2019 has some big changes to the Medicare rules, including now calling them the Medicare Communications and Marketing Guidelines (as opposed to the Medicare Marketing Guidelines).
3 Major changes quick review:
- You can now email market to unsolicited contacts
- Open Enrollment Period is back but you cannot advertise it
- Agents can set appointments and distribute business cards/contact info at educational events
Below are some key areas for agents to know going into AEP and beyond:
40.2 – Marketing Through Unsolicited Contacts
Plans/Part D Sponsors may make unsolicited direct contact with potential enrollees using the following methods:
- Conventional mail and other print media (e.g., advertisements, direct mail)
- Email provided all emails contain an opt-out function
Plans/Part D sponsors may not:
- Use door-to-door solicitation, including leaving information such as a leaflet or flyer at a residence;
- Approach potential enrollees in common areas (e.g., parking lots, hallways, lobbies, sidewalks, etc.); or
- Use telephonic solicitation, including leaving electronic voicemail messages.
Note:
- Agents/brokers who have a pre-scheduled appointment with a potential enrollee who is a “no-show” may leave information at that potential enrollee’s residence.
- If a potential enrollee provides permission to be contacted, the contact must be event-specific, and may not be treated as open-ended permission for future contacts.
40.3 – Marketing Through Telephonic Contact
Plans/Part D sponsors and their agents/brokers may not make unsolicited telephone calls to prospective enrollees. However, they are permitted to contact their current enrollees to discuss plan business, but cannot market prior to October 1 under the pretense of plan business.
40.7 Prohibition of Open Enrollment Period Marketing
During the OEP, Plans/Part D Sponsors may not:
- Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP
- Specifically, target beneficiaries who are in the OEP because they made a choice during Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification
- Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
- Call or otherwise, contact former enrollees who have selected a new plan during the AEP
50.1 – Educational Events
May set up a future marketing appointment and distribute business cards and contact information for beneficiaries to initiate contact
110.2 – Permitted Agent Activities
Permitted activities include, but are not limited to:
- Conducting sales presentations;
- Holding one-on-one sales appointments with potential enrollees;
- Providing business reply cards at educational events;
- Creating and distributing communication materials. As outlined in section 90.1, broker-created communications do not require a material identification number;
- Distributing marketing materials as long as CMS has accepted/approved those materials as submitted through the Plan(s)/Part D sponsor(s) with whom the broker contracts; and
- Using CMS-created materials provided the materials are not modified in any way.
Download the full Medicare Communication and Marketing Guidelines:
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/FinalPartCMarketingGuidelines.html