How to Get Opt-In Authorization for Nonhealth Information


Cross-selling other products such as life or final expense insurance to your existing Medicare clients is a great way for brokers to grow their business. But before you send any emails or brochures about nonhealth-related products or information to your current enrollees, make sure you have their permission in the form of an opt-in, or Scope of Appointment.

What Is Considered Nonhealth or Nonplan Information?

Nonhealth and/or nonplan information may include brochures, fliers, or emails about products such as annuities or life insurance policies. If you sell these types of products in addition to Medicare and want to send your current enrollees information about them, you must have the enrollee’s authorization first. Nonhealth information may also include topics such as volunteer or community activities and pending state or federal legislation that could impact the enrollee (MMG, Section 160.2).

Do You Need an SOA to Discuss Nonhealth-Related Information?

Yes. Brokers may only discuss nonhealth-related information with a Medicare enrollee if their permission has been documented through an opt-in, or SOA. Brokers may not discuss nonhealth-related plans, products, or information during a Medicare appointment.

Let’s say you’re meeting with a current Medicare enrollee to review their plan and needs. During the appointment, the conversation naturally progresses to the topic of life insurance, and your client asks about life insurance policies, which you also sell. At this point, you should redirect the conversation back to Medicare, since that is what was outlined in the meeting’s SOA. But, before ending the Medicare appointment, you can have your client sign a separate SOA, or opt-in, for a later appointment date, where you may discuss life insurance, a nonhealth-related product.

How Can Brokers Get Opt-In Authorization From Current Enrollees?

There are several different ways brokers can receive an enrollee’s opt-in authorization (MMG, Section 160.3).

  • Direct Mail: Brokers may send, at their own expense, written authorization forms to their current enrollees.
  • Email: Enrollees can email their opt-in authorization to the health plan (the insurance company, not the agent). The email must include the enrollee’s electronic signature.
  • Via a Website: You can direct enrollees to a website to give their permission. Once a beneficiary “opts in,” it must be made clear that the enrollee will receive additional information that may be nonplan- or nonhealth-related. The link must inform the beneficiary that they are leaving the Medicare product website and being taken to a non-Medicare product website.
  • In Person: Enrollees can give brokers their opt-in authorization while at marketing events, health fairs, or other public venues.
  • Over the Phone: The call must be an enrollee-initiated inbound telephone call, and the authorization must be recorded.

Where Can a Broker Include an Opt-In Authorization Form?

There are a two instances in which a broker may include an opt-in authorization form in mailings.

  • Plan- or health-related mailings. However, brokers may not include a request for opt-in authorization on the enrollment form. This applies to direct mail and email.
  • Nonhealth-related mailings. Before sending this type of information through direct mail or email, you must already have the targeted enrollee’s permission to do so. For example, do not send an authorization form that enables you to send information about life insurance with information about a life insurance policy. The authorization form must be sent first. You cannot send these materials together at the same time because you do not yet have permission to send information about life insurance.

Do Brokers Need Separate Agreements for Different Types of Information?

Yes. If seeking authorization through a written form or online, include a checkbox for each general category (e.g. life insurance, long-term care insurance, vision insurance, etc.). This can be accomplished over the phone as well. This information should be described in general terms; you may not use specific plan types.

Do Brokers Need to Keep Records of Client Opt-In Authorization?

Yes. Brokers should keep evidence of their client’s opt-in authorization for audit purposes, according to Centers for Medicare & Medicaid Services (CMS) rules (MMG, Section 160.3). This evidence may include:

  • Written forms an agent gathers from public venues such as a marketing event or health fair.
  • Recorded authorization from a client-initiated phone call.
  • Authorization sent through email that includes the client’s electronic signature.

Where Can I Get More Medicare Marketing Guidance?

Excelsior’s resource center is available 24/7 to give you the help you need with Medicare guidelines, sales advice, and more to keep your business on track. Learn how the Excelsior team can double, or triple, your income by contacting us.


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References
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/CY-2018-Medicare-Marketing-Guidelines_Final072017.pdf

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