One reference for the numbers that actually run an agent's business in 2026 — commissions, chargeback windows, compliance deadlines, and licensing costs. Bookmark it, and confirm your specifics with your carriers and FMO.
2026 CMS fair-market-value maximums (carriers may pay at or below these; higher in CT, PA, NJ, CA, and D.C.):
| Product | New / initial | Renewal / year |
|---|---|---|
| Medicare Advantage (MA / MAPD) | $694 | $347 |
| Standalone Part D (PDP) | $114 | $57 |
Renewal income compounds as your in-force book grows. See the Medicare commission guide for detail.
ACA pays per member, per month — typically $20–$30 PMPM for new members in 2026, sometimes reduced on renewals. Annual ACA income ≈ members × PMPM × 12. Project it on the agent income calculator; see the ACA commission guide.
Final-expense and life policies usually advance 9–12 months of commission up front. A lapse or NSF in roughly the first 6–9 months triggers a chargeback of the unearned portion. Persistency below a carrier's threshold can cost the contract. Estimate a single case on the chargeback calculator.
IRMAA starts at $109,000 (single) / $218,000 (married filing jointly) of 2024 income and rises through six tiers. The appeal (Form SSA-44) after a life-changing event is a high-value touchpoint with affluent clients. Full table: 2026 IRMAA brackets.
Scope of Appointment (SOA): agree the SOA before the personal marketing appointment begins (the old 48-hour advance wait is eliminated effective October 1, 2026 under the CY2027 final rule, 91 FR 17384, and still applies through September 30, 2026). Record retention: SOA records must be kept 10 years; call recordings split 6 years (marketing/sales portion) and 10 years (enrollment portion) under the CY2027 final rule (91 FR 17384). CTM complaints usually trace to scope or documentation gaps. See the SOA rules guide.
AHIP certification (to sell MA/PDP): about $175, you need 90% to pass, three attempts; the CY2027 exam releases June 22, 2026. E&O insurance: commonly $1,000,000 per occurrence / $2,000,000 aggregate. Plus a state health license and carrier appointments (usually via an FMO). See how to become an agent.
Standard Part B premium $202.90/mo, deductible $283; Part A hospital deductible $1,736; Part D base premium $38.99; Part D out-of-pocket cap $2,100 (donut hole gone). Full breakdown: Medicare costs 2026.
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The 2026 CMS maximum is $694 per new Medicare Advantage enrollment and $347 per renewal year, with higher rates in CT, PA, NJ, CA, and D.C. Standalone Part D pays $114 new and $57 renewal.
ACA pays per member, per month — typically $20 to $30 PMPM for new members in 2026, sometimes reduced on renewals.
About $175 for three attempts, and you need a 90% score to pass. The CY2027 exam releases June 22, 2026.
CMS requires Scope of Appointment forms to be retained for 10 years. Call recordings follow a split rule under the CY2027 final rule (91 FR 17384): the marketing/sales portion is kept 6 years and the enrollment portion 10 years.
Figures on this page are verified against U.S. government primary sources: