Dawn McFarland on How Brokers Can Protect Their Role

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BROKER SPOTLIGHT

By Phil Calhoun in conversation with Dawn McFarland
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Dawn McFarland, founder and president of M&M Benefit Solutions Insurance Services, brings a rare mix of regulatory discipline, field experience, and association leadership to the California benefits market. Her career path has taken her from banking to insurance, from voluntary benefits to Medicare, and from local chapter involvement to state leadership. This conversation is drawn from a recording between Dawn McFarland and California Broker Magazine CEO Phil Calhoun, with a focus on career development, association advocacy, Medicare and group market shifts, and the impact of California legislation and AI on the broker community.

From Banking to Benefits

Dawn McFarland did not start her career in insurance, but that may be part of what made the transition so effective. After years in banking, where audits, regulation, and operational precision were part of daily life, she entered the insurance world in her mid-30s just as Covered California was launching. That timing mattered. “I know that change is really a playground for opportunity,” she said, describing how she saw the new market landscape as a place to build a business and find a niche.

Her first step was into voluntary benefits, but she quickly learned that the model had limits for the kind of business she wanted to build. She also knew she did not want to manage a large staff the way she had in prior roles. “I learned one thing I knew I didn’t want to do when I transferred careers. I didn’t want to manage people like I’d managed people for way too long,” she said. With strong retention and a growing book, the business demanded a team structure she did not want to build. That realization pushed her toward Medicare, where she found a better fit for her strengths and a more direct client relationship.

Finding The Right Niche

She described that shift as both practical and personal. “I really like working one on one with people,” McFarland said. “I thrive personally better in the experience of working with the underserved.” For brokers listening, that insight is familiar but important. Long-term success is often less about chasing every product and more about aligning the business with the markets and service model that fit the producer.

Today, McFarland said her wheelhouse remains Medicare and individual coverage. She also noted that as the industry changes, diversification becomes necessary, including long-term care and life insurance. Her comments reflect a broader truth for brokers in California, where carrier shifts, consumer needs, and regulatory pressure often force agencies to rethink their mix of business.

Association Leadership and Mentorship

Her association path followed a similar logic. McFarland entered chapter leadership after realizing that working through brokers was the right channel for her business. But what kept her involved was bigger than business development. A conversation with association leader Sima Reed reframed the purpose of membership around advocacy, consumer access, and protecting the role of the agent. “What we do is important,” McFarland recalled being told. The mission resonated. “I’m one of the activist kind of people. I think our voice matters.”

That sense of purpose carried her from local service to the state board and national involvement, and eventually to her current role as California state president. She said mentorship helped along the way, naming leaders such as Alan Katz, Bruce Benton, and Pat Griffey as influential voices. The recurring theme in her comments was not just guidance, but access to people who understood volunteer leadership, government relations, and the realities of running a business while serving an association.

Watching The Group Market

For California brokers, McFarland’s view of the market may be the most immediate takeaway. She believes the pendulum is swinging back toward the group market after years of intense Medicare focus. That shift is not only commercial, she said, but regulatory. In her view, California SB 1244 is an example of how lawmakers are raising questions about compensation and transparency without fully understanding the differences between fully insured and self-funded arrangements. “There’s some real misunderstanding,” she said. “The same rules and the same things don’t apply when you go into the self-funded market.”

“Membership & participation matter, especially if you make a living in the industry.”

She stressed that the issue is not simply what the law requires, but the narrative behind it. Her concern is that broker roles are being described in ways that do not reflect how the industry actually works. At the same time, she sees transparency as a positive force if it is handled with precision. “The more we know and the more that is out on the table, the more likely we’re going to get closer to solving the cost of healthcare,” McFarland said. That is a useful framing for agency owners who are trying to stay ahead of legislative changes without losing credibility with employer clients.

AI and The Human Role

AI is another area where McFarland is watching the details closely. She is not dismissive of the technology, but she is wary of how quickly it is evolving and how little guardrail exists around it. “AI is so far ahead of any of us that we’re just trying to catch up to what it can and what it will do,” she said. For now, she sees the real work as educating herself on AI uses in sales, claims processing, cybersecurity, and data protections.

She compared the current moment to Y2K, when people feared the unknown and had to prepare for a major technological transition. “We are still the human beings in charge,” she said, underscoring that insurance still depends on judgment, accountability, and relationship management. Her point will resonate with brokers who see AI as a tool, not a replacement, for the expertise clients still expect from trusted advisers.

