Market Intelligence

Five Assumptions vs. What the Data Actually Shows

We tracked 298 confirmed NC contracts over 36 months and cross-referenced them against the full national plan matrix. Most of what is being said is based on assumptions. Here is what the numbers show.

2,069
NC plans confirmed (floor)
298
contracts with 36mo enrollment history
167
plans with full before-and-after data
56%
of NC plans are mid-size (1K–10K members)
Summary

Five Assumptions at a Glance

Each assumption is tested against CMS enrollment data and the national plan matrix. Verdicts reflect the weight of evidence, not certainty.

Assumption
What the data shows
Verdict
Plans went NC to control costs on their richest products.
NC plans are slightly leaner than commissionable plans on most benefit metrics. Only two carriers showed evidence of targeting richer products.
Mostly False
Going NC always leads to enrollment decline.
NC plans underperformed commissionable plans by 13–18 percentage points at the median across every size band.
Mostly True
NC plans signal broader market distress — benefit cuts, low stars, financial trouble.
NC contracts improved +0.024★ while commissionable contracts declined −0.022★. Only 22% of NC contracts had star drops vs. 31% of commissionable.
Mostly False
Medicare Advantage is contracting and plans are responding by going NC.
MA grew to 35M members in February 2026, up from 34.4M a year ago. Growth slowed from 6.5% to 3.8% but the direction is still up.
Mostly False
Carriers will come back to brokers once they feel the enrollment pain.
NC continuity plans declined −5.6% median vs. commissionable +4.2%. No carrier replaced the broker channel in the data.
Likely True

Assumption 1

Did Carriers Go NC on Their Most Expensive Plans?

The assumption was that carriers targeted their richest products — the best OTC cards, lowest cost-sharing, and most supplemental benefits — to slow enrollment in plans that were too expensive to operate.

Benefit Metric NC Plans Richer? Non-Commissionable Commissionable
Average Benefit Richness Score ✕ No 28.5 29.4
% Offering OTC Benefits ✕ No 20% 55%
Average OTC Value (plans that offer it) ✓ Yes $601 $498
Average Part D Deductible ✕ No $491 $399
Median MOOP In-Network ✕ No $6,700 $6,200
% With $0 Plan Premium ✓ Yes 93% 83%
4★ or Above (rated contracts) ✕ No 29.1% 43.3%

Source: CMS Plan Intelligence Matrix, 5,596 active MA plans, March 2026. 4★+ share from CMS Summary Ratings CSVs 2025–2026 (contract-level). NC status from CircleEngage internal tracker compiled from carrier announcements.

Carrier-level nuance: HCSC and BCBS TX did go NC on plans richer than their commissionable counterparts — consistent with cost-management intent. But Humana, Aetna, UHC, and Florida Blue went NC on plans that were leaner. The cost-management thesis fails for most plans in the data.
Carrier NC Plans Richness vs. Own Comm OTC vs. Own Comm MOOP vs. Own Comm Post-NC Enrollment
Alignment Health 9 +0.3% −40.5% +11.3% +11.6%
Anthem / Elevance 6 −33.6% −20.7% +29.1% −15.8%
BCBS TX / HCSC 3 +15.2% +5.5% +3.6% +12.7%
Devoted Health 5 −8.3% −23.1% −5.0%
Elevance / Anthem 26 −23.2% −30.8% +32.1% −9.5%
Florida Blue 9 −20.8% +10.4% −29.8%
HCSC 18 +14.5% +13.3% +2.7% −5.4%
HealthSpring / Cigna 18 −35.0% −66.3% +10.1% −17.9%
Humana 30 −18.0% −14.5% +16.3%
UHC / UnitedHealthCare 34 −13.4% −7.4% −10.3%

Green = NC plans richer / better performing than carrier's own commissionable plans. Red = NC plans leaner / worse performing. Post-NC enrollment: CPSC ±12-month window, plans with sufficient bilateral data.


Assumption 2

What Happened to Enrollment After Going NC?

The question is not whether NC plans grew or shrank in absolute terms. It is how NC plans performed compared to commissionable plans of the same size, in the same market, at the same time.

Small
Under 1,000 members
+17.9%
NC median change
+35.0%
Commissionable median
Gap: −17pp
Mid-Size
1,000 – 10,000 members
−6.9%
NC median change
+5.8%
Commissionable median
Gap: −13pp
Large
10,000 – 50,000 members
−11.4%
NC median change
+2.1%
Commissionable median
Gap: −13pp
National
50,000+ members
−18.5%
NC median change
−0.9%
Commissionable median
Gap: −18pp

Source: CMS LIS Enrollment files 2025 and 2026, continuity plans only (>100 enrolled both years). NC n=1,495; commissionable n=2,254.

