Inside the Industry Health Insurance Video Series

Understanding the Proposed CMS Final Rule 2027 with Jessica Brooks Woods

Join Jessica Brooks Woods, CEO of the National Association of Benefits and Insurance Professionals (NABIP), and Allison Babberl, Content Marketing Manager at AgencyBloc, for a discussion about the changes included in the proposed CMS Final Rule 2027. Learn more about how CMS is proposing eliminating the 48-hour rule on Scope of Appointments (SOAs), reducing the retainment period for call recordings, and more. We also discuss how the CMS Final Rule 2027 and the One Big Beautiful Bill (HR1) both work to reduce administrative burden and ease restrictions for health insurance professionals.

Listen Now:

Inside the Industry: Understanding the Proposed CMS Final Rule 2027 with Jessica Brooks Woods

Inside the Industry is a recurring video series 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, and JBW denotes Jessica Brooks Woods.

Allison Babberl: Welcome, everyone. We're here for another edition of Inside the Industry. And I am joined by someone you probably recognize. I don't know, what did you say? You're the "Velvet Hammer." The Velvet Hammer, the one and only Jessica Brooks Woods, CEO of NABIP. Jessica, it's so great to have you and see you again.

Jessica Brooks Woods: The Velvet Hammer. Thank you so much. It is such a joy to be with you as well.

AB: The Velvet Hammer. That is great. Of course, it's the one and only Jessica Brooks Woods, CEO of NABIP. Jessica, it's so great to have you and see you again.

JBW: Thank you so much. It is such a joy to be with you as well.

AB: Can you give a quick one-minute story? What is the Velvet Hammer? Is this like a Thor thing? Are you like the God of Thunder now?

JBW: Well, this nickname in healthcare was given to me, so I guess I earned it. It happened several years ago in my career, and I was in a tumultuous market with two big giants, a giant health insurer and a giant healthcare system, and they weren't getting along. And I was there to represent the voice of the purchaser, the voice of employers in that matter, and earn the "Velvet Hammer" reputation by tackling some tough issues there.

AB: I love that. I feel like we should get you a Velvet Hammer to put on your wall. Oh, even better. I know. We were just talking about BlocBuilder. You'll have to bring it so I can see it live and in person.

JBW: I actually have one. We had a superhero thing. I'll have to bring it to BlocBuilder.

AB: Oh, even better. I know. We were just talking about BlocBuilder. You'll have to bring it so I can see it live and in person.

JBW: Absolutely.

AB: Well, as much as I'd love to talk about velvet hammers with you for 10 minutes, and I'm sure everyone would love the distraction after a really tough enrollment season, but I know the initial proposal of the Final Rule 2027 was recently released. Can you just take a couple of minutes and summarize some of the top trends? Of course, these are not approved. It's not out yet, but these are the trends that we're seeing.

JBW: Yes. Well, I think that's a really good point. It's not final, which means we have a voice and we can still help shift and shape it. But I see the 2027 proposed rule as an invitation for us to join and have a seat at the table. We really appreciate the fact that oftentimes in healthcare policy, it doesn't happen overnight. So you're like, nothing's happening, nothing's happening. But this rule kind of showed that our voices are being heard. I would say it's high-level reducing administrative burden while maintaining accountability. We have been advocating for both. Let's rid the bad actors and make it harder for them to have a space here. No one wants them here. But also reduce the burden, like the 48-hour rule, keeping the records for 10 years. So CMS is signaling that this complexity alone doesn't equal consumer protection. We want consumer protection, but just making it overly burdensome for those actually serving the consumers doesn't help. And that's what I think is the message from that. And we should be really, really energized and motivated by it.

What's important to understand is that this shift didn't happen overnight. This is years of work coordinated through NABIP, The Medicare Advisory Group, we were just talking pre about some of the Medicare Advisory Group members that are doing great work meeting with the committees, CMS, etc., regularly. We're seeing CMS step back from this one-size-fits-all sort of more targeted regulation around the marketing, the definition of a TPMO. That's being looked at. Those are things that we've advocated for. The record retention, the enrollment processes, revisiting that TPMO discussion is a big one because it recognized that not every entity operates at the same scale, that they shouldn't be treated as one big conglomerate, that there are different identities within that.

