Compliance Essentials Worth Revisiting Before AEP

The rules around marketing materials, the CMS disclaimer, SOAs and call recording are easy to overlook between AEP seasons. Here’s a quick reset.

Use Only Approved Marketing Materials 

Only use materials that have been reviewed and approved according to CMS guidelines — you can typically find these through your broker portal, organized by plan and ready to use. If you want to incorporate a carrier’s logo or plan-specific information into your own materials, you’ll need prior carrier approval. 

Don’t Forget the Required CMS Disclaimer 

As a Third-Party Marketing Organization (TPMO), you’re required to include a CMS-mandated disclaimer on all marketing materials and websites, which is also spoken within the first minute of every sales and enrollment call. For most brokers, this means noting how many organizations and plans you represent in the beneficiary’s service area and directing them to Medicare.gov or 1-800-MEDICARE for additional options. For the most current disclaimer language, refer to the official CMS Medicare Communications and Marketing Guidelines (MCMG).

Remember to Get the SOA Signed First 

A completed Scope of Appointment (SOA) is required before discussing any plan details with a beneficiary. In most cases, the SOA should be collected at least 48 hours in advance of the appointment.

The 48-hour requirement may not apply to beneficiary-initiated interactions, such as walk-ins or inbound calls. Check with your BAE for guidance on SOA collection requirements in these situations.

Know Which Calls to Record 

Phone calls and virtual meetings that include marketing, sales or enrollment discussions should be recorded, whether inbound or outbound. Exceptions include appointment-setting calls, post-sale service calls (such as questions about ID cards) and in-person meetings. Store recordings in a HIPAA-compliant system and confirm current retention requirements with your BAE before AEP.

If you need help or have questions, contact your local BAE anytime:
Nathan Wirth 
586-601-7024
nathan.wirth@trinity-health.org