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MOLINA 2027 Information

📣 2027 Molina Marketplace Footprint & Commissions

Last week, Molina shared important updates regarding our 2027 Marketplace service area footprint and broker commission structure. ➡️ Read the full communication here.

📘 2027 Molina Marketplace Producer Guide Available

The 2027 Marketplace Producer Guide is now available. It includes enhanced compliance and oversight requirements, expanded Producer Code of Ethics guidance, new consumer consent and documentation standards, Producer of Record (POR) procedures, Book of Business transfer guidance, and 2027 Open Enrollment information.

 

Producers are encouraged to review the updated guide and familiarize themselves with these important requirements.

➡️ View the updated guide here.

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🩺 Helping Members Connect with Accordant

Molina Healthcare partners with Accordant to provide eligible members access to specialized nurse support, personalized care planning, health coaching, care coordination, and additional resources at no extra cost.

 

We encourage brokers to reinforce the value of this program with eligible members and encourage participation when contacted by Accordant Care.

 

➡️ Learn more and view Accordant's broker outreach details here.

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📋 2027 OEP Readiness

💻 Molina Marketplace PY2027 Product Trainings are being posted to the Molina Agent Center. Check back regularly, as additional trainings and RSVP opportunities will be added in the coming weeks.

➡️ Access the Evolve Portal here.

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View a state-by-state breakdown of key dates, timelines, and Exchange resources on our
🌐 PY2027 OEP Readiness landing page.

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Returning brokers can complete the PY2027 FFM Certification:

➡️ Through MLMS via the CMS Enterprise Portal.

 

PY2027 FFM Registration and Training for Returning Brokers:
➡️ View the CMS instructions here.

 

Need help with Identity Proofing?
➡️ Review Section 5.4 of the CMS IDM User Guide.

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FFM PY2027 CMS Agent Authorization Changes

CMS is implementing new consumer verification and agent authorization requirements for enrollments submitted through Enhanced Direct Enrollment (EDE) platforms beginning with OEP 2027.

 

➡️ View CMS Agent Authorization & Identity Proofing FAQs here.

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Molina OEP + SEP Bonus Program

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BONUS GUIDELINES

  • This bonus applies to qualifying members in all states where Molina offers a 2027 Marketplace product.

  • The bonus program applies to qualifying Open Enrollment Period (OEP) and Special Enrollment Period (SEP) business.

  • Members must remain continuously enrolled for three consecutive months in 2027. At the time of bonus calculation, the member must be up to date on premium payments and not be in a grace period.

  • Members with unresolved enrollment, eligibility, or data discrepancies (including 834 discrepancies) will not be included in the bonus calculation.

  • Each qualifying member will be counted only once. A maximum of five (5) members per policy will be counted.

  • Molina may review, adjust, withhold, deny, offset, or recover bonus payments based on compliance concerns, investigations, fraud, or misconduct, eligibility or enrollment issues, Producer of Record (POR) changes, premium, regulatory, administrative, data, or other corrections affecting bonus eligibility, including after payment.

  • Molina’s determination of bonus eligibility and bonus calculations shall be final and made in accordance with applicable law and the terms of this program.

  • Bonus amounts must be earned by each producer individually. Enrollments credited to one producer will not be combined with enrollments credited to another producer.

    • If there is a POR change during the first three months of enrollment, the producer on record as of the final day of the three consecutive months will be eligible for the bonus payment.

  • If the National Producer Number (NPN) has been removed and is not present at the time the bonus is calculated, the member will not be included in the bonus payment.

  • This is a one-time payment per member and not a per member per month (PMPM) payment.

  • The initial bonus payment will be made to the agency in May 2027 for qualifying members with a January 1, 2027 effective date. Qualifying members with later effective dates will be calculated and paid monthly thereafter.
     

Example:

  • January 2027 effective dates (new and renewal): Calculated as of 3/31 (only counting members with January effective dates), paid out in May.

  • February 2027 effective dates (new enrollments): Calculated as of 4/30 (only counting members with February effective dates), paid out in June.

  • March 2027 effective dates (new enrollments): Calculated as of 5/31 (only counting members with March effective dates), paid out in July.

  • The final bonus payment will be calculated as of February 28, 2028 (and paid in April 2028) for December 2027 effective dates.

  • Producer and agencies must remain properly licensed, certified, appointed (where required), and in good standing at the time bonus amounts are earned and paid.

  • Molina reserves the right to amend, suspend, terminate, interpret or administer this bonus program, at its sole discretion, subject to applicable law.

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