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plicable), benefits, and provider access lim-
itations in the plan. 
‘‘(iii) Comparative quality of the plan. 
‘‘(iv) The fact that plan attributes 
may change annually. 
‘‘(4) 
APPOINTMENT, 
CERTIFICATION
AND 
TRAINING OF AGENTS AND BROKERS.—The model 
regulations shall establish procedures and require-
ments for appointment, certification (and periodic 
recertification), and training of agents and brokers 
that market or sell Medicare private plans consistent 
with existing State appointment and certification 
procedures and with this paragraph. 
‘‘(5) AGENT AND BROKER COMMISSIONS.— 
‘‘(A) IN GENERAL.—The model regulations 
shall establish standards for fair and appro-
priate commissions for agents and brokers con-
sistent with this paragraph. 
‘‘(B) LIMITATION ON TYPES OF COMMIS-
SION.—The model regulations shall specifically 
prohibit the following: 
‘‘(i) Differential commissions— 
‘‘(I) for Medicare Part C plans 
based on the type of Medicare private 
plan; or 
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‘‘(II) prescription drug plans 
under part D based on the type of 
prescription drug plan. 
‘‘(ii) Commissions in the first year 
that are more than 200 percent of subse-
quent year commissions. 
‘‘(iii) The payment of extra bonuses 
or incentives (such as trips, gifts, and 
other non-commission cash payments). 
‘‘(C) AGENT DISCLOSURE.—In developing 
the model regulations, the NAIC shall consider 
requiring agents and brokers to disclose com-
missions to a beneficiary upon request of the 
beneficiary before enrollment. 
‘‘(D) PREVENTION OF FRAUD.—The model 
regulations shall consider the opportunity for 
fraud and abuse and beneficiary steering in set-
ting standards under this paragraph and shall 
provide for the ability of State commissioners to 
investigate commission structures. 
‘‘(6) MARKET CONDUCT.— 
‘‘(A) IN GENERAL.—The model regulations 
shall establish standards for the market con-
duct of organizations offering Medicare private 
plans, and of agents and brokers selling such 
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plans, and for State review of plan market con-
duct. 
‘‘(B) MATTERS TO BE INCLUDED.—Such 
standards shall include standards for— 
‘‘(i) timely payment of claims; 
‘‘(ii) beneficiary complaint reporting 
and disclosure; and 
‘‘(iii) State reporting of market con-
duct violations and sanctions. 
‘‘(7) IMPLEMENTATION.— 
‘‘(A) PUBLICATION OF NAIC MODEL REGU-
LATIONS.—If the model regulations are sub-
mitted on a timely basis under paragraph (1)— 
‘‘(i) the Secretary shall publish them 
in the Federal Register upon receipt and 
request public comment on the issue of 
whether such regulations are consistent 
with the requirements established in this 
subsection for such regulations; 
‘‘(ii) not later than 6 months after the 
date of such publication, the Secretary 
shall determine whether such regulations 
are so consistent with such requirements 
and shall publish notice of such determina-
tion in the Federal Register; 
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‘‘(iii) if the Secretary makes the de-
termination under clause (ii) that such reg-
ulations are consistent with such require-
ments, in the notice published under clause 
(ii) the Secretary shall publish notice of 
adoption of such model regulations as con-
stituting the marketing and enrollment 
standards adopted under this subsection to 
be applied under this title; and 
‘‘(iv) if the Secretary makes the deter-
mination under such clause that such regu-
lations are not consistent with such re-
quirements, the procedures of clauses (ii) 
and (iii) of subparagraph (B) shall apply 
(in relation to the notice published under 
clause (ii)), in the same manner as such 
clauses would apply in the case of publica-
tion of a notice under subparagraph (B)(i). 
‘‘(B) NO
MODEL
REGULATIONS.—If the 
model regulations are not submitted on a timely 
basis under paragraph (1)— 
‘‘(i) the Secretary shall publish notice 
of such fact in the Federal Register; 
‘‘(ii) not later than 6 months after the 
date of publication of such notice, the Sec-
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retary shall propose regulations that pro-
vide for marketing and enrollment stand-
ards that incorporate the requirements of 
this subsection for the model regulations 
and request public comments on such pro-
posed regulations; and 
‘‘(iii) not later than 6 months after 
the date of publication of such proposed 
regulations, the Secretary shall publish 
final regulations that shall constitute the 
marketing 
and 
enrollment 
standards 
adopted under this subsection to be applied 
under this title. 
