Insurance Agency Compliance and Disclosure Requirements Sources
Free sources for the rules that govern how insurance agencies market, enroll, and protect client information.
A NextAgency Resource
Last Updated: August 8, 2026
Health and senior insurance agencies need to track federal compliance and disclosure regulations. These rules are scattered across multiple agencies or behind paywalls. NextAgency gathered credible, no-cost sources as a starting point for agencies searching for information.
The federal government imposes a host of consumer protection laws and regulations on agencies selling health and senior policies. Tracking them all can be a challenge. While agency management systems like NextAgency make it easier to comply with many of them, insurance agency owners are ultimately responsible for their agency’s compliance. Compliance requirements carry penalties, and the version you find through a web search or AI query may not be the version in force today. Confirm the information you rely upon is up-to-date.
Organizations like the National Association of Benefits and Insurance Professionals (NABIP) provide extensive and useful resources to its members. Sometimes, however, you just need to quickly find information concerning what’s required of you. This directory helps health and senior insurance agencies identify trustworthy, free sources for some of the federal compliance and disclosure requirements that govern their work: Medicare Advantage and Part D marketing rules; ACA Marketplace enrollment and consent requirements; HIPAA privacy and security obligations; and ERISA disclosure duties for group health plans.
Caveats and Context
This directory is a curated starting point to help you get grounded on the regulations it covers. It does not replace the advice of compliance firms or attorneys. The information below was researched and written by Claude AI and checked by ChatGPT. AI can make mistakes, ignore useful sources, and make up sources that don’t exist. We don’t believe this is the case with this list, but you should consult experts (not AI) for accurate and actionable information.
This directory addresses federal regulations impacting Medicare, ACA and group policies. We recognize insurance is regulated at the state level. This is especially true for life insurance. NextAgency operates in nearly 40 states. Covering those jurisdictions is outside the scope of this article. Did we mention we’re providing a starting point?
This is not an exhaustive list. It is a curated starting point directing insurance agencies to the federal agencies that write and enforce these rules along with credible secondary sources (trade associations and benefits firms) that translate them into less technical language. There are other regulations and topics that we may cover in later articles.
What this list covers are agencies and sources for information on:
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Medicare Advantage / Part D marketing, Scope of Appointment, TPMO (Third-Party Marketing Organization) disclaimers, call recording → Centers for Medicare & Medicaid Services (Managed Care Marketing); Medicare.gov (provides consumer-facing marketing rules; useful for agencies but not a comprehensive compliance reference); NABIP; Ritter Insurance Marketing.
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ACA / Marketplace enrollment, consumer consent, eligibility documentation, record retention → Centers for Medicare & Medicaid Services (Marketplace Agents & Brokers); the CMS Agent/Broker FAQ portal.
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HIPAA privacy, security, breach notification, Notice of Privacy Practices → U.S. Department of Health and Human Services, Office for Civil Rights.
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Group health plan / ERISA disclosure, SPDs, broker compensation disclosure, COBRA notices → U.S. Department of Labor, Employee Benefits Security Administration; plus benefits firms (Corporate Synergies, EPIC, HUB International) for plain-language tracking.
Primary Sources: The Agencies That Write and Enforce the Rules
These are the federal bodies that issue the requirements. When a requirement’s exact wording matters — and in compliance it almost always does — the primary source is the one to trust.
Centers for Medicare & Medicaid Services — Managed Care Marketing
What you’ll find: The federal rules governing how agents market Medicare Advantage and Part D plans, including the distinction between “marketing” and “communications,” Scope of Appointment requirements, the required Third-Party Marketing Organization (TPMO) disclaimer, prohibited language, rules for educational versus sales events, and agent/broker training and testing guidelines. The hub also hosts model materials such as the standardized Annual Notice of Change and Evidence of Coverage templates.
