OEP Do’s and Don’ts: Staying Compliant and Accurate This Enrollment Period

As OEP begins, let’s stay sharp. Review these quick compliance and accuracy reminders to ensure every enrollment is correct and complete.

Common Application Issues to Watch For

Accuracy is essential and even small errors can delay enrollment or create compliance risks. Please take extra care to verify the following details before submitting an application:

• Paper Submissions: We’ve noticed a significant rise in application issues with paper submissions. Using Connecture for enrollments greatly improves accuracy and helps ensure applications are processed correctly.
• Member Name: Confirm the member’s name matches their Medicare card exactly — including Sr., Jr. or middle initials when applicable.
• MBI Numbers: Ensure MBI numbers are entered correctly and belong to the correct member. Submitting another member’s MBI poses a serious compliance risk.
• Addresses & Phone Numbers: Double check if contact information is current and accurate.
• Counties: Spell out county names fully: do not abbreviate. This helps avoid processing delays and ensures accurate plan service area determination.

OEP Do’s 

• Market to age-ins eligible individuals approaching 65 who have not yet made an enrollment decision.
• Market to dual-eligible and low-income subsidy beneficiaries as they may make changes once per calendar quarter during the first nine months of the year.
• Provide educational materials or hold one-on-one meetings only upon the beneficiary’s request.
• Promote self-service tools and include general information about enrollment periods on your website, including OEP details.

OEP Don’ts 

• Do not send unsolicited materials advertising the ability or opportunity to make additional enrollment changes or referencing OEP.
• Do not target beneficiaries specifically because they made a change during AEP, as purchasing mailing lists or identifying this group is a compliance violation.
• Do not contact former enrollees who have chosen another plan during AEP.
• Do not engage in or promote activities that position OEP as a new sales opportunity as this period is for education, not solicitation.

Final Reminder

Your attention to detail and adherence to compliance standards protect both your clients and our organization. Taking a few extra minutes to verify data accuracy helps ensure seamless enrollments and a smooth OEP season for everyone involved.

If you need help or have questions, contact your local BAE anytime:

Michele Schatzberg
515-371-1027
michele.schatzberg@trinity-health.org