FTC warns 25 health plan marketers as 2027 open enrollment starts November 1

The Federal Trade Commission's staff is warning 25 companies that advertise health plans, or generate sales leads for them, about misleading claims, the agency said on October 29. The letters come as open enrollment for 2027 coverage on HealthCare.gov is about to begin on November 1, and the FTC expects to send more on a rolling basis.

The recipients promote Affordable Care Act Marketplace insurance or other health products, including limited indemnity plans and medical discount programs. The letters do not allege wrongdoing by any of them. They ask the companies to review their advertising and say FTC staff is closely watching the market.

What the FTC is warning about

Based on information its staff collected and its past cases, the FTC listed four kinds of claims that may break the law:

• misrepresenting a plan's benefits or limitations, including any insurance benefits
• presenting a plan as major or comprehensive medical insurance, or its equivalent, when it is not
• misrepresenting what a plan costs
• falsely promising free offers, cash rewards, rebates or other incentives for signing up

The letter also cites the Telemarketing Sales Rule, which bars robocalls with prerecorded messages that pitch products, including health insurance, without the consumer's express, informed consent. The same rule bars calls to numbers on the National Do Not Call Registry unless the consumer has consented or another narrow exception applies. A separate rule bans posing as a government agency, such as the Department of Health and Human Services, or as an insurance company. Breaking either rule can bring a civil penalty of up to $53,088 per violation, the letter says, and each unlawful call, ad or misrepresentation may count as a separate violation.

Today's letters remind companies that open enrollment is not an invitation to misrepresent what their plans actually cover.

Cases the letters cite

The letters list earlier FTC cases against marketers and lead generators in this market. Several ended in large payments.

Key dates for 2027 coverage

In a fact sheet on October 30, the Centers for Medicare & Medicaid Services said more than 75% of people who buy coverage through HealthCare.gov "will continue to have access to premiums at or below $50 in 2027," and that people who qualify for tax credits will be able to get a plan for which the federal government pays nearly 90% of the lowest-cost premium. On average, it said, shoppers can choose from 100 plans and five to six insurers. The fact sheet gives no figure for the average change in premiums. HealthCare.gov lets shoppers preview plans with personalized price estimates.

How to protect yourself

The FTC's advice is to begin at the official source: HealthCare.gov or the Marketplace Call Center at 1-800-318-2596. In a consumer alert, it warns that misleading pitches can turn up in paid search results, on social media and in text messages, and that some ads only look as if they come from the government or a well-known insurer. Robocalls that use a prerecorded message to sell health insurance are illegal, the agency says, so a caller who uses one is probably a scammer or, at best, a company to avoid. Misleading ads and illegal robocalls can be reported at ReportFraud.ftc.gov.

The rules for premium help are also changing for later years. CMS has proposed that marketplaces verify eligibility before paying premium tax credits, starting with 2028 coverage, as our report on the proposal explains.