Best for: Agents and agencies selling Medicare products who need the official word on what they can and cannot say, and how appointments and events must be handled. (Note: The NextAgency insurance agency management system includes compliance and disclosure tools that automate obtaining required forms).
Why it’s here: CMS writes and enforces these rules. Every carrier certification an agent completes ultimately traces back to them.
Access: Free.
URL: https://www.cms.gov/medicare/health-drug-plans/managed-care-marketing
Centers for Medicare & Medicaid Services — Marketplace Agents & Brokers
What you’ll find: The federal requirements for agents assisting consumers with ACA/Marketplace coverage — documenting consumer consent before providing assistance, documenting that the consumer reviewed and confirmed eligibility application information, the 10-year Marketplace record-retention requirement, PII handling standards, the model consent form, registration and training steps, and the rules on associating a National Producer Number with an enrollment. A separate searchable Agent/Broker FAQ for Marketplace Agents portal answers common questions directly. (Note: The NextAgency insurance agency management system automates providing prospects and clients the required consent form).
Best for: Agents who enroll clients through the Federally-facilitated Marketplace and need the current consent, documentation, and data-handling rules straight from the source.
Why it’s here: CMS runs the Federally-facilitated Marketplace and sets these standards of conduct directly.
Access: Free.
URL: https://www.cms.gov/marketplace/agents-brokers/resources — FAQ portal: https://www.agentbrokerfaq.cms.gov
Medicare.gov — Marketing Rules for Health Plans
What you’ll find: A plain-language summary of what Medicare plans and the people who work with them can and cannot do when contacting and meeting with beneficiaries. It covers permitted and prohibited conduct at appointments, the prohibition on marketing at educational events, and the rule against advertising with confusing words or misleading Medicare logos.
Best for: A quick, plainly worded reference — useful when an agent wants to confirm a boundary fast, or point a client to a neutral government explanation of the rules agents must follow.
Why it’s here: It is the federal government’s own consumer-facing statement of the marketing rules, which makes it a credible plain-English complement to the more technical CMS marketing hub.
Access: Free.
URL: https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/plan-marketing-rules
U.S. Department of Health and Human Services — Office for Civil Rights (OCR)
What you’ll find: The authoritative source for HIPAA — the Privacy Rule, Security Rule, and Breach Notification Rule — plus guidance on the Notice of Privacy Practices, the “minimum necessary” standard, business associate obligations, breach reporting through the HHS portal, risk analysis, and topical guidance such as the use of online tracking technologies. OCR also publishes a Security Risk Assessment Tool aimed at small and mid-sized practices.
Best for: Any agency that handles protected health information — which is effectively every health and senior agency — and needs to understand privacy, security, and breach obligations.
Why it’s here: OCR administers and enforces the HIPAA Rules. Its guidance is the federal government’s own interpretation of what compliance requires.
Access: Free.
Currency note: HHS revised the model Notice of Privacy Practices in 2026 (including substance-use-disorder updates). Confirm you are working from the current version before adopting notice language.
URL: https://www.hhs.gov/hipaa/for-professionals
U.S. Department of Labor — Employee Benefits Security Administration (Health Plans)
What you’ll find: The federal disclosure and reporting requirements for group health plans under ERISA — Summary Plan Description and Summary of Material Modifications rules, the Reporting and Disclosure Guide for Employee Benefit Plans, the Compliance Assistance Guide – Health Benefits Coverage Under Federal Law (which includes a self-compliance tool and model notices), COBRA notice obligations, and the broker/consultant compensation disclosure requirement added by the Consolidated Appropriations Act, 2021 (ERISA section 408(b)(2), explained in Field Assistance Bulletin 2021-03). (Note: The NextAgency insurance agency management system includes tools for making this required compensation disclosure). Interactive tools include the Health Benefits Advisor and the ERISA Fiduciary Advisor.
Best for: Agencies working the group-benefits side who need to understand what must be disclosed to plan participants and to employer-plan fiduciaries, and when.
