CMS's Notice of Benefit and Payment Plan Proposed Rule for 2027: A Wake-Up Call for Insurance Marketers (What’s changing and how to get ready)

Insurance marketing has always lived in the tension between speed and scrutiny. Launch faster. Personalize more. Scale across channels, all without triggering compliance issues, consumer complaints, or regulatory action.

U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), just turned that tension up another notch.

On February 9, 2026, CMS issued the HHS Notice of Benefit and Payment Parameters (NBPP) for 2027, a proposed rule that sets standards for Health Insurance Exchanges and the organizations that connect consumers to Affordable Care Act (ACA) coverage.

If you’re an insurance marketer, this matters because the proposal doesn’t just tweak actuarial parameters. It leans heavily into marketing conduct, documentation, and auditability.

And in regulated marketing, auditability is another way of saying: prove it — quickly.

Who is impacted?

This proposed rule primarily addresses ACA Exchange/Marketplace plans and enrollment. The most directly impacted groups include:

• Health plans and issuers offering Qualified Health Plans (QHPs) through Federally Facilitated Exchanges (FFEs) and State-Based Exchanges on the Federal Platform (SBE-FPs)
• Agents, brokers, and web-brokers assisting consumers with Exchange enrollment
• Marketing and compliance teams within those organizations
• Agencies, lead-generation partners, call centers, and other third parties that create or distribute consumer-facing materials on behalf of issuers and brokers

Even when rule text targets specific entities, oversight and “timely production” requirements quickly become operationally shared across partners.

If your organization also markets Medicare Advantage or Part D, this NBPP proposed rule is not the Medicare rulebook. But in practice, most enterprises don’t operate completely separate marketing governance systems by line of business. When the bar rises in one area, marketing operations tend to standardize upward across all of them.

What’s likely to change for marketers?

1. Marketing conduct becomes more explicit and more enforceable

CMS proposes strengthening regulations on marketing practices for Qualified Health Plans offered through Exchanges, as well as for agents, brokers, and web-brokers assisting with enrollment.

The CMS fact sheet highlights prohibited practices such as:

• Miscommunicating enrollment timelines or deadlines
• Offering cash, rebates, or cash equivalents to induce enrollment
• Falsely asserting or implying consumers will qualify for “zero-dollar insurance” or “zero-dollar premiums”

For marketers, this narrows the gray zone around claims, incentives, and urgency language. Expect tighter internal standards and far less tolerance for ad hoc creative variations that drift from approved language.

2. “Timely production of marketing materials” pushes teams toward audit-ready operations

CMS also proposes requirements for the timely production of marketing materials for monitoring, audit, or enforcement purposes.

That language is an operational signal. It implies organizations should be able to answer questions like:

• What exactly ran (creative, landing page, script)?
• Which version ran, and on which dates?
• Who reviewed and approved it, and when?
• What changed between versions, and why?

If documented approvals and versioning still lives in email threads, multiple systems, shared drives, or scattered screenshots, “timely production” becomes painful very quickly.

3. Standardized consent and documentation could reshape enrollment-adjacent workflows

CMS proposes requiring agents, brokers, and web-brokers to use HHS-approved eligibility application review forms and consumer consent forms, while clarifying what qualifies as a consumer “taking an action” to review and confirm application accuracy and consent.

Even if marketing doesn’t own enrollment directly, marketing often owns:

• The consumer experience that drives into enrollment
• Partner content distributed through agencies and broker channels
• Call scripts, FAQs, and landing pages that shape consumer understanding and consent expectations

Standardized forms and clearer definitions tend to trigger broader operational shifts: governed templates, stricter version control, and tighter partner oversight.

4. Greater issuer accountability raises the cost of process gaps

CMS proposes authority to audit or conduct compliance reviews of issuers offering Qualified Health Plans through an Exchange, potentially on an as-needed or annual basis, along with updates to civil money penalties and enforcement authority.

For marketing leaders, the takeaway is simple: process is now part of compliance. Content isn’t judged solely on what it says, but on whether you can prove how it was created, reviewed, approved, and distributed.

5. Exchange distribution models may tilt further toward web-brokers

CMS proposes a new optional Exchange model: The State Exchange Enhanced Direct Enrollment option allowing State-Based Exchanges to rely exclusively on web-brokers for consumer-facing eligibility and enrollment websites.

If adopted, this increases both the importance and the risk surface of partner ecosystems. Marketing content governance becomes harder when more consumer journeys run through third-party platforms and distributed organizations.

6. Plan design flexibility could drive content volume and version explosion

CMS also proposes discontinuing standardized plan options and removing limits on the number of non-standardized plan options for Federally-facilitated Exchanges and State-based Exchange on the Federal Platform.

More plan variation typically means:

• Greater benefit nuance to explain
• Greater volumes of enrollment-focused marketing content 
• More state-, segment-, and channel-specific disclaimers
• More versions of essentially the same asset
• More opportunities for small changes to create outsized compliance risk

In short: higher creative volume paired with a higher burden of proof.

What should insurance marketers do now?

This is still a proposed rule, but operational preparation doesn’t need to wait for final text. Practical steps teams can take now include:

• Inventory high-risk content (ads, landing pages, email/SMS, scripts, broker toolkits)
• Identify where proof breaks down, including file storage, version traceability, and retrieval by date
• Standardize what must be standardized, including claims language, enrollment timelines, incentive language, and channel or state disclaimers
• Treat partners as part of your compliance system, not as ad hoc contributors

How Aproove helps: workflow consulting plus audit-ready approvals at scale

At Aproove, we’ve leaned into a simple reality: regulated marketing teams don’t just need software. They need a system that makes compliance operational.

That’s why we position Aproove as a centralized compliance workflow platform, replacing fragmented, manual approval processes with structured, automated, audit-ready workflows. And it’s why we engage as workflow consultants alongside the platform itself.

Because the biggest risk is rarely the PDF. It’s the process behind it.

1. Workflow consulting: discovery, mapping, and governance

We start with discovery: stakeholders, exceptions, and how work actually gets done. From there, we build an implementation blueprint that aligns approvals, roles, and governance to your risk profile and operating model.

2. Turning decision workflows into daily execution

Once mapped, Aproove operationalizes those workflows with capabilities aligned to what CMS is signaling:

• Complete audit trails with timestamps and faster audit-packet generation
• Smart version control that clearly shows what changed and why
• Configurable routing across Marketing, Compliance, Actuarial, and external partners
• Secure external access for agencies and vendors without breaking governance

3. We deconstruct the marketing files to flag risk 

Aproove uses HIPAA compliant secure infrastructure to deconstruct each marketing file: extracting text-in-context, marketing offers, disclaimers, images, and brand assets. This allows Aproove to analyze the file content and bring human experts directly to the "risk points", to provide smart versioning, and to bring AI-agents into the file with context to flag risk. We accelerate the time-to-risk analysis, and ensure your humans are always the final decision maker

4. Outcomes that match the new reality

As compliance expectations rise, speed doesn’t disappear. Deadlines, open enrollment calendars, and launch windows remain. The teams that win will be the ones that can move fast — and prove every step.

What this means for insurance marketing teams

The 2027 NBPP proposed rule sends a clear message: marketing, enrollment, and compliance controls are converging. CMS is explicitly pointing to marketing conduct, documentation, oversight, and the ability to produce evidence quickly.

Insurance marketers don’t need to panic. But they do need to modernize how approvals, versioning, partner participation, and audit readiness work in practice.

If you want to stress-test your current marketing compliance workflow against what CMS is signaling and see what “audit-ready at speed” really looks like, we’d be glad to compare notes.