Rules for Hosting a Compliant Medicare Educational Event

While events are often a great way to generate leads, holding Medicare educational events during the COVID pandemic is a legal and ethical grey area. What is allowed at seminars for the 2021 AEP?

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The Centers for Medicare and Medicaid Services (CMS) have set forth rules on what you can and cannot do when holding Medicare education events. We’ll cover these guidelines below.

Can Agents Hold Medicare Educational Events During COVID-19?

The spread of COVID has led to numerous changes in our society: masks, hand sanitizer, social distancing, etc. Many areas are restricting gatherings as well, so are Medicare educational seminars even permitted during the current pandemic?

The answer is: It depends. States and counties have been affected by COVID differently, and therefore, have responded differently. We recommend asking this question to your state’s Department of Insurance, as well as the carriers you represent. The answer will depend on health of your state and counties, the lockdown or restrictions of states and counties, and if your carriers are even allowing in-person member events at this time. In some cases, you may be able to hold a compliant virtual Medicare educational event, but again, check with your carriers first.

Some retail sales programs will not be offered this AEP or will be offered with additional restrictions. Additionally, some carriers have already made the decision to cancel in-person seminars for this AEP. If virtual meetings are not an option, you may have to explore other ways to help your prospective and current clients this AEP. We must all do our part right now to stay safe and protect each other from unnecessary health risks.

Wondering if you need to wear a mask or set out hand sanitizer for appointments? Can you ask your clients COVID-screening questions or check their temperatures before meeting? We answer these questions and more in our post on how to sell Medicare during COVID and AEP

Establishing Your Event

Have you found out you can still host a Medicare educational event? Then, it’s time to start planning it. Before you get too involved, make sure you review your motivation for putting on the presentation. Affairs like these serve to inform Medicare beneficiaries about Medicare Advantage, Part D, or other Medicare programs. During them, you cannot market specific plans. If marketing is your goal, you must hold and follow CMS’ guidelines for a Medicare sales event. As for the when and where, educational events may be held in a public venue. Under no circumstance should you hold them in in-home or one-on-one settings.

What about a virtual Medicare event? Depending on the carrier and state, you may be able to compliantly hold a virtual education event for Medicare prospects or enrollees during the 2021 AEP. If you are holding a virtual presentation, you will need to choose an online platform (e.g., Skype, Zoom, Facebook Live), instead of a physical location, for your event. Your carriers will likely have specific rules for virtual events, so check with them first.

Promoting Medicare Educational Events

You can advertise these events via most forms of marketing, including newspaper and radio ads, flyers, and direct mailers. However, there are a couple guidelines you must follow when marketing educational events:

  • All educational events must be explicitly marketed as “educational” to beneficiaries.

  • Educational event advertisements and invitations must also contain the following disclaimer: “For accommodations of persons with special needs at meetings call <insert phone and TTY number>.”

CMS used to have rules on how agents had to promote and present prospective enrollee educational events and enrollee-only educational events; however, these were absent in their 2019 Medicare Communications and Marketing Guidelines (MCMG). We believe that, based on the 2019 MCMG definitions of marketing and communications, the intent to hold an enrollee-only event may qualify as “marketing.” (Typically, enrollee-only events are held for a specific carrier’s current enrollees, and the intent is to retain the current enrollees in a plan.) Since enrollee-only events are conducted on behalf of a specific carrier, we would advise you to follow carriers’ guidelines to stay compliant.

Note: CMS has released updates to the 2019 MCMG in the form of a memo in August 2019. Many of the guidelines from the 2019 MCMG, including the ones we just mentioned, as well as the updates from the 2020 MCMG memo, are still relevant for 2021.

Giving Your Presentation

Remember, during educational events, your primary focus is to educate attendees. It is not to lead or attempt to lead attendees toward a specific plan or set of plans.

Follow the guidelines below to help ensure your compliance.

Educational Event Do’s and Don’ts
Do’s Don’ts
Hand out objective educational materials on MA, Part D, and other Medicare programs Display a sign-in sheet or collect contact info (e.g., names, addresses, phone numbers) of attendees — this doesn’t constitute as permission to contact
Give away promotional items (that aren’t considered marketing materials) that include plan name, logo, toll-free number, and/or carrier website1 Hand out applications or marketing materials which contain specific plan info (e.g., premiums, copayments, etc.)
Answer questions posed by attendees Answer questions beyond what attendees ask
Provide meals, refreshments, or light snacks2 Give away cash or other monetary rebates
Provide generic business reply cards to attendees Provide or collect enrollment forms
Give out your business card and contact info for beneficiaries to use to initiate contact (includes completing and collecting a Scope of Appointment) Discuss any carrier-specific plan or benefits or distribute marketing plan materials
Schedule marketing appointments Give an educational presentation in a one-on-one situation
1,2Items must comply with CMS’ nominal gifts ordinances.

According to the changes set forth by CMS in the 2020 MCMG memo, we believe that agents may conduct a sales event or marketing appointment immediately after an educational event, even in the same location if they’d like. We also interpret this to mean that agents can collect SOAs and take applications after an educational event has concluded.

The Importance of Staying Compliant

CMS and carriers take compliance very seriously. We do too.

Keep in mind, carriers may send secret shoppers to your educational events. If you violate Medicare Advantage & Part D Communication Requirements, you could be subject to:

  • Administrative hearings
  • Administrative penalties
  • Cease and desist orders
  • License suspension or revocation

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Medicare beneficiaries need your expertise, and you need their trust and business. While COVID is changing the Medicare landscape, you will likely be able to hold Medicare educational events in some capacity this AEP — in-person or online. Those events will just look a little differently and so will the rules. As long as you follow them, there’s no reason why you and your clients can’t stay healthy and both benefit this AEP!

Editor’s Note: This article was originally published in May 2017. It has been updated to include information more relevant to the 2021 Annual Enrollment Period.

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