The Humana number you may have seen is not what it looks like. Humana's widely cited +1.2M enrollment growth came from plan consolidation — 76 plan-PBP combinations exiting and absorbing ~285,000 members into surviving plans. Humana NC continuity plans (plans in both years with >100 members) actually declined: −4.2% aggregate, −9% median, with 65% of plans declining.
Plan Size NC 2024 Cohort NC 2025 Cohort NC 2026 Cohort* All Cohorts
Small +125.2% (n=2) +21.1% (n=13) −2.2% (n=18) +14.7%
Mid-Size −25.0% (n=42) +7.1% (n=38) −9.8%
Large +8.0% (n=11) −3.0% (n=11) −9.4% (n=11) −1.5%
National +5.4% (n=9) +5.4%

*2026 cohort has fewer than 5 months of post-NC data. Treat as early indicators, not conclusions. Green = growth; Red = decline relative to starting enrollment.


Assumption 3

Are NC Plans a Sign of Broader Plan Distress?

The assumption was that NC plans are the ones cutting benefits, losing stars, and exiting markets. The reality is more structural: carriers appear to be identifying plans where broker-channel dependency is lowest.

Quality Metric NC Plans Commissionable What It Means
Star Rating Change (2025→2026) +0.024★ improved −0.022★ declined NC contracts trending better year-over-year
Plans With Star Declines 22% dropped 31% dropped NC plans less likely to have declined
4★ or Above (rated contracts) 29.1% 43.3% Gap reflects PPO/size composition, not deterioration
% With $0 Premium 93% 83% NC plans attract price-sensitive members
PPO Concentration 48% 25% PPO members navigate more independently
Important: The PPO structural argument does not hold in practice. National and large plans — which are disproportionately PPOs — had the steepest enrollment declines after going NC. Plan type does not protect against enrollment loss when commissions are removed.

Assumptions 4 & 5

Is the Market Contracting? Will Carriers Come Back?

35M
MA members, February 2026 — up from 34.4M a year ago. The market is not contracting.
3.8%
2025 growth rate, down from 6.5% in 2024. Slowing, not reversing. Non-SNP broker-heavy plans grew slowest.
−9.8pp
The enrollment gap between NC and commissionable continuity plans at the median. That is a measurable, attributable cost.
No carrier replaced the broker channel. NC continuity plans declined −5.6% at the median while commissionable plans grew +4.2%. Whether any given plan acts on that 9.8-point gap depends on whether they measured it and whether the outcome was intended. The carriers most likely to return to brokers are the ones who can see the gap clearly.

Implications

What to Do With This Information

For Health Plan Sales & Distribution Leaders
  • If your plan is in the 1,000–10,000 member range and went NC without a direct-channel replacement strategy, the data says you are running a 9–15 point enrollment reduction strategy. That may be acceptable — but it should be a deliberate choice.
  • PPO concentration does not reduce NC risk. Large and national PPO-heavy plans had the steepest enrollment declines. The structural argument does not hold in practice.
  • If you went NC on a plan, expect the narrative that you cut your best products. The data says that is usually wrong — but the perception will exist. Getting ahead of it with data is more credible than messaging alone.
For Brokerage Heads of Sales
  • The leverage argument is universal, not segmented. NC plans underperformed commissionable plans by 13–18 points at the median across every size band. The enrollment cost is present at every scale.
  • No carrier in this analysis successfully replaced the broker channel — not Humana, not UHC, not Anthem. The +1.2M Humana growth figure was plan consolidation, not channel replacement.
  • There is no guarantee plans will return, even in a better market. Carriers who attributed the enrollment shortfall to other factors have less reason to change course.

Limitations

What This Data Cannot Tell You

  • Whether any carrier's NC decision was financially correct. We do not know what each plan was trying to achieve or what their cost structure looked like.
  • Why NC plans have a lower 4★+ rate (29.1% vs. 43.3%). Year-over-year trajectory rules out deterioration, but the composition explanation — PPO-heavy and smaller plans — needs a longer time series to confirm.
  • Whether mid-size enrollment declines were intentional. Some carriers may have targeted exactly the outcome we observed.
  • How the 2026 NC cohort will look at 12 months. Most 2026 plans have fewer than five months of post-NC history. Those findings are provisional.
  • Whether regulatory changes will shift carrier strategy. Recent CMS rulemaking is favorable to brokers, but favorable rules do not force carriers to reinstate commissions.
  • What happened in the 1,000+ NC plans not in our tracker. Our 298-plan CPSC sample is directional. The true NC vs. commissionable gap is likely larger than what we report.

Methodology

How We Analyzed This

CMS Plan Intelligence Matrix

Cross-sectional snapshot of all 5,596 active MA plan contracts for 2026, built from four CMS source files: the Landscape file, CPSC enrollment file, Part C and D Star Ratings master tables, and PBP benefit data file. NC status was determined by matching contract IDs against our internal tracker compiled from carrier announcements and broker bulletins. The 2,069 matched plans are a confirmed floor — some plans in the comparison group may be NC plans not yet captured, meaning the true gap is likely larger than reported.

CPSC Enrollment Tracker

36 months of CMS CPSC monthly enrollment data, March 2023 through March 2026. For each of the 298 confirmed NC contracts, we measured enrollment in the 12 months before and after the NC effective date. We required at least 3 months of valid data on each side, yielding 167 plans with sufficient bilateral data. 74% of plans showed a worsening enrollment trend after going NC. Among mid-size plans specifically, that figure was 88% — the most internally consistent signal in the data.