Reducing the call record retention from 10 years to 6. I think even considering 3 years, and not just the record retention as we do it today, but even mentioning potentially solutions like transcripts. Is saving the transcripts versus all the audio an opportunity now that we have AI? That's another good example of like modernizing this quite a bit but still maintaining those protections. And so that's something I think is a really big deal that we would be excited about, those of you listening in, as an example. So happy to talk more about it in detail, but those are some of the bigger components. I think smaller agencies will benefit significantly, and we're seeing, again, a lot of our recommendations as the proposed rule. And the door is open to validate that. If you're an agent and you're a member of NABIP or any other association, I would recommend you connect and rally around and respond to the proposed rule by saying yes, we totally agree. We think that should be 3 years not 6. You know, definitely consider transcripts. You know, speak about the definitions and the 48-hour rule. All of that is on the table right now, which is great.

AB: I think you said it really well. And I was talking to, I think it was Calvin Bagley, I was talking to not long ago, speaking of other leaders in the Medicare space. The problem is that there are bad actors, and the bad actors are getting away with being bad actors. And the administrative burden is not preventing them. It is just burdening those who are the good actors.

So that's where a lot of this is coming from, would that be a fair assessment?

JBW: Yes. I would say that's I would say that's fair.

AB: And how do you think, I know this year there was a lot of conversation about the, as I call it, the OBBB, the One Big Beautiful Bill. How does that kind of like, that was launched earlier this year in 2025. Now, we have the Final Rule 2027 proposed plan coming out, which would go into effect in the 2026 year. How do these kind of work together and lead us down this less admin path you're discussing?

JBW: You know, I would like to say that they worked together in conjunction. I don't really think it worked out that way, honestly. Yeah, mean, when you think about the BBB, HR1 is the technical name, but they really didn't have a whole lot in there around Medicare space. There were some enhancements to some of the things that we wanted to see, with HSAs and the pinicker accounts and DPCs. ICHRAs wasn't included in that. We thought that would be included. So there were some things that surprised us that weren't really emphasized in The Big Beautiful Bill. But, there were some wins in there. And we'll see some of that in 2025.

But not so much in this part of the marketplace, in my opinion. I think the proposed rule is really saying, okay, we've been hearing you loud and clear. It says that the voice of the agent isn't a distant component of the healthcare ecosystem. It shows that the agent's voice is at the table. And I don't know if the BBB reflected that as evident, as this proposed rule. But I do think it does speak to the incremental steps that it does take, and that where regulation and legislation have to complement one another, because the BBB is more on the legislative side, where this is a regulatory entity through CMS with the proposed rule. But the responsibility that they complement one another and that these regulations aren't counter or that they enhance and help us actually move the needle further is the opportunity here. And I think they compliment each other good enough, you know, in that regard. The BBB doesn't step on the proposed rules toes or vice versa. It's allowing us to expand and consider the modernization that's needed and taking away the unnecessary burdens that are getting in the way of good consumer protections. I would say that was the compliment of both of them is that consumer protections seem to be centered in the motivation and intentions behind both the BBB and the rule.

AB: Yeah, definitely. You're right. The OBBB definitely focused more on that group and individual side. But I think you're right, it's starting to open the door of what changes can we make. What things can we offer to the industry to start to take steps in the right direction? And you mentioned it earlier about getting involved. I think looking forward in 2026, things like this are happening. The lift of burdensome admin, the lift of other things happening is because people are getting involved. Agents are speaking up and speaking to their organizations, their uplines, their associations. I know you're a part of NABIP. There's also NAIFA, there's HAFA, there are lots of other letters out there. And I think looking forward to 2026, that involvement is really critical for agents across the country at every level, in every line of business, because I think that's where we get better together, because honestly, the people on the Hill, they're not insurance agents. They don't understand when they put something into place like the 48-hour rule. What a burden that is when you have 3,000 Medicare clients, right?

