Insurance companies and agents are tasked with remaining compliant with the Centers for Medicare & Medicaid Services (CMS) while marketing their services. It makes sense on the surface, but the details may need some clarifying.
When getting creative with marketing materials, agents still have to be mindful of how they’re representing themselves as it pertains to the Medicare Advantage & Part D Communication Requirements. In 2022, CMS created new requirements for agents and brokers, who are now considered third-party marketing organizations (TPMOs). While the biggest change is that agents and brokers will now have to record all Medicare sales calls in their entirety including the Scope of Appointment (SOA) and plan presentation, there are other TPMO requirements that will affect your marketing.
We’ve put together a few common compliance questions and answers to help you nevigate these requirements.
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Q: First, what’s required of agents before engaging in Medicare marketing or sales?
A: CMS states that only agents who are licensed, certified, or registered under state law are permitted to market an insurance company’s Medicare Advantage or prescription drug plans. Agents are also required to complete the insurance companies’ annual mandatory certification processes for the carriers they wish to represent. Only after an agent is trained and certified to understand the rules, regulations, and specific Medicare product details can a carrier confirm an agent’s ready-to-sell status.
Q: What’s required of an agent to become certified?
A: For each carrier an agent plans to market, the agent must complete that company’s annual certification process. It’s important to check with each company’s specific requirements, as processes may vary. Each company may also have a different notification method to inform an agent that they’re ready-to-sell, so checking on their specified system for confirmation is best. Ritter’s Certification Center can help to navigate some of these companies’ requirements.
Q: How can I easily record calls with my Medicare clients?
A: RIMdev, our in-house development team, produced a solution to securely record and store outbound marketing calls from a client’s record in the Ritter Platform, as well as any inbound calls received to your own unique phone number generated through the Platform. You can start preparing for CallVault by loading phone numbers for all of your clients who will receive benefit reviews into the Clients tab of the Platform.
Q: How do I keep my marketing materials compliant with the new TPMO requirements?
A: Agents must add this TPMO disclaimer to email communications, their website, print materials, other marketing materials, and within the first minute of sales call if marketing fewer than all plans available in a geographical location:
“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 1-800-MEDICARE to get information on all of your options.”
You must also provide the disclaimer when communicating electronically with a beneficiary through email, online chat, or other means of communication.
Q: While running a website, can I reference a Medicare Advantage plan’s marketing materials and the trademarks of the companies I represent?
A: Agents cannot reference a specific Medicare Advantage or prescription drug plan’s marketing materials or use an insurance company’s trademark on their site. When a plan-specific or company-specific reference is used regarding a Medicare plan, it’s considered that company’s marketing material. It’s like forging a signature or fabricating a quote. If it wasn’t approved or provided by the company, it’s not OK to use it. Additionally, if an agent wants to reference any Medicare Advantage plan information or the insurance company logo on their website, the agent must work with the specific insurance company to obtain their prior approval.
Q: Can I reference Medicare Advantage or prescription drug plan info on direct mail marketing material?
A: No, for the same reasons specified in the answer to the previous question. Any time a plan-specific reference is made on marketing materials, it’s considered that company’s materials. CMS does allow brand promotion, but not specific product references, and prior approval of using the carrier’s logo or name is required. It is possible, though, to use a specific company’s pre-approved marketing materials. Note that generic direct mail marketing material without any plan or company-specific information does not require prior approval, provided all other marketing guidelines are met.
Q: When should I avoid using “Medicare” on my marketing materials?
A: According to Section 1140 of the Social Security Act, it’s forbidden to use the words or symbols including “Medicare,” “Centers for Medicare & Medicaid Services,” “Department of Health and Human Services,” or “Health & Human Services” in a way that would indicate the approval, endorsement, or authorization of Medicare or any other government agency. Additionally, agents shouldn’t use the word “Medicare” on their business card in any fashion that suggests they represent Medicare, like putting the words “expert,” or “specialist” behind it.
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