The 2016 Medicare Marketing Guidelines (MMG) were released, dated 7/3/2015.  Senior Marketing Specialists highlights the top 5 agent focused changes (in no particular order):

Note: Red text indicates updated or added verbiage from 2015

  1. Section 30.3 Plan/Part D Sponsor Responsibility for Subcontractor Activities and Submission of Materials for CMS Review –

Note: The following types of materials do not need to be submitted into HPMS:

Materials, except for websites, that only indicate the products (e.g., HMO, PPO, or PDP) an agent sells. Plans/Part D Sponsors must submit agent/broker websites that reference specific MA/Part D products in HPMS.

(HPMS = Health Plan Management System)

What this means for agents:  If you have a flyer that mentions you sell MA or Part D plans, you can use them without running them through compliance as long as it follows all other MMG rules.  We can still run them through our compliance department if you would like to verify they are compliant.  However, your website will still have to be submitted for review if you mention MA or Part D plans, even if there is no plan specific information.

  1. Section 70.9.3 – Scope of Appointment

The documentation may be in writing, in the form of a signed agreement by the beneficiary, or a recorded oral agreement. Any technology (e.g., conference calls, fax machines, designated recording line, pre-paid envelopes, and email) can be used to document the scope of appointment.

What this means for agents: Agents can use email or a recorded conference call to document the SOA (Scope Of Appointment) form.

  1. Section 70.9.3 – Scope of Appointment

When conducting marketing activities, a Plan/Part D Sponsor may not market any health care related product during a marketing appointment beyond the scope that the beneficiary agreed before the meeting with that individual. The Plan/Part D Sponsor must document the scope of the agreement 48 hours prior to the appointment, when practicable. Distinct lines of plan business include MA, PDP and Cost Plan products. If a Plan/Part D Sponsor would like to discuss additional products during the appointment in which the beneficiary indicated interest, but did not agree to discuss in advance, the Plan/Part D Sponsor must document a second scope of appointment (SOA) for the additional product type to continue the marketing appointment.

What this means for agents: The “indicated interest” comment cleans up last year’s language to indicate the beneficiary has to express interest, rather than the agent assuming other lines of insurance or other products will be discussed.

  1. Section 100.6 – Social Media – This is a brand new section to the MMG. The first and one of the most relevant paragraphs for agents is:

Plans/Part D Sponsors must submit to HPMS social media (e.g., Facebook, Twitter, YouTube, LinkedIn, Scan Code, or QR Code) posts that meet the definition of marketing materials, specifically those that contain plan-specific benefits, premiums, cost-sharing, or Star Ratings.

What this means for agents:  If you are posting generic posts to social media (no benefits, premiums or other costs), you do not have to submit it to HPMS as long as it adheres to the rest of the MMG for advertising.

  1. Section Appendix 1 – Definitions – VAIS (Value Added Items and Services)

Value-Added Items and Services (VAIS) are items and services that are not plan benefits, are not part of the Plans’/Part D Sponsor’s benefit package and may not be marketed to prospective enrollees, or used as an inducement or incentive for enrollment. VAIS are non-Medicare covered services or items, typically discounts, offered by a VAIS provider to the enrollees of an MA plan. Note: VAIS information cannot be included in or bound with materials intended for prospective enrollees, or posted on parts of the website directed at prospective enrollees.

What this means for agents:  Agents cannot use VAIS to entice prospects to enroll into an insurance plan.  According to the language used, they will not be included in materials or websites accessible to prospective enrollees.

You can download the 2016 Medicare Marketing Guidelines for your reference & review: CMS MMG 2016 Dated 7_2_2015

Our compliance advice:  ask, don’t assume. 

If you have a question, please give Senior Marketing Specialists a call at (800) 689-2800