Best Medicare FMO for Growth

Best Medicare FMO for Growth

Best Medicare FMO for Growth
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The Medicare insurance market continues to grow, creating an exceptional opportunity for independent agents to scale their business. To succeed in today’s competitive environment, agents need to align with the Best Medicare FMO—one that offers high-quality lead programs, cutting-edge technology, comprehensive training, and unmatched agent support. That’s exactly where Pinnacle Financial Services delivers.

Why Pinnacle Financial Services Is the Best Medicare FMO for Independent Agents

With numerous FMOs and IMOs promising the world, selecting the right partner can be a challenging task. At Pinnacle Financial Services, we earn the title of Top Medicare FMO by consistently delivering results-driven tools and support that help agents grow faster and more efficiently.

We don’t just claim to be the best—we prove it every day through our focus on:

  • Proven Medicare lead generation programs
  • Innovative agent training and onboarding
  • User-friendly technology solutions
  • Dedicated back office and compliance support

Comprehensive Tools and Resources That Set Pinnacle Apart

Pinnacle Financial Services empowers Medicare agents with a robust suite of tools, training, and lead generation support—all offered at no cost to our partners:

Start strong with exclusive access to high-quality Medicare leads designed to help you book more appointments and close more sales.

  • State-of-the-Art Technology

Leverage advanced digital tools, including:

Ongoing Medicare Agent Training

Whether you’re new or experienced, our in-person and virtual training sessions provide up-to-date knowledge across Medicare Advantage, Medicare Supplement, and PDP plans. We also offer free CE (Continuing Education) credits to keep your license in good standing.

  • Top-Tier Medicare Commissions

Pinnacle partners benefit from competitive commission structures across all carriers, helping you maximize your earnings with every sale.

Our experienced staff is ready to guide you through every aspect of the Medicare sales process—from onboarding to retention—with personalized agent support and compliance assistance.

Ready to Grow? Join Pinnacle, Your Medicare FMO Partner

Whether you’re just starting started in Medicare sales or are already a top producer, Pinnacle Financial Services offers everything you need to scale your business—qualified leads, smart technology, continuous training, and support that puts agents first.

Contact Us Today

Get started with the #1 Medicare FMO by reaching out:

Phone: 1 (800) 772-6881 x7731
Email: sales@pfsinsurance.com

Pinnacle Financial Services is more than just an FMO—we’re your partner in Medicare sales success. Let us help you unlock your full potential as a high-performing Medicare agent.

 

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Bob Brzyski

Bob Brzyski

Vice President of Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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TPMO Marketing and Communications Guidance

TPMO Marketing and Communications Guidance

TPMO Marketing and Communications Guidance
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This bulletin provides an overview of CMS’s Medicare marketing and communications regulations as they pertain to Third-Party Marketing Organizations (TPMOs). The complete Medicare Communications and Marketing Guidelines (MCMG) can be accessed directly on the CMS website: Medicare Communications and Marketing Guidelines (MCMG)

Applicability of the Guidelines

The CMS Medicare Communications and Marketing Guidelines apply to a variety of entities, including all Third-Party Marketing Organizations (TPMOs). These guidelines are specifically relevant to Medicare Advantage (MA) and Prescription Drug Plans (PDPs). They do not apply to products such as:

  • Affordable Care Act (ACA) health plans
  • Medicare Supplement (Medigap) insurance
  • Other non-Medicare health insurance products 

Definition of a TPMO

CMS defines a Third-Party Marketing Organization (TPMO) as any individual or organization—including independent agents and brokers—who is compensated to perform lead generation, marketing, sales, or enrollment-related activities connected to the MA enrollment process. This includes entities designated as First Tier, Downstream, or Related (FDRs).

Do CMS Rules Apply to Lead Vendors?

Yes. Lead vendors fall under the definition of a TPMO because they are paid to generate leads and perform marketing functions related to MA plan enrollment. 

Understanding “Marketing Materials”

Under CMS regulations (§§422.2260 and 423.2260), “marketing” is defined as any communication or activity intended to influence a Medicare beneficiary’s decision to enroll in or remain enrolled in an MA or PDP plan.

