Hey there, fellow agents! We all know that life in the insurance world can be a whirlwind, especially during certification season and Annual Enrollment Period (AEP) preparations. This year, the uncertainty is at an all-time high, isn’t it? We’re all wondering how we’re going to market and sell, and what the future holds for our beloved customers.
But fear not, my friends! Here at Senior Benefit Services, Inc. we’ve got your back! So buckle up, because together we’re going to crush AEP this year.
When Does Everything Begin?
October 1st through the 14th is what we call the pre-enrollment period or the marketing period. This is when we can start marketing and we are allowed talk to our customers about potential changes in their plans for next year. You are also able to market to new customers. You cannot complete an enrollment and take the application with you to submit after AEP begins.
October 10th through December 7th is the Annual Enrollment Period (AEP). This is when we can start writing and submitting applications for Medicare Advantage and Part D plans.
What Steps Should You Be Taking?
There is a saying from Brian Tracy that goes something like this “You will never hit a target you can’t see!”
So how does this translate to the AEP? First, you need to make sure you have your goals set. Are your goals to write 100 new clients? Maybe you already have a large block of Medicare Advantage business and you want to focus on client retention. Have you established how you are going to engage with your existing clients to complete this?
Think of your goals as “the target” you are trying to hit!
Be Aware Of The Changes For This AEP
Educational Events
NEW: You may collect Business Reply Cards (BRC) or Permission To Contact (PTC) forms at the event, but you can no longer collect Scope of Appointment (SOA) forms.
NEW: You can no longer hold a marketing event in the same location (or nearby) immediately following the educational event. There must be at least a 12 hour window between the two events.
Marketing Updates
NEW: Mentioning benefits such as dental, vision, and hearing are now deemed to fall under the CMS Marketing Guidelines. Agents will no longer be able to discuss these benefits under the umbrella of being educational.
NEW: You are not allowed to include products, benefits, costs or premiums unless the Medicare Advantage carrier name is identified on the same material.
NEW: Using the word Medicare will now be under scrutiny. Things you should avoid:
- Any piece of direct mail that the beneficiary could possibly confuse as being from CMS. Example: title being “Medicare Notice” or “Confidential Medicare Information Enclosed”
- Marketing pieces that have an image of the red/white/blue Medicare card on it. This includes not only direct mail, but flyers or any other marketing pieces.
- URLs that include the term Medicare in them. An example would be cmsmedicarebenefits.com or www.medicareenrollment.com
- Having Medicare in the agency name such as Medicare Health Insurance Partners
- Using Medicare in a title such as {title=Medicare Advisor}. This includes everything including on business cards, email signatures, or advertising materials.
NEW: Permission To Contact forms will expire after 12 months. The exact date of expiration will be 12 months from the date the PTC form was signed and dated.
NEW: Agents cannot use comparison information that shows how a Medicare Advantage plan would provide savings. An example of this would be a comparison of MA vs uninsured individual or MA vs Original Medicare only.
Scope Of Appointment
NEW: 48 hour rule returns. The scope must be obtained a minimum of 48 hours before the meeting with a Medicare beneficiary. This includes face-to-face meetings, video calls (such as Zoom), or tele-sales.
There are currently 3 exceptions to the 48 hour rule:
- A Medicare beneficiary walks into your office without prior notice.
- Valid enrollment period is within 4 days of ending.
- Call-ins – while CMS has yet to include this in their regulations, most national insurance carriers have included this exception in their guidance.
Third Party Marketing Organizations (TPMOs) Disclaimer
As you are already aware, CMS includes agents as TPMOs. The former verbiage was “We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1-900-MEDICARE to get information on all of your options.”
This must now be replaced with the following:
- Agents that do not sell all carriers in a service area must use “We do not offer every plan available in your area. Currently we represent organizations which offer {number} products in your area. Please contact gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
- Agents that do sell all carriers in a service area must use “Currently we represent organizations which offer {number} products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”
Final Thoughts
While some of these new regulations are going to majorly impact some agents and organizations, it should help level the playing field. For too long many of the call centers have taken the attitude of “lets say what we need to for a sale” rather than focusing on the true needs of the consumer and what will be the best option for their health insurance needs. While most agents know that the majority of complaints filed to CMS come from consumers enrolled into Medicare Advantage plans by call centers, it still does not change that these new regulations will apply to them as well. To read the ruling located on the Federal Register you can click here. Also, with all the new guidelines, don’t forget about the old ones….including recording your sales calls. Let’s make 2024 a great Annual Enrollment Period (AEP)!