‘‘(C) REFERENCES
TO
MARKETING
AND 
ENROLLMENT STANDARDS.—In this title, a ref-
erence to marketing and enrollment standards 
adopted under this subsection is deemed a ref-
erence to the regulations constituting such 
standards adopted under subparagraph (A) or 
(B), as the case may be. 
‘‘(D) EFFECTIVE DATE OF STANDARDS.— 
In order to provide for the orderly and timely 
implementation of marketing and enrollment 
standards adopted under this subsection, the 
Secretary, in consultation with the NAIC, shall 
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specify (by program instruction or otherwise) 
effective dates with respect to all components of 
such standards consistent with the following: 
‘‘(i) In the case of components that 
relate predominantly to operations in rela-
tion to Medicare private plans, the effective 
date shall be for plan years beginning on 
or after such date (not later than 1 year 
after the date of promulgation of the 
standards) as the Secretary specifies. 
‘‘(ii) In the case of other components, 
the effective date shall be such date, not 
later than 1 year after the date of promul-
gation of the standards, as the Secretary 
specifies. 
‘‘(E) CONSULTATION.—In promulgating 
marketing and enrollment standards under this 
paragraph, the NAIC or Secretary shall consult 
with a working group composed of representa-
tives of issuers of Medicare private plans, con-
sumer groups, medicare beneficiaries, State 
Health Insurance Assistance Programs, and 
other qualified individuals. Such representatives 
shall be selected in a manner so as to assure 
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balanced representation among the interested 
groups. 
‘‘(8) ENFORCEMENT.— 
‘‘(A) IN GENERAL.—Any Medicare private 
plan that violates marketing and enrollment 
standards is subject to sanctions under section 
1857(g). 
‘‘(B) STATE RESPONSIBILITIES.—Nothing 
in this subsection or section 1857(g) shall pro-
hibit States from imposing sanctions against 
Medicare private plans, agents, or brokers for 
violations of the marketing and enrollment 
standards adopted under section 1852(m). 
States shall have the sole authority to regulate 
agents and brokers. 
‘‘(9) MEDICARE PRIVATE PLAN DEFINED.—In 
this subsection, the term ‘Medicare private plan’ 
means a Medicare Part C plan and a prescription 
drug plan under part D.’’. 
(b) EXPANSION OF EXCEPTION TO PREEMPTION OF 
STATE ROLE.— 
(1) IN GENERAL.—Section 1856(b)(3) of the 
Social Security Act (42 U.S.C. 1395w–26(b)(3)) is 
amended by striking ‘‘(other than State licensing 
laws or State laws relating to plan solvency)’’ and 
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inserting ‘‘(other than State laws relating to licens-
ing or plan solvency and State laws or regulations 
adopting the marketing and enrollment standards 
adopted under section 1852(m))’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to plans offered on or 
after July 1, 2008. 
(c) APPLICATION TO PRESCRIPTION DRUG PLANS.— 
(1) IN
GENERAL.—Section 1860D–1 of such 
Act is amended by adding at the end the following 
new subsection: 
‘‘(d) APPLICATION OF MARKETING AND ENROLL-
MENT
STANDARDS.—The marketing and enrollment 
standards adopted under section 1852(m) shall apply to 
prescription drug plans (and sponsors of such plans) in 
the same manner as they apply to Medicare Part C plans 
and organizations offering such plans.’’. 
(2) REFERENCE
TO
CURRENT
LAW
PROVI-
SIONS.—The amendment made by subsection (a) 
and (b) apply, pursuant to section 1860D– 
1(b)(1)(B)(ii) of the Social Security Act (42 U.S.C. 
1395w–101(b)(1)(B)(ii)), to prescription drug plans 
under part D of title XVIII of such Act. 
(d) CONTRACT REQUIREMENT TO MEET MARKETING 
AND ADVERTISING STANDARDS.— 
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