Marketing materials are evaluated based on two criteria:

  • Intent: Designed to attract attention to, or influence decision-making about, a specific MA or PDP plan.
  • Content: Includes references to plan benefits, premiums, cost-sharing, incentives, or comparative plan information.

A material meets the Intent standard if it:

  • Aims to promote a specific MA or PDP plan.
  • Influences a consumer’s enrollment decision.
  • Encourages retention in a current plan.

A material meets the Content standard if it:

  • Mentions plan benefits, premiums, or cost-sharing.
  • Includes metrics like Star Ratings, plan comparisons, or rewards.

Examples of Communication Materials

Example 1:
“ABC Health is now offering Medicare Advantage coverage in Nowhere County. Call 1-800-MA-AGENTS for more information.”
→ This qualifies as a communication piece. However, the use of a carrier name may require submission for carrier review.

Important: Any use of a carrier’s logo must be submitted for carrier review and approval.

Example 2:
A flu shot reminder letter stating, “ABC Health enrollees can get their flu shot for $0 copay at a network pharmacy…”
→ While cost sharing is mentioned, the piece is intended only to inform current enrollees, not to market a plan, and is therefore considered communication, not marketing.

Examples of Marketing Materials

Example 1:
“ABC Health Offers $0 Premium Plans in Nowhere County”
→ This includes both promotional intent and benefit-related content, qualifying it as marketing.

Example 2:
“Call us to learn about plans that include hearing, dental, $0 premiums, and Medicare Part B givebacks.”
→ Even without naming a specific plan, the mention of plan features and premiums qualifies this as marketing.

Note: Any material that mentions benefits or costs is considered marketing and must be submitted for carrier and CMS approval before use.

Requirements for Marketing Materials

When a piece is classified as marketing, you must:

  • Submit the piece for pre-review to each carrier you represent.
  • File the material in HPMS (Health Plan Management System) and obtain CMS approval.
  • Ensure the material is used only for carriers that have explicitly opted in through HPMS.

Filing Requirements and Timeline

  • Marketing materials must be filed in HPMS annually for each Plan Year.
  • CMS typically opens HPMS for filing in June for the following plan year.
  • Materials submitted between June–September may not be used before October 1.
  • TPMOs must select the appropriate media type when submitting. 

Carrier Pre-Review and HPMS Filing

TPMOs should coordinate closely with carriers and uplines to ensure compliance with the required pre-review and CMS filing processes. Carrier-specific processes may vary, and most carriers issue annual marketing guidance.

To independently file with CMS:

  • Obtain consultant access to HPMS for your legal entity.
  • Once access is granted, request that each carrier add your User ID to their HPMS workflow to allow visibility and opt-in capability.

For access instructions, refer to:
 CMS Consultant Access Instructions (PDF)

Depending on your contract structure, you may also be able to request filing assistance from your upline or parent agency—but only for carriers within that agency’s hierarchy.

Shared Marketing Material and Unique SMIDs

If a TPMO uses a marketing piece originally created and approved by another TPMO, it must still be submitted in HPMS under its own unique SMID. Approval of the original piece does not extend to other TPMOs by default.

Can You Use an Unapproved Marketing Piece?

No. Marketing materials must not be used unless:

  • They have been approved by CMS, and
  • Each applicable carrier has opted-in via HPMS.

For further guidance or clarification, TPMOs should consult directly with their contracted carriers and compliance teams to ensure full adherence to CMS marketing standards.

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Bob Brzyski

Bob Brzyski

Vice President of Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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Lead Star Medicare Leads

Lead Star Medicare Leads

Lead Star Medicare Leads
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What You’ll Learn from Episode 26 of Insurance360: Smarter, Compliant Medicare Lead Generation with “Professor Leads”

If you’re in the insurance world, or just curious about where it’s headed, you’re going to love Episode 26 of our Insurance360 podcast. In this episode, we sit down with none other than Bill DeCourcey, a.k.a. “Professor Leads,” for an eye-opening conversation about what’s working right now in Medicare lead generation, and how to do it all by the book.

Let’s break it down. 

Setting the Scene

Bill, who’s well-known in the industry for his practical, no-fluff insights, joins our host for a deep dive into the evolving landscape of insurance. With his trademark energy and real-talk style, Bill shares what he’s seeing on the front lines and how both agents and agencies can adapt.

