, we both know Amanda Brewton and a lot of the other ones that are sharing that content out. And I think for a new agent, especially, or someone that just doesn't quite know yet what they want to do or how to do it right.

I think LinkedIn's a really great place to get in and just start following. Be that fly on the wall to learn and better understand how to read the CMS rules coming out because, again, they're not written like, it's not a book you want to sit down and just read and have a good time, right? It is. I always think of it. I don't know if you have ever had to read The Odyssey. I read The Odyssey in, I think middle school. And I found it to be a great bedtime story. I got a couple of pages in and I'd fall asleep. And that's kind of what these rules are like. So we think that's a great place for agents to go to learn more.

MM: Right. Because it's concise. And you've talked about Amanda and we talked about Brandon earlier. What they do is even like next level because they're out there advocating for the rights of the agent. they're them too are definitely people that that I love to follow and see what they're posting, what they're informing other agents on. And LinkedIn is definitely a great place.

AB: Another one I follow is Jared Strock. He posts a lot about the changes and all the graphs. I am a nerd like you and I don't know if obsession is the right word or just dedication, but I love the graphs.

MM: His newsletter is wonderful. I like that one. That's a better way. I couldn't think of a word, like to spin it positively, but there you go, dedication. I like it.

AB: Dedication. There you go. Well, from one dedicated nerd to the other, Mari, is there anything else? I know we hit on some of the biggest pieces, the 48-hour rule, the reduction in retention, which is huge, and also introducing transcripts as a capability that you can have, house the transcripts of the calls and not necessarily the full call recording, which also is easier to use because no one wants to listen back to an hour-long call and write down all your notes again. So transcripts are huge.

MM: Huge, huge. And you know, like in Medicarians, I noticed that the third most popular topic when you look at all the sessions combined was AI. And it makes perfect sense because of where everything is nowadays. And so, you know, these AI transcript apps or tools like Granola and Otter and even Loom. There's several that we use here at the agency. It's just, it's wonderful because not only does it, like you said, nobody wants to sit through a long call, but it also helps us as agents to have a summary of what every client conversation.

My agents even do this with in-person appointments because it just helps you have a summary of everything that was said with your client, you can go back and just remember. If you see them year two, sometimes you don't remember all those conversations that happened the previous year. And so it's just a wonderful tool to remember things like even like when they mentioned when their anniversary is. When I was, because I'm not a selling agent anymore, I dedicate myself to train and empower and build the agents in my team. But one of the things that I think helped me be a successful agent was that I was someone that — I wrote everything. If they told me the name of the dog in the conversation, if they told me that their grandson was graduating, if they said they were celebrating an anniversary, I wrote all those things down because then I would keep up with them. And how was the graduation and congratulations to your grandson, just stuff like that.

So these transcripts are definitely something that is going to help every single agent out there. And we're not going to deal with like, oh, my phone ran out of I ran out of storage in the middle of the call because I know that that happens sometimes. And so good news on this final rule for sure. We needed a final rule with some good news. And last year's was like, man.

AB: Yeah, I think we did need it. Ithink this year is much more on the positive side. They came out and everyone's going, "Okay, this is exciting!" Instead of going, "okay."

MM: Like maybe they don't hate us as much as we thought. So yeah, some good news.

AB: Well, I don't want to keep you. I know you've got a lot going on. We're coming up on AEP. It's going to be here before we know it. I know it's April right now, but AEP is not that far away. So I'll let you get back to it. I appreciate you coming on and talking about some of these trends and just sharing what they mean and what they mean to agents in the field and giving insight into how other agents can learn more. I really appreciate your time today, Mari.

I feel like you and I could do a three-hour podcast and still only be on the first three things of the trend.

MM: Absolutely. I mean, I warned you. I'm very long-winded. So thank you for keeping me on time.

AB: Thank you again. And we'll see everyone back here again for our next edition of Inside the Industry next month.

Posted on Thursday, April 30, 2026 in Inside the Industry