Why it’s here: EBSA has principal jurisdiction over Title I of ERISA and publishes the model notices and self-compliance tools employers and their advisors are expected to use.
Access: Free.
Currency note: As of this article’s publication date, the Reporting and Disclosure Guide PDF is dated December 2022. EBSA advises checking its site for the current laws and regulations, and updated model notices (for example, the CHIP model notice) are released periodically — verify against the live pages.
Secondary Sources: Organizations That Explain the Rules
These sources do not write the rules, but they track them and explain them in plainer language than the regulatory text itself. They are useful for orientation and for catching changes — but the primary source remains the authority. Some content is free to all; some sits behind membership or registration, which each listing notes. Some may be your competitors; others are associations working on your behalf.
Corporate Synergies — Benefits Compliance Resource Center
What you’ll find: Dated compliance alerts (eAlerts) tracking enacted federal benefits-compliance developments and the court rulings that affect them — for example, updates on HIPAA Notice of Privacy Practices deadlines, PBM disclosure developments, and ACA cost-sharing limits.
Best for: Agencies that want a running feed of what changed and when, with enough specificity to know whether a change touches their plans.
Why it’s here: It publishes free, dated, specific benefits-compliance content.
Access: Free.
URL: https://www.corpsyn.com/benefits-compliance-resources/
HUB International — Employee Benefits Compliance
What you’ll find: Educational resources and guides on federal group-health-plan compliance — ERISA disclosure calendars and required-notice checklists, ACA reporting and mandate resources, HIPAA obligations, and COBRA administration — along with webinars breaking down current-year developments.
Best for: Agencies that want structured guides, timelines, and checklists on group-benefits federal requirements.
Why it’s here: The educational compliance content is publicly available and factual.
Access: Free (some webinars and deeper resources require registration).
URL: https://www.hubinternational.com/products/employee-benefits/benefits-compliance/
NABIP — Compliance Corner and Medicare Resources
What you’ll find: The National Association of Benefits and Insurance Professionals (NABIP, formerly NAHU) maintains a Compliance Corner aggregating the federal statutes affecting employee benefits, plus Medicare resources including a carrier- and FMO-agnostic webinar series with legislative updates, and its CMS-recognized Medicare, Medicare Advantage, and Compliance Requirements (MMACR) certification.
Best for: Agents who want a benefits-industry association’s ongoing read on federal compliance, and a recognized alternative for the annual Medicare certification.
Why it’s here: NABIP is the trade association focused specifically on benefits and insurance professionals, which makes its compliance content directly relevant to this audience.
Access: Mixed. Some resources are open; the fuller Compliance Corner content is members-only, and the MMACR certification is a paid course (open to non-members). Treat this as a members-oriented source with limited free access. We believe the Compliance Corner alone is worth the cost of NABIP membership.
URL: https://nabip.org/membership-resources/compliance-corner
Ritter Insurance Marketing — Compliance Resources
What you’ll find: A library of plain-language articles on Medicare marketing compliance for agents — Scope of Appointment basics, rules for educational versus sales events, call-recording and permission-to-contact requirements, and TPMO disclaimer guidance.
Best for: Newer Medicare agents who want the CMS rules explained in practical, agent-facing terms before going to the primary source for exact wording.
Why it’s here: The educational content is publicly available and specific to the Medicare agent audience, and Ritter is a field marketing organization.
Access: Free.
Learn More:
The NextAgency Resource Center offers articles of interest to life and health insurance agencies on topics such as technology, AI, running your agency and marketing communication.
Author Information:
This article was researched and the source listings were written by Claude (Anthropic). Claude’s findings were fact-checked by ChatGPT. Other portions of the article were written by Alan Katz, a co-founder of NextAgency. AI, and humans, make mistakes. And regulatory compliance sources evolve quickly. Please confirm information before relying on it. NextAgency does not warrant or guarantee the accuracy of this article, and nothing here is legal advice.