What You’ll Hear in This Episode:

How the Industry is Evolving

The insurance game is changing fast. Bill kicks things off by discussing the significant shifts occurring in the industry, driven by technological innovations and increasing consumer expectations. Whether you’re a carrier, an agent, or a client, these changes are touching everyone.

Customer Service is Getting an Upgrade

Next, Bill delves into how agents are enhancing their service offerings. From AI-driven tools to streamlined onboarding processes, he explains how smart innovation can make life easier for both agents and clients, and why staying ahead of these trends is essential.

 Navigating the Compliance Maze

Of course, no talk about Medicare lead generation would be complete without touching on compliance. Bill breaks down the current regulatory headaches, what might be changing, and how to stay on the right side of the rules while still growing your business.

Bill’s Big Takeaway

Bill wraps up the episode with a powerful reminder: in a space that’s constantly shifting, staying informed and flexible isn’t optional, it’s essential. If you’re an agent, a marketer, or just someone interested in the insurance space, you need to keep learning and evolving.

Why This Episode Matters

This isn’t just another industry podcast. Bill’s take is real, relatable, and refreshingly straightforward. He has a way of simplifying the complex stuff, so whether you’re a seasoned pro or just getting started, you’ll walk away with practical insights you can use.

Want More?

Don’t miss the full episode, it’s packed with more nuggets than we could fit here. Tune in, take notes, and subscribe to Insurance360 so you never miss a conversation that could change how you do business.

 [Listen to Episode 26 now]
Got questions or takeaways of your own? Drop us a comment or share the episode with someone in your network who should hear it!

Want to Get Started with Effective Compliant Medicare Leads?

Complete today- Spot Sign

Stay Up to Date on Insurance 360 Podcast- Insurance 360 Podcast

Request Lead Star Account- info@pfsinsurance.com

 

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Bob Brzyski

Bob Brzyski

Vice President of Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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Understanding Referral Fees in Insurance: What Agents Need to Know

Understanding Referral Fees in Insurance: What Agents Need to Know

Understanding Referral Fees in Insurance: What Agents Need to Know
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Understanding the ins and outs of referral fees is key to staying compliant and protecting your insurance license. Whether you’re an agent or running an agency, knowing what you can and can’t do helps you avoid costly missteps. This guide breaks down the dos and don’ts, answers common questions, and shares practical tips to help you build ethical, compliant referral relationships with confidence.

What Is a Referral Fee?

A referral fee is any cash, gift, or compensation—direct or indirect—provided by a licensed agent or agency to an unlicensed individual or entity for the purpose of soliciting insurance business. This practice is highly regulated, and any missteps can result in severe penalties.

What’s Allowed vs.  What’s Not

Here’s a clear breakdown to help agents stay compliant with state insurance laws and Medicare Marketing Guidelines.

You Can:

  • Receive compliant referrals from providers (if initiated by the provider and compliant with CMS guidelines)
  • Pay referral fees to other licensed agents or agencies (check state rules for any variations)
  • Accept nominal gifts (up to $15 per person, $75 annually) from or give them to customers, as long as they are not cash or monetary
  • Receive referral fees from licensed Medicare Advantage organizations (up to $100 for MAPD/MA and $25 for PDP plans in 2025)
  • Provide beneficiaries with non-monetary nominal gifts

 You cannot:

  • Pay referral fees to providers, consumers, or unlicensed individuals
  • Offer cash or rebates to consumers in exchange for referrals
  • Use or accept patient lists from providers without proper written consent
  • Provide any compensation for a referral from someone who is not licensed to sell insurance

Rebating: Know the Risks

Rebating is the act of offering financial incentives to influence the sale of insurance. This includes giving back a portion of your commission or offering anything of value to entice a customer. Rebating is illegal in most states and may result in license termination or other disciplinary actions.

Examples of Rebating:

  • Paying a customer for a referral
  • Offering to waive part of a premium
  • Giving gift cards or cash for enrolling in a plan 

Best Practices to Stay Compliant

  • ✔ Always confirm the license status of anyone you’re exchanging referral fees with
  • ✔ Check your state’s rules before paying or receiving referral fees—even between licensed agents
  • ✔ Get written authorization before contacting any referred individual
  • ✔ Keep detailed records of all referral sources and communications

 

Need Help Navigating Referral Compliance?