JBW: Exactly.

AB: And you have to see them all in a 6-week period, right? And they don't understand this. So, I personally think that getting involved is where you can really have your voice heard and also really make real change in the industry. What are your thoughts there?

JBW: Absolutely. Again, this is evidence of that. We're seeing exact language that we've had in our written communications. We have several roundtables, so to speak, where we bring our committees to CMS directly to have conversations. We have our Medicare Advisory Group meeting with them and different committees, as well as other groups like our Individual Working Group on the ACA side.

So these relationships are dynamic.

But they can't be dynamic if we don't have active volunteers who are members, who are bringing their real-world, real-life experience to the table, and sharing the implications and the consequences of some of these rules that were out of touch. That didn't make sense and they weren't common sense. Like the record recording and the 48-hour rule, especially, right? And understanding what that sounds like and looks like practically. What the burden is not just on the agent, because honestly. Let's be frank, the agent isn't their priority.

But both of our priorities is the consumer. And that's where our middle ground is. That's where we can meet in the middle and say, okay, we're on the same page. And when you understand the impact to the consumer, how they even think it's ridiculous. Like, what do you mean? I have to come back? You have to re-engage? We can't just finish this here? That's taken me away from something else that's really important to my life. Maybe another basic need that I need to focus on. Maybe I don't have the resources to just reengage on this, the time, whatever it may be, it's a burden on me, and it's making it difficult for me. And when they realize that that's not really protecting the consumer or creating optimal consumer experience, then it opens your ears a bit to say, okay, then what is the solution? What can we do? But this is really what we're trying to achieve. Okay, we're trying to achieve the same thing. Here are some suggestions. Or do you only want the largest of the largest entities to exist and really cancel out small agencies that are in the communities, that understand the community, that have unique relationships, but they can't afford to increase the cost to their CRM to store this level of information that you're really actually not going to see, use, or try to access. What is a reasonable timeframe? When does any kind of compliance issue typically happen? Is that in 2-3 year timeframe? Is that in the 1-5 year timeframe? Then why are we keeping them for 10 years? What's that sweet spot? What is the data now telling us that makes sense? And so I love that, that we're able to share the real-world experience because you're engaged, because you joined your association that's advocating for you, that's letting everyone know we're forced to be reckoned with together, and we're not on opposite sides of the table when it comes to consumers. We're on the same team. Let's do this and make it make sense for everyone. And that's the, you can't do that on the sidelines. That's the moral of the story, Allison.

You cannot do that on the sidelines. We need you to join, we need you to be a part, and bring your experiences so that we can actually move the needle.

AB: Exactly, exactly. I think you said it perfectly. If you're on the sidelines, no change happens.

I think one last thing, we're coming up on time here, Jessica, but can you just explain what are the next steps for the final rule? It's in proposed right now. What happens after this? When can people expect to see the actual rule come out?

JBW: Well, January 26th is the final date where you can submit your comments. So right now, it's engaging with your association directly if you're not part of an association and looking at the rule, understanding those big buckets of opportunity to respond and understand where you're aligned and where you're not aligned.

I think it also helps you understand directionally where the administration is thinking of going and helping you as a business to be prepared for that time, because the preparation starts 1/1. We know it's not effective until 2027, but you have to start gearing up your business and resources for that direction.

AB: Awesome. Thank you so much for this information. I'm really excited to see what comes out with the final rule. It'll get launched probably in the spring. So when the snow starts melting, you'll probably see the final rule coming out, and we can all get excited to see where things keep improving and how we're looking forward to 2027 even.

JBW: Absolutely.

AB: Awesome, thank you so much, Jessica.

JBW: Thank you.

Posted on Tuesday, December 30, 2025 in Inside the Industry