How to Follow CMS Rules for Enrollee-Only Educational Events


Want to teach your current Medicare enrollees about next year’s plan offerings? You might consider hosting an enrollee-only educational event. But before you send out the invites, review these CMS guidelines (MMG, Sections 70.8 and 70.8.1) about what you can (and can’t) do during the event. And remember: the guidelines for activities at sales events and appointments, and educational events for potential enrollees differ.

What Does CMS Allow at Enrollee-Only Educational Events?

At an educational event with existing enrollees, discussing information specific to a certain plan isn’t considered a sales activity. So you can discuss (or present) plan-specific details, such as benefits and premium amounts, without having to follow sales activity guidelines. If you are presenting at the event, you can include specific information in your slides. You can also distribute materials (such as pamphlets and fliers) with plan-specific information.

What Does CMS Prohibit at Enrollee-Only Educational Events?

Brokers are not permitted to conduct enrollment at any educational event, including those for existing enrollees. Enrollment activities include handing out plan applications, collecting plan applications, and conducting online enrollments. Sales activities (such as handing out plan-specific information) are usually prohibited at educational events; existing-enrollee educational events are the only exception.

Brokers are not permitted to market during an educational event. So you can present plan-specific information at these events, but you cannot advise enrollees to pick a certain plan or set of plans. Any conversation that persuades, or attempts to persuade, enrollees to pick a certain plan or set of plans is prohibited.

Additionally, you cannot host an educational event in-home or with only one person. The event must be in a public venue with more than one existing-enrollee attendee.

Finally, the event must be explicitly advertised as “educational.” This is true for all educational events. Plus, the explicit label helps enrollees understand the purpose of the event. If you do not advertise the event as educational, it will be considered a sales or marketing event and will have to follow different guidelines.

What Else Do the CMS Guidelines Say?

To find more of the CMS Medicare Marketing Guidelines, visit our online resource center. And to learn more about the Excelsior team and how we can help you, contact us.

 

Source: https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/2017MedicareMarketingGuidelines2.pdf

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