Broker Newsletter - January 2026

Publish Date

Your January Newsletter Update


To Our Valued Brokers,  

We want to extend a sincere thank you for an incredible year in 2025. Your amazing efforts to keep existing business with Tufts Health Plan made a significant difference.

We’re excited for what’s ahead in 2026, including growing our D-SNP enrollment, retaining existing members, and adding new members to all our plan options. We look forward to working together towards another successful year!

 

D-SNP SEP enrollment code

Remember, there is a Special Enrollment Period (SEP) code “P” available for month-to-month enrollments with D-SNP (Dual Eligible Special Needs Plans). This allows flexibility for eligible members of SCO and One Care to enroll outside of the standard enrollment periods.

The SEP may be used once per month with an effective date of the first of the following month.

 

Avoid mistakes and follow these 5 steps when enrolling D-SNP members

There are five important steps to ensure your applications for D-SNP plans are error-free. This guide provides all the details you need. 

See D-SNP enrollment guide


Commissions overview

Tufts Health Plan made the difficult decision to discontinue our $0 Tufts Medicare Preferred Access PPO plan and to make some 2026 plans non-commissionable. Below is an outline of the commissionable and non-commissionable plans for your reference:

Discontinued Plans:

  • Tufts Medicare Preferred Access PPO
  • Tufts Medicare Preferred HMO Saver Rx  

List of Non-Commissionable Plans:

  • Massachusetts PPO (H9907) – Tufts Medicare Preferred PPO Rx
  • Massachusetts HMO (H2256) – Tufts Medicare Preferred HMO Smart Saver 

Note: PPO Rx and Smart Saver are non-commissionable for new business only


List of Commissionable Tufts Medicare Preferred HMO Plans at 2026 Fair Market Value:

  • Prime Rx Plus
  • Prime Rx
  • Prime No Rx
  • Value Rx
  • Value No Rx
  • Basic Rx
  • Basic No Rx

List of Commissionable DUAL ELIGIBLE plans at 2026 Fair Market Value:

  • Massachusetts SCO (H8330) – Tufts Health Plan Senior Care Options (HMO-DSNP)
  • Massachusetts One Care DSNP (H5314) – Tufts Health One Care (HMO-DSNP)


Renewals:

  • We will continue to pay renewals on all existing members at 2026 Fair Market Value

These updates will not impact Harvard Pilgrim Health Care Medicare Supplement sales which will be compensated at current rates.

 

Make sure new members start off right

Once your clients enroll in Tufts Health Plan, make sure they have the information they need to start their plan off right. This checklist created specifically for brokers makes it easy.

Get New Member Checklist

 

OEP do’s and don’ts

You can still sell during the Open Enrollment Period (OEP) but there are some important guidelines to keep in mind.  

 

What can you do and not do during OEP that runs from January 1 to March 31?  

The Centers for Medicare & Medicaid Services (CMS) prohibits “knowingly” targeting or marketing to Medicare Advantage enrollees during OEP, including distribution of unsolicited marketing materials and activities that use OEP as a sales opportunity.

 

What you can do:

  • Provide information and respond to questions about OEP and the opportunity to switch Medicare Advantage plans when asked.
  • Send marketing materials about Tufts Health Plan when requested by a client.
  • Educate individuals aging into Medicare (“age-ins”) and Low Income Subsidy (LIS) and dual-eligible recipients about Tufts Health Plan.


Need to view plan details? Find them on our plan compare page.