News to Use for Agents in the Senior Market

A Publication of Senior Marketing Specialists
Week of March 27, 2017


tmbubble  Medicare Advantage Marketing Reminders

Marketing/Sales Events – Formal and Informal
Marketing/Sales events are defined both by the range of information provided and the way in which the content is presented. In addition, marketing/sales events are defined by the Plan’s ability to collect Enrollment Applications and enroll Medicare consumers during the event. A marketing/sales event is designed to steer, or attempt to steer, consumers toward a plan or limited set of plans.

  • A formal marketing/sales event is structured in an audience/presenter style with sales personal or plan representative formally providing specific sponsor information via a presentation on the products being offered.
  • An informal marketing/sales event is conducted with a less structured presentation or in a less formal environment like a retail booth, kiosk, table, recreational vehicle, or food banks where an agent can discuss plan information when approached by a consumer.

Educational Event
An educational event is an event designed to inform Medicare consumers about MA, Prescription Drug or other Medicare programs but do not steer, or attempt to steer consumers toward a specific plan or limited number of plans. Educational events may not include any sales or marketing activities such as the distribution of marketing materials or the distribution or collection of enrollment applications. When advertised, educational events must be advertised as educational; otherwise they are considered marketing/sales events. Educational events are held in public venues, do not extend to personal/individual appointments, and cannot include lead generation activities.

48 Hour Cooling Off Period
Scope of Appointment (SOA) cooling off period – At an appointment, agents are not to discuss, leave enrollment documentation, or conduct marketing activity related to a healthcare product not previously identified and agreed upon by the consumer at the time the appointment was originally scheduled. If, however, the consumer requests the presentation of previously unidentified and agreed upon products, the agent must secure a new SOA and then can proceed with the discussion. If during an appointment the agent determines that a MA or PDP outside of the original SOA may be a better fit, the following would apply:

  • A future appointment may be scheduled to discuss the newly identified healthcare related product as long as the new appointment is no less than 48 hours in the future from the present appointment. A new SOA will need to be immediately obtained for the future appointment.
  • A new SOA form must be completed, signed by the consumer, and filed for the future appointment scheduled to discuss the newly identified healthcare related product.
  • An Enrollment Guide may be left with the consumer. No discussion or related marketing activity may be conducted.

Product Cross-Selling Marketing and/or selling non-healthcare related products during marketing activity related to Medicare Advantage or Part D is strictly prohibited. Discussion of non-healthcare related products initiated by a consumer at a personal/individual marketing appointment requires a separate appointment at least 48 hours later (but would not need a Scope of Appointment form).

Medicare Marketing Guidelines
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines.html

Why is this important? Using multiple forms of marketing can bring tremendous rewards, but it must be done compliantly. Compliance is put in place to protect Medicare beneficiaries and applied properly it does not hinder your ability to help your clients.


tmbubble Medicare and Medicaid Milestones 1937-2015

Understanding Medicare through looking at its history.
https://www.cms.gov/About-CMS/Agency-Information/History/Downloads/Medicare-and-Medicaid-Milestones-1937-2015.pdf

Why is this important? Watching the progress of Medicare can help you better understand the programs now in place and why they are important.


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