Marketing is always a great way to find new clients for Medicare Advantage plans. However, with everything that goes along with Medicare Advantage there are rules on how you can market those plans. One of the ways in which agents like to reach out to potential new clients is through events. There are two forms of presentations that an agent can take part in during the AEP and other times of the year to market to potential enrollees:
- Educational Events
- Marketing/Sales Events
An agent can hold Educational Events for potential or current Medicare beneficiaries or those representing Medicare beneficiaries (example: family members). Educational events are strictly designed to inform the people that attend about Medicare Advantage, Prescription drug, or other Medicare programs without going into the specifics of a particular carrier. Of course, there are more detailed guidelines to protect attendees from dealing with an unwanted sales presentation.
Guidelines for the Educational Event:
- Must be explicitly advertised as educational
- May be hosted in a public venue by the Plan/Part D sponsor or an outside entity
- May include communication activities and distribution of communication materials
- Communication is defined as clearly presenting information without containing any marketing content
Guidelines for the Agent at the Education Event:
- May answer beneficiary initiated questions
- May set up a future marketing appointment and distribute business cards and contact information for beneficiaries to initiate contact (this includes completing and collecting a Scope of Appointment form)
- Must NOT include marketing or sales activities or distribution of marketing materials or enrollment forms
- May NOT conduct a marketing/sales event immediately following an Educational Event in the same general location (example: same hotel)
In addition, if the Educational Event is organized by a plan sponsor then the following disclaimer must be used in all announcements: “This event is only for education purposes and no plan specific benefits or details will be shared.” This announcement is not required if the agent is not representing or being sponsored by a particular plan.
The purpose of a Marketing/Sales Event is to steer potential enrollees toward a particular plan or a limited set of plans. During the event, the agent is allowed to educate those who attend the Marketing/Sales Event about Medicare Advantage, Part D, and other Medicare programs which also makes the sales presentation an Educational Event. However, there are separate guidelines for the agent during a Sales Presentation.
Guidelines for a Sales/Marketing Presentation
- Sign in sheets must clearly be labeled as “optional”
- Health screenings or other activities that may be perceived as or used for “cherry picking” are not permitted
- Plans/Part D sponsors (agents representing one particular carrier) cannot require attendees to provide contact information as a prerequisite for attending an event
- Contact information supplied for raffles or drawings may ONLY be used for that purpose
- Agents representing a particular plan sponsor must use the CMS approved scripts and presentation provided By the Plan/Part D sponsor.
There are 2 types of Marketing/Sales Events:
- Formal: Structured in an audience/presenter style with the agent providing specific plan sponsor information
- Informal: The presenter or agent typically utilizes a table or kiosk to discuss the benefits of the Medicare Advantage or Part D products ONLY WHEN APPROACHED by a potential or a beneficiary of a potential enrollee
Formal Marketing/Sales Events Guidelines:
- The audience was previously invited to attend
- The audience can be comprised of current members of Medicare or Medicare Advantage and prospective members as well as those attending on behalf of a Medicare beneficiary
- Presenters must announce all products that will be covered at the beginning of the presentation
Informal Marketing/Sales Events Guidelines
- Cannot approach potential enrollees or beneficiaries of potential enrollees
- Discussing non-health care related products (such as annuities and life insurance) is considered cross-selling and is strictly prohibited.
Both Formal/Informal Event Guidelines:
- May hand out information including enrollment applications
- May collect enrollment applications at these events
- May formally present benefit information to the audience via a scripted talk, electronic slides, handouts, etc.
- May provide educational content to the audience or passersby
- May provide a nominal gift to attendees with no obligations. Nominal gift is defined as an item worth $15 or less.
- May NOT conduct health screening or other like activities that could give the impression of “cherry picking.”
- May NOT compare one plan sponsor to another by name unless both plan sponsors have concurred
- May NOT provide meals to attendees
Scope of Appointment Form:
If a beneficiary requests a one-on-one meeting then the beneficiary must fill out a Scope of Appointment form prior to the appointment. Scope of Appointment forms are not required during a Formal Marketing/Sales Event.
Contact the Carrier For Details:
CMS attempts to regulate the guidelines for Educational Events and Marketing/Sales Events with the use of Secret Shoppers. These are contractors of CMS that pose as Medicare beneficiaries to make sure the agent is staying compliant during their events. Typically the plan sponsor (carrier) requires the agent to report an upcoming Educational Event or Marketing/Sales Event. Please make sure to contact your carrier for complete details on how to properly register your event.
While there are plenty of rules for holding an Educational Event or Marketing/Sales Event, keep in mind CMS creates these guidelines to make sure the client is able to learn about their Medicare options with no pressure to purchase anything from the agent. If you want to know more about Marketing Medicare Advantage and Rx click here for our article reviewing the Dos and Don’ts.
Any Questions or Comments?
Feel free to leave a question or comments feel free to let me know in the comment section below. Or email me at firstname.lastname@example.org.
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/CY2019-Medicare-Communications-and-Marketing-Guidelines_Updated-090518.pdf (page 17 of 84)
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/downloads/R91MCM.pdf (more details)