Understanding the nuances of referral fee regulations can be complex, but you don’t have to figure it out alone.

      Schedule a consultation with our compliance experts.
      Request more information on staying compliant with Medicare and state guidelines.

Protect your license. Grow your business the right way.

[Contact Us Today] – Let’s ensure your referral strategy is fully compliant.  Information is subject to change without notice.  Always check with compliance.

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Bob Brzyski

Bob Brzyski

Vice President | Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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Canadian Medstore

Canadian Medstore

Canadian Medstore

Bob Brzyski

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Tackling Prescription Costs Head-On with the Canadian Medstore: A Fresh Perspective

In this latest episode, Bob and Rob take on one of the most pressing issues in healthcare today, prescription drug costs. As the complexities of the healthcare industry continue to grow, they cut through the noise to focus on what truly matters: affordable options for those who need them most. This week, they welcome Bill Hepsher of The Canadian Medstore, offering listeners a practical approach to lowering prescription expenses.

Diving into the Prescription Drug Maze

The conversation zeroes in on real-world solutions, particularly for Medicare clients facing the burden of high prescription costs. Bill Hepsher, drawing on two decades of industry experience, joins Bob and Rob to share insights into how The Canadian Medstore helps individuals save significantly on their medications. His expertise offers a fresh perspective for agents and clients alike, highlighting strategies that make a meaningful difference.

Where Medicare Part D Falls Short

Early in the episode, Bob reflects on insights from a recent Medicare event, where even amidst updates like Part D changes and the Inflation Reduction Act, prescription costs remain a struggle for many. This recurring challenge reignited Bob’s determination to seek effective solutions, bringing him back to his initial conversation with Bill. Their shared mission, to empower insurance professionals with tools to help clients lower drug costs, sets the tone for an informative conversation.

The Story Behind Canadian Medstore

Bill’s journey into the prescription savings space is rooted in personal experience. His brother’s battle with non-Hodgkin’s Lymphoma and the exorbitant cost of anti-rejection medications led Bill to explore affordable alternatives. Discovering lower-priced options through Canadian pharmacies, he turned this personal mission into a broader effort to assist Americans in accessing essential medications without crossing the border. The result was the founding of The Canadian Medstore, now a trusted resource for affordable prescriptions.

Tariffs, Politics, and Prescription Drugs

Amid ongoing economic shifts and global politics, questions arise about the stability of cross-border prescription options. Bill addresses these concerns directly, explaining how individual prescriptions from Canada remain unaffected by tariffs for now. However, he acknowledges the ever-changing landscape and assures listeners that he remains vigilant in monitoring developments that could impact access.

A Game-Changer for Healthcare Agents

The episode takes an exciting turn for healthcare agents, positioning The Canadian Medstore as more than just a patient resource. Bill emphasizes how agents can leverage this partnership to help Medicare clients save on high-cost, non-generic medications like Eliquis. By offering clients alternative solutions for navigating formularies and premium challenges, agents can significantly enhance their value and strengthen client relationships.

This approach goes beyond simply filling prescriptions, it bridges critical gaps for clients who might otherwise feel left without options. Bill and his team provide agents with an additional tool to support their clients’ healthcare journeys.

Looking Ahead: The Future of Affordable Meds

As the discussion wraps up, Bob and Rob reflect on the importance of accessible prescription options, especially as healthcare policies and economic conditions continue to evolve. They underscore the need for dependable alternatives like The Canadian Medstore, which serve as a safeguard against rising drug costs and the limitations of programs like Medicare Part D.

The episode closes with a call to action for agents, healthcare professionals, and anyone committed to helping others: explore The Canadian Medstore as a resource for clients facing prescription cost challenges.

To watch or listen, visit the Insurance 360 Podcast to get all the conversation.

Insurance 360 Podcast

To get signed up to offer Part D Plans- www.pfsinsurance.com/spot

 

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Bob Brzyski

Bob Brzyski

Vice President Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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