Medicare Presentations: How to Stay Compliant

Medicare agents should be preparing now for a busy AEP. It is anticipated there will be a lot of changes to Medicare plans for 2025. This is expected to create some turmoil in the marketplace causing many enrollees to shop for new plans. These enrollees will be looking for guidance on understanding their ANOCs and determining if they need to find a new plan for 2025.

This creates an opportunity for you to meet with your current clients as well as new prospects, many of whom may have never worked with a Medicare agent before. Hosting Medicare presentations in your community is an effective way to connect with people in a group setting. It’s not too early to start developing your marketing strategy for your presentations. Successful events require preplanning.

There are two distinct types of presentations, educational events, and sales events. CMS has strict compliance guidelines for each one, so you need to decide in advance what type of event you are holding. Here’s what you need to know:

Educational Events

The purpose of an educational event is to educate attendees on Medicare in general. You may not discuss specific plans, hand out plan materials or attempt to steer attendees to any particular plan or carrier. Unlike a sales event, you are not required to register an educational event with carriers or CMS

Before the Event

Book an appropriate venue – educational events must be held in a public meeting space.
Advertise your event – your event must be marketed as “educational” and must include the disclaimer: “For accommodations of persons with special needs at meetings call <phone number and TTY number>”
Pre-order marketing materials – you may hand out generic Medicare information on MA, Part D, or other Medicare programs.

At the Event

Do:

Hand out your business cards and generic business reply cards and encourage attendees to initiate contact with you after the event. Attendance at an educational event is not considered permission to contact.
Answer attendee questions but do not provide any additional information beyond what they ask.
Provide light snacks and beverages, as well as small giveaways as long as gifts do not exceed $15 per person.

Do Not:

Display a contact sheet or collect contact information
Discuss specific carrier plans or distribute information about specific plans
Provide or collect enrollment applications

Sales Events

The purpose of a sales or marketing event is to present specific Medicare plans and direct enrollees toward particular plans or carriers. There are two different types of sales events:

Informal: The agent, working at a booth, kiosk, or table, offers plan information only upon request when approached by attendees.

Formal: The agent presents plan specific information to an invited audience.

Before the event

Book an appropriate venue- sales events must be held in a public venue but cannot be held in proximity to places where individuals receive health care. They may be held in common areas such as lobbies or cafeterias. Remember you may not host a sales event within 12 hours of an educational event in the same building or an adjacent building.
Register your event with the appropriate carrier(s)- since carrier requirements vary, it’s important to know each carrier’s deadlines for registering an event. If you are comparing one carrier plan to another carrier plan you must get written consent from all carriers being discussed.
Advertise your event- you must Include the necessary TPMO disclaimer on any marketing materials as well as the disclaimer: “For accommodations of persons with special needs at meetings call <phone number and TTY number>”. You may not require attendees to provide any contact information in order to RSVP.
Prepare your presentation and pre-order any marketing materials- you must use only CMS approved presentations and talking points. Your carrier representatives may be able to provide these materials which will save you time and money. They may even be able to attend your event and assist with your presentation.

At the Event

Do:

Provide a sign in sheet as long as it clearly indicates that signing in is optional
Name all the products and plan types you will be discussing at the start of the event.
Hand out your business card and collect business reply cards
Collect enrollment applications if the enrollee has a valid election period
Collect SOA’s which must be specific to the type of plans you will be discussing and must be collected at least 48 hours in advance of meeting
Provide light snacks and beverages as well as small giveaways as long as gifts do not exceed $15 per person.

Do Not:

Request or accept referrals
Attempt to contact anyone who did not fill out an SOA or give explicit written permission to contact them.

What Happens if You Have to Cancel Your Event

If you have to cancel your event you should let attendees know as far in advance as possible. You should also notify the venue and submit a notice of cancellation to the carrier. If you are cancelling on short notice, you or another representative should be on site at the venue to inform any attendees who did not get word of the cancellation.