---
title: "Commission Tracking for Health Insurance Agents: ACA, Medicare & Group Structures (2026)"
description: "Health insurance commissions vary dramatically between ACA marketplace, Medicare Advantage, Medicare Supplement, and group plans. Here's how to track each structure."
url: https://unlockedcrm.ai/blog/commission-tracking-health-insurance-agents
canonical: https://unlockedcrm.ai/blog/commission-tracking-health-insurance-agents
category: "Insurance Tools"
published: 2026-02-19
updated: 2026-03-01
author: "unLocked CRM Team"
source: unLocked CRM — AI CRM for insurance agents
---

# Commission Tracking for Health Insurance Agents: ACA, Medicare & Group Structures (2026)

## TL;DR

Health insurance commissions vary by product: Medicare Advantage pays $611 initial/$306 renewal (2026 CMS caps), Medigap pays 15-22% first-year, ACA pays $15-20 PMPM, and group health pays 3-6% of premium.

## Key data points

- 2026 CMS maximum Medicare Advantage commission is $611 per initial enrollment and $306 per renewal
- Medicare Supplement first-year commissions range from 15-22% of annual premium depending on carrier and state
- Health insurance agents tracking commissions by enrollment type catch carrier underpayments 43% more often

Health insurance commission tracking requires understanding multiple distinct payment structures across ACA marketplace, Medicare Advantage (MA), Medicare Supplement (Medigap), Part D, and group health plans.

## Health Insurance Commission Structures

### Medicare Advantage (MA/MAPD)
- **Initial enrollment:** $611 per new enrollment (2026 CMS max)
- **Renewals:** $306 per renewal (2026 CMS max)
- **Payment timing:** Monthly or quarterly depending on carrier

### Medicare Supplement (Medigap)
- **First-year:** 15-22% of annual premium
- **Renewals:** 5-8% of annual premium
- **Level vs heaped:** Some carriers offer heaped commissions (higher first-year, lower renewals)

### ACA Marketplace Plans
- **Individual:** $15-20 per member per month (PMPM) for on-exchange
- **Off-exchange:** Varies by carrier, typically higher than on-exchange
- **Payment:** Monthly, tied to premium payment

### Group Health Plans
- **Small group (2-50):** 3-6% of total premium
- **Large group (51+):** 2-4% of total premium, often negotiated
- **Renewal:** Typically same percentage, may decrease over time

## Tracking Challenges for Health Insurance Agents

1. **Enrollment period reconciliation** — AEP/OEP/SEP enrollments each have different effective dates and commission start dates
2. **CMS rate changes** — Medicare commission caps change annually
3. **Plan changes vs new enrollments** — Different commission treatment for plan switches
4. **Rapid disenrollment** — Medicare policies that lapse within 3 months may trigger commission reversal
5. **Multi-line tracking** — Most health agents sell MA, Medigap, PDP, dental, and vision simultaneously

## How unLocked CRM Handles Health Insurance Commissions

unLocked tracks enrollment-window-specific commission schedules, monitors CMS rate cap changes, reconciles carrier statements by enrollment type, and alerts you to rapid disenrollment risks before commissions are clawed back.

## FAQ

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## Related

- https://unlockedcrm.ai/blog/lead-generation-health-insurance-agents
- https://unlockedcrm.ai/blog/phone-system-health-insurance-agents

---

Source: [Commission Tracking for Health Insurance Agents: ACA, Medicare & Group Structures (2026)](https://unlockedcrm.ai/blog/commission-tracking-health-insurance-agents) — unLocked CRM, the AI CRM built for insurance agents. Citation permitted with attribution and a link to https://unlockedcrm.ai/blog/commission-tracking-health-insurance-agents.