Why Engagement Matters

Her advice to brokers and benefit professionals is direct. Membership and participation matter, especially if you make a living in the industry. “If you earn a living in this industry, that you become a member of the association,” she said. She also urged brokers to engage beyond passive membership by joining chapter leadership, attending Sacramento and Washington, D.C. advocacy trips, and seeing what volunteer leadership looks like through CAHIP’s farm team meetings.

In her view, the profession needs more voices telling lawmakers what brokers actually do and why that work matters. That message is especially relevant in California, where policy decisions can have a fast and lasting impact on compensation, access, and client service. McFarland made clear that presence and participation are not optional if the industry wants to be heard.

McFarland closed with a practical and realistic message about the market itself. The industry has always been volatile, she said, and the anxiety level shifts with every new disruption. But brokers should not mistake volatility for decline. “There is still opportunity,” she said. “Our profession and our expertise will be necessary however this unfolds.” For California brokers navigating compliance, market shifts, and technology change, that is a strong reminder that the fundamentals still matter.

Engage with Dawn McFarland

Dawn McFarland is the founder and president of M&M Benefit Solutions Insurance Services. Brokers and industry professionals can connect with her through her company, and those interested in association involvement can also engage through CAHIP chapter leadership, farm team meetings, and advocacy events in Sacramento and Washington, D.C. www.mnmbenefitsolutions.com/

Picture of Dawn McFarland

Dawn McFarland

is the founder and president of M&M Benefit Solutions Insurance Services. She has found a passion as an agent who helps individuals, especially Medicare eligible, navigate choosing how they receive their health care. Dawn volunteers as a community educator for the Alzheimer’s Association and was recently elected President Elect for the State of CA Agents and Health Insurance Professionals. She has been recognized by the National Association of Benefits Insurance Professionals (NABIP) with both the Distinguished Service Award and the coveted State Legislative Achievement Award. She also served four years on the Medicare Advisory Council for NABIP, was president of the LA Chapter of CAHIP, and is a member of the founding group of the NABIP Bill of Rights.

Featured in our July 2026 Special Issue page 20 – Click here to download!

Field Notes from the Threshold

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PROFESSIONAL DEVELOPMENT

By Joshua Schneeloch

California’s benefits brokers are standing in a doorway between the distribution they have known and the one coming to replace it. This is the first in a series on who will carry insurance the last mile.

I have spent 35 years studying how products reach the people who need them. The first 20 of those years happened in Europe, inside broadcast media technology, where I learned that distribution is the quiet engine underneath every industry that lasts. The next 15 happened here in the United States, inside insurance, where the same lesson repeated itself in a new language. Distribution is the part of our business that nobody applauds and everybody leans on. When it works, it disappears into the background. When it begins to fail, everything built on top of it starts to wobble.

I am writing this first column from what I have come to picture as a threshold, a doorway between the insurance distribution we have known and the one arriving to replace it. California’s brokers are standing in that doorway right now, and many of them have not yet felt the draft.

Here is the shape of it. The average U.S. insurance agent is roughly 59 years old. Around 1.37 million insurance professionals are now 55 or older, close to one in four people in the field, while only about 214,000 sit between the ages of 20 and 24. That works out to six people walking toward the exit for every one walking through the front door. The Bureau of Labor Statistics has projected that over a 15-year horizon, half of the current insurance workforce will retire, leaving more than 400,000 positions unfilled. I will give that number a full column in August.

Carriers can design brilliant products and technologists can build elegant platforms, and none of them reach a single family until a trusted human being carries it the last mile.

That transition was demanding, and it was still the gentle version of what insurance now faces. Media let a young person learn the new systems in months and start adding value almost at once, because the barriers to entry were low and the rules were light. Our business asks for far more before a newcomer earns a single dollar. There is licensing to pass, compliance and law to absorb, products and regulation that change every year, and a long apprenticeship across real kitchen tables before the instincts take hold. A new producer can spend a year or more learning the trade before the income arrives, and that lean runway is exactly when most of them walk away.

Now layer the timing on top. In broadcast, the older generation aged out gradually while the young filled in behind them. In insurance, a wave that has been building for twenty years is cresting all at once, with almost the entire experienced workforce reaching for the exit inside the same narrow window. And there is one more force. Automation was already creeping into our work two decades ago, quietly, at the edges. Today it has grown into a massive movement, with artificial intelligence reshaping how every part of the business gets done.

This is where the threshold turns into an opening. It is lifting the grinding administrative weight off the producer’s desk and freeing the human to do the human work, reading a room, anticipating a need, and earning trust across a table. Identity has become a language this generation speaks fluently, and selling from identity, from who you are and what you stand for, is the most durable form of selling there is.

