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Disclaimers and Recording Rule Speculation

CMS marketing guidelines

May 24, 2022 by Lance Hoeltke

Plan Advisors understands that the buzz around disclaimers and the recording rule speculation surrounding each and every enrollment is ever-present. In fact, we continue to receive more guidance on what creating compliant marketing materials should look like and how to do it. With all of the new information we continue to receive, we feel it is worth mentioning. 

The following disclaimers are, in fact, final and required for all marketing materials from this point forward. So, how do we know what disclaimers apply to us and what disclaimers are necessary? Humana has created a spectacular guide that you can view here.

Marketing or Communication Disclaimers?

Marketing. The commercial’s intent is to draw the beneficiary to a Medicare Advantage plan(s) since name-specific plans remain unacknowledged. The content addresses plan premium, cost-sharing, and benefit information for plans represented and sold by the third party.

Let’s Break it Down…

It is important to note that if your material aligns with what marketing is, then these additional disclaimers apply: 

  • Federal Contracting Statements must be present on all “marketing” materials, except banners, banner-like advertisements, outdoor advertisements, text messages, social media posts, and envelopes.
    • Example Text: “Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.”
  • Third-Party Marketing Disclaimers must exist on all third-party websites, marketing materials, and television/radio advertisements that meet the definition of “marketing”. (Note: For those that truly offer every option in a service area, this disclaimer is not imperative.)
    • Required Text: “We do not offer every plan available in your area. Any information we provide is limited to those plans that we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”
  • Benefits Disclaimers apply if plan benefits include additional coverage (i.e. Dental, Vision, Hearing, OTC, Transportation, Fitness, etc.).
    • Example Text: “Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays and coinsurance may apply.”
  • Part B Give-Back Disclaimers must be present on all materials when Part B give-back info is written.
    • Required Text: “Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reductions vary.”
  • When mentioning STAR Ratings Disclaimers, it is necessary to convey that Medicare performs yearly evaluations, and that a 5-star rating system is active.
    • Example Text: “Every year, Medicare evaluates plans based on a 5-star rating system.”

Recording Rule Speculation

At Plan Advisors, we want to emphasize that the rumors surrounding recording every meeting and enrollment is simply a proposed rule. It is up for discussion and open for comment. Additionally, the Medicare industry will receive more guidance on this information within the next few weeks. The National Association of Health Underwriters (NAHU) and American Political Advocacy and Trade Association of Health Insurance Companies (AHIP) are actively working to ensure that this exists solely for call centers instead of the on-the-go agent.

It is important to note that we will continue to update our brokers as we move forward and learn more of the final decisions surrounding the changes to marketing disclaimers and the recording rule speculation surrounding each and every enrollment.

Filed Under: AHIP, CMS, CMS marketing guidelines, Humana, Marketing, marketing materials Tagged With: AHIP, CMS, CMS Guidelines, Disclaimers, Marketing, Medicare Industry, NAHU

November 18, 2014 by Lance Hoeltke

[Read more…] about Special Election for Medicare Advantage Clients on the Move

Filed Under: Bishop Marketing Agency, Change of Residence, CMS marketing guidelines, Humana MAPD plan, Humana Medicare Agents, MAPD and PDP membership, MAPD enrollment, Medicare Annual Enrollment Period, Medicare Beneficiaries, Medicare choices, Medicare election periods, Medicare options, PDP enrollment, Selling, selling Medicare Advantage Plans, Service

May 22, 2014 by Lance Hoeltke

Answers about enrolling Veterans with Medicare outside of the Annual Election PeriodWe often get questions relating to the enrollment of Medicare eligible veterans outside of the Annual Election Period.  In short, veterans are treated just as any other Medicare eligible person.  There are a few things to note, however, when working with a veteran who is Medicare eligible.  Here’s a short list of things to consider when helping veterans make an informed decision about Medicare Advantage enrollment:

[Read more…] about Veterans and Medicare Plan Enrollment

Filed Under: CMS guidelines, CMS marketing guidelines, HMO, Humana, Humana MAPD plan, Humana Medicare Agents, Humana Medicare Plans, Humana’s Medicare health plans, MAPD and PDP membership, MAPD enrollment, Marketing Humana Medicare Plans, Medicare Advantage, Medicare Annual Enrollment Period, Medicare Beneficiaries, Medicare choices, Medicare Health Plans, Medicare options, PDP, PDP enrollment, Selling, Veterans and Medicare

August 12, 2013 by Lance Hoeltke

Statistically, the number of Humana’s MAPD/PDP enrollments that result in an allegation against an agent is just a small fraction of a single percent.  The number of allegations that are founded as a result of investigation are just a fraction of allegations themselves, which is outstanding.  Here are my root cause reasons for these strong compliance outcomes:

[Read more…] about A Couple Bad Apples Cause Excessive Re-certification Work for All

Filed Under: AEP, certifications, CMS, CMS guidelines, CMS marketing guidelines, Humana, Humana Medicare Agents, Humana Medicare Plans, MAPD enrollment, Marketing Humana Medicare Plans, Medicare legislation, selling Medicare Advantage Plans, Service

October 10, 2012 by Lance Hoeltke

book of business, client protection, Medicare income stream

 

During the Annual Enrollment Period, it’s easy to get caught up in growing your book of business and increasing that residual income stream. Make sure that your pursuit of new business does not cost you what you’ve already found.

 

If it’s been too long since you’ve reached out to that client you wrote on a Medicare Advantage Plan three years ago, you may want to consider giving them a call. Ask them if they have taken a look at the 2013 benefits for their current plan. Ask them if they’d like you to review it with them. Is there a new plan in their coverage area that will better fit their needs? Are they even interested in looking?

important reasons to protect your Medicare business

Whatever the answer, remember that by reaching out you are accomplishing some important things:

1) You are letting your client know that you’re still in the business of helping and guiding them.

2) You are protecting your book of business.

3) You are protecting your residual income stream.

 

This process may seem obvious to the veteran agent. But even the most seasoned insurance salesperson can get a little comfortable and start to take their loyal book of business for granted. When you’re thinking about how to fill your time leading up to (and during) AEP, remember that those clients you helped three and four years ago still have eyes and ears. They still have mailing addresses that are being bombarded with offers from other plans and agencies. They still have TV sets advertising the latest and greatest in Medicare coverage options. A simple phone call or 15 minute appointment could ensure that your client remains your client.

Filed Under: AEP, CMS marketing guidelines, get more Medicare leads, MAPD and PDP membership, MAPD enrollment, Medicare AEP, Medicare Annual Enrollment Period, Medicare Beneficiaries, Medicare lead generation, Service

October 4, 2012 by Lance Hoeltke

As you know, selecting the correct election period for your client when facilitating an MAPD enrollment is an important step toward ensuring the beneficiary’s enrollment form is processed for their proposed effective date. For 2013, there is a change in guidance of when to use IEP vs. ICEP. Let’s take a closer look…

[Read more…] about New rules regarding when to use the IEP vs ICEP election code

Filed Under: CMS marketing guidelines, ICEP, ICEP election period, IEP, IEP election period, IEP vs ICEP, IEP2, MAPD, MAPD and PDP membership, Medicare election periods, Selling, Service

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