The Ultimate Guide to Certification and Medicare Compliance

✅ Do's

• Brush up on TPMO guidelines and oversight requirements. Be sure to include a TPMO disclaimer on all printed, co-op materials. You can contact your BAE to explore potential co-op advertisement opportunities.
• A general rule of thumb is to ensure you secure a Scope of Appointment (SOA) form prior to meeting with new enrollees. This allows you to schedule follow-up meetings for anyone that expressed interest via this formal documentation. Providing factual information, fulfilling a request for materials and taking demographic information to complete an enrollment application do not require the use of state-licensed agents or brokers.
• Call sales event attendees if they have given permission to follow-up. You must have documented permission to contact, like an SOA form.
• Be sure to provide an overview of all products and plan types offered prior to moving through a sales event presentation. Ensure you have event assets available for prospects prior to the start of the event, like enrollment form kits and/or plan comparison guides. Being prepared makes it easy to answer any of their questions before, during and after the presentation.
• Distribute branded giveaway items with your contact information to increase brand awareness and likelihood of a follow-up! Items must comply with CMS guidelines and what is defined as a “gift.”

🚫 Don'ts

• Inappropriate sales tactics are noncompliant and include incentives to enroll that ultimately pressure beneficiaries and lead to a bad experience. Always lead with facts first and avoid any superlatives, like “best” or “most” when discussing plan details.
• Discussing plan details or products without a previously submitted Scope of Appointment (SOA) form is noncompliant. An SOA is required to protect beneficiaries’ best interests. It ensures that upon meeting, only what the beneficiary wants to explore is discussed.
• Holding consecutive sales events at the same location or adjacent locations is not allowed. There must be at least 12 hours between each Marketing/Sales event held at the same location or campus.
• Cross-selling or promoting any products that are irrelevant to the plan is not allowed. You also can’t compare external carriers to each other without obtaining prior consent from all involved or without having data to back up the comparisons. i.e., you can’t distribute booklets for a different health plan while presenting for another, unless explicit approval is given.
• Cash or anything else of monetized value cannot be given away in association with or on behalf of the plan.

Questions? 

Contact your local BAE or reference the Medicare Communications and Marketing Guidelines (MCMG) to learn more.