Over the coming months, Schneeloch on Distribution will map this threshold one panel at a time, from where the next producers will come, to the image problem that keeps young talent away, the changing shape of the work, and the pipeline California must build to last.

I am calling these field notes because that is what they are. For years, I have researched this question and gathered knowledge and hard-won experience across two continents, and I keep landing on the same conclusion, which is that distribution is destiny. Carriers can design brilliant products and technologists can build elegant platforms, and none of them reach a single family until a trusted human being carries it the last mile.

This is the work I am now taking on directly. I am stepping into the Professional Development board seat at CAHIP-LA, the largest NABIP chapter in the nation, to build a mentorship initiative that pairs our most knowledgeable professionals with the young people entering the field. The aim is to carry decades of experience forward to the next generation before our veterans walk out the door, and to begin early and on purpose, solving the problem holistically and at the root where surface fixes never reach.

We are standing at the threshold. The draft is real.

If you want a hand in shaping what we build on the other side of the door, reach out to CAHIP-LA at info@cahip-la.org, or join the movement at nabip.org/professional-development.

For a direct conversation about alignment, services, and book protection strategies with Joshua Schneeloch, visit www.joshuaschneeloch.com or linkedin.com/in/joshuaschneeloch.

Picture of Joshua Schneeloch

Joshua Schneeloch

is a sales strategist and founder with thirty-five years of experience across two continents and two industries. He spent twenty years in broadcast media technology in Europe before building a fifteen-year career in United States insurance and broker development, including four-time recognition in Aflac’s President’s Club and Colonial Life’s Benefits Counselor of the Year award, along with a producer development role at Dickerson Insurance Services. He holds a master’s degree in strategic marketing and sales from the University of Hamburg and is natively bilingual in German and English. He is the founder of White Wing Insurance Solutions and AgentEase, a keynote speaker on identity-based selling, and a member of CAHIP-LA. He lives in the South Bay of Los Angeles.

Featured in our July 2026 Special Issue page 24 – Click here to download!

 

Medicare Telehealth Compliance Updates for 2026

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HEALTH & WELLNESS

By NCDS Medical Billing and Practice Management

What independent practices need to know about virtual care regulations in the year ahead.

Telemedicine didn’t disappear when the public health emergency ended—it matured. And now, with the passage of the Consolidated Appropriations Act of 2026, Congress has extended key Medicare telehealth flexibilities through Dec. 31, 2027.

Health insurance professionals can advise clients of the current telehealth rules and regulations. That means no January 2026 rollback. No short-term lapse. No sudden return to restrictive pre-pandemic rules.

But make no mistake: telemedicine compliance is still evolving. In 2026, telemedicine compliance will be less about whether you offer virtual care—and more about how you deliver it, where it’s delivered from, what platform you use, how you bill it, and how well you document it.

This article breaks down the confirmed regulatory landscape shaping telemedicine compliance in 2026—and what your practice should be doing now to avoid audits, denials, and revenue disruption.

Compliance Isn’t Static—Telemedicine Rules Are Structured (But Temporary)

The Consolidated Appropriations Act of 2026 extends many Medicare telehealth flexibilities through Dec. 31, 2027, including:

  • Home as an eligible originating site
  • Removal of geographic restrictions (rural and urban allowed)
  • Expanded practitioner eligibility
  • Continued coverage for audio-only services in certain situations
  • Delayed in-person visit requirements for mental health services
  • FQHC and RHC distant site billing
  • Extension of Hospital-at-Home waiver (through Sept. 30, 2030)
  • Temporary telehealth prescribing flexibility for controlled substances (through Dec. 31, 2026)

This provides stability—but not permanence. Practices must prepare now for a regulatory shift that could occur in 2028.

1. Telehealth flexibilities are extended—but not forever

The biggest compliance misconception in 2026 is assuming telehealth rules are now permanent. They are not. Unless Congress acts again, many flexibilities are scheduled to change beginning Jan. 1, 2028, including:

  • Potential return of geographic restrictions
  • Facility-based originating site requirements (except behavioral health)
  • Removal of certain practitioner types from telehealth eligibility
  • In-person requirements for mental health telehealth initiation

What this means: You have stability through 2027—but planning for 2028 should begin now.

2. Approved telemedicine platforms are non-negotiable

Pandemic enforcement discretion is over. Telemedicine visits must be conducted using HIPAA-compliant, secure platforms that:

  • Encrypt data in transit
  • Provide access controls
  • Offer audit trails
  • Include Business Associate Agreements (BAAs)

Consumer platforms like FaceTime or non-healthcare Zoom licenses expose practices to:

  • HIPAA violations
  • Compliance findings
  • Payer scrutiny during audits

Secure technology is now a baseline expectation—not a recommendation.

3. Place of Service (POS) accuracy is critical

CMS continues to enforce accurate POS coding for telehealth services. Current guidance:

  • POS 10 – Telehealth Provided in Patient’s Home
  • POS 02 – Telehealth Provided Other than in Patient’s Home

Since Jan. 1, 2024, telehealth services provided to patients in their homes are paid at the non-facility rate. Common compliance triggers:

  • Using POS 11 (office) incorrectly
  • Failing to distinguish between POS 02 and POS 10
  • Missing documentation of patient location

These errors affect both reimbursement and audit risk.

4. Audio-only services continue—with conditions

Through Dec. 31, 2027, Medicare beneficiaries may receive audio-only telehealth services in their homes. Beginning Jan. 1, 2028:

  • Audio-only will be limited primarily to behavioral health
  • The practitioner must be capable of audio-video technology
  • The patient must be unable or unwilling to use video

Documentation must clearly identify:

  • Modality used
  • Patient consent
  • Clinical appropriateness

5. Behavioral health telehealth: expanded but structured

Behavioral health continues to receive strong telehealth support. Geographic restrictions for behavioral health are permanently removed. However, beginning after Dec. 31, 2027:

  • An in-person visit within six months prior to the first telehealth service may be required
  • Ongoing in-person visits every 12 months may apply
  • Patients who began telehealth behavioral health services prior to 2028 may be treated as established patients.

Tracking this requirement will be essential to protect reimbursement.

6. Virtual supervision and teaching physician flexibilities

Beginning Jan. 1, 2026: CMS allows virtual presence (audio/video only, not audio-only) for:

  • Direct supervision services without a 010 or 090 global surgery indicator
  • Most incident-to services
  • Many diagnostic tests
  • Cardiac and pulmonary rehab
  • Certain outpatient services

Teaching physicians may also maintain a virtual presence during key portions of Medicare telehealth services. Supervision rules are no longer temporary—but they are highly specific.

7. Remote Patient Monitoring (RPM) remains under scrutiny

While not directly altered by the new legislation, RPM continues to be closely audited. Common risk areas:

  • Time tracking accuracy
  • Proof of device usage
  • Clinical review documentation
  • Medical necessity documentation

Telehealth extensions do not relax RPM compliance standards.

8. State licensure compliance is back to normal enforcement

Temporary interstate licensure waivers are largely expired. Providers must be licensed in the state where the patient is physically located at the time of service.

This remains a high-risk area for:

  • Behavioral health
  • Multistate virtual practices
  • Growing telehealth groups
  • Common documentation mistakes that trigger audits

Across telemedicine services, compliance gaps most often include:

  • Missing telehealth consent
  • No documentation of modality (audio-only vs. audio-video)
  • Incorrect POS coding
  • Incomplete supervision documentation
  • Failure to track mental health in-person visit requirements
  • Weak RPM documentation

These are operational gaps—not rare mistakes.

How to prepare now for 2026 and beyond

The extension provides breathing room—but not immunity. Independent practices should:

  • Confirm all telehealth platforms are HIPAA-compliant
  • Train billing teams on POS 02 vs. POS 10
  • Update EHR templates to capture modality and consent
  • Implement tracking for future mental health in-person requirements
  • Review licensure coverage
  • Monitor regulatory updates tied to 2028

How NCDS helps practices stay compliant

Telemedicine compliance is layered. Billing, documentation, supervision, technology, licensure—they all intersect. At NCDS, we help practices:

  • Validate telehealth coding before claims submission
  • Monitor CMS updates in real time
  • Identify risk areas before audits occur
  • Align workflows with payer expectations
  • Prepare for 2028 changes proactively

Compliance isn’t reactive. It’s structured. Telemedicine compliance is stable—but not permanent. The Consolidated Appropriations Act of 2026 provides welcome stability through 2027.

But the message for practices in 2026 is clear: Secure platforms. Accurate documentation. Correct coding. Verified licensure. And a forward-looking plan for 2028. Telemedicine isn’t temporary anymore. But the flexibility still is.

“Health insurance professionals can advise clients of the current telehealth rules and regulations.”

 

Featured in our July 2026 Special Issue page 26 – Click here to download!