What are the guidelines for holding a Medicare sales event?
If marketing is your goal, you must hold and follow CMS’ guidelines for a Medicare sales event. As for the when and where, educational events may be held in a public venue. Under no circumstance should you hold them in in-home or one-on-one settings.
Can I host a Medicare educational event for enrollees?
Medicare educational events are an excellent way to gain the trust, and referral information, of enrollees in attendance. But before you host, present at, or attend an educational event for enrollees, there are some CMS guidelines (Medicare Communication & Marketing Guidelines, Section 50.1) you will have to follow.
How does Medicare determine date of last exposure or ingestion?
When a case involves continued exposure to an environmental hazard, or continued ingestion of a particular substance, Medicare focuses on the date of last exposure or ingestion to determine whether the exposure or ingestion occurred on or after 12/5/1980.
How do I find out if my insurance carriers allow in-person events?
We recommend asking this question to your state’s Department of Insurance, as well as the carriers you represent. The answer will depend on health of your state and counties, whether individuals attending are vaccinated or not, the restrictions of states and counties, and if your carriers are allowing in-person member events at this time.
What is a Medicare marketing event?
CMS definition - Marketing/sales events are events designed to steer, or attempt to steer, enrollees or. potential enrollees toward a plan or a limited set of plans.
What is considered by CMS to be a sales and marketing event?
What Does CMS Consider a Sales Event or Appointment? An activity will be considered a sales event or appointment if it is designed to persuade potential enrollees to choose a specific plan (or set of plans), according to CMS.
What events does an agent have to report to UnitedHealthcare?
What type of events must an agent report to UnitedHealthcare? Only the marketing/sales events, both formal and informal. While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address.
When must a marketing sales event be reported?
Report all marketing/sales events (including additional events reported throughout the month) prior to advertising the event or 10 calendar days prior to the event's scheduled date, whichever is earlier.
When must a marketing sales event be reported to United Healthcare?
It needs to be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the date of the event.
How are Medicare events categorized?
There are two types of sales events: formal and informal. Here's what sets them apart: Formal Sales Events: Agent presents plan-specific information to an audience invited to the occasion. Informal Sales Events: Agent offers plan info upon request only while at a table, booth, kiosk, or RV.
What is an educational event for Medicare?
An educational event is an event designed to inform Medicare beneficiaries about Medicare Advantage, Prescription Drug or other Medicare programs and does not include marketing/selling.
What is UnitedHealthcare's event cancellation reporting rules?
Event cancellations using this submission method must be submitted at least 6 business days before the event date. Advertised events cancelled less than 7 calendar days before the event date must send a UnitedHealthcare representative at the originally scheduled event date and time.
How Should agent Erin respond when consumer Mrs Rose notices?
How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 Stars? Erin should tell Mrs. Rose that the plan has received a "Below Average" rating.
What is bundling at a sales event?
Bundling is a marketing strategy where companies sell several products or services together as a single combined unit. The bundled products and services are usually related, but they can also consist of dissimilar items which appeal to one group of customers.
How long does it take to report a change of ownership?
Final adverse legal actions that are required to be reported by providers, suppliers and owners within 30 days include:
Do providers have to report changes to Medicare?
Providers, organizations, and suppliers enrolled in Medicare have a continuing duty to report changes in their enrollment information to Medicare . Reporting certain events can negatively impact your Medicare billing privileges, which is why it is important for an experienced attorney to help you prepare the report properly.
Who must report a claim to Medicare?
Reporting a Case. Medicare beneficiaries, through their attorney or otherwise, must notify Medicare when a claim is made against an alleged tortfeasor with liability insurance (including self-insurance), no-fault insurance or against Workers’ Compensation (WC). This obligation is fulfilled by reporting the case in the Medicare Secondary Payor ...
When does Medicare focus on the date of last exposure?
When a case involves continued exposure to an environmental hazard, or continued ingestion of a particular substance, Medicare focuses on the date of last exposure or ingestion to determine whether the exposure or ingestion occurred on or after 12/5/1980.
How to get BCRC contact information?
Contact information for the BCRC may be obtained by clicking the Contacts link. When reporting a case in the MSPRP or contacting the BCRC, the following information is needed: Beneficiary Information: Once all information has been obtained, the BCRC will apply it to Medicare’s record.
What is a BCRC letter?
If Medicare is pursuing recovery directly from the beneficiary, the BCRC will issue a Rights and Responsibilities letter and brochure. The Rights and Responsibilities letter is mailed to all parties associated with the case.
What is a rights and responsibilities letter?
The Rights and Responsibilities letter is mailed to all parties associated with the case. The Rights and Responsibilities letter explains: What happens when the beneficiary has Medicare and files an insurance or workers’ compensation claim; What information is needed from the beneficiary;
Does Medicare cover non-ruptured implants?
For non-ruptured implanted medical devices, Medicare focuses on the date the implant was removed. (Note: The term “exposure” refers to the claimant’s actual physical exposure to the alleged environmental toxin, not the defendant’s legal exposure to liability.)
Does Medicare cover MSP?
Medicare has consistently applied the Medicare Secondary Payer (MSP) provision for liability insurance (including self-insurance) effective 12/5/1980. As a matter of policy, Medicare does not claim a MSP liability insurance based recovery claim against settlements, judgments, awards, or other payments, where the date of incident (DOI) ...
When will CMS update the MCMG?
Note: CMS has released updates to the 2019 MCMG in the form of a memo in August 2019. Many of the guidelines from the 2019 MCMG, including the ones we just mentioned, as well as the updates from the 2020 MCMG memo, are still relevant for 2021.
Can you market Medicare plans?
During them, you cannot market specific plans. If marketing is your goal, you must hold and follow CMS’ guidelines for a Medicare sales event. As for the when and where, educational events may be held in a public venue. Under no circumstance should you hold them in in-home or one-on-one settings.
Can Medicare send secret shoppers?
Keep in mind, carriers may send secret shoppers to your educational events. If you violate CMS’ Medicare Communications and Marketing Guidelines, you could be subject to: Medicare beneficiaries need your expertise, and you need their trust and business.
Can you hold a virtual Medicare event?
The answer will depend on health of your state and counties, the lockdown or restrictions of states and counties, and if your carriers are even allowing in-person member events at this time. In some cases, you may be able to hold a compliant virtual Medicare educational event, but again, check with your carriers first.
What happens if you don't register an event with a carrier?
Furthermore, if you fail to register an event with a carrier, you could lose out on sales commission and have your contract revoked.
What is the responsibility of a carrier for a sales event?
Exact reporting deadlines and requirements vary from carrier to carrier, but carriers are responsible for maintaining accurate records of all their agents’ educational events and informal and formal sales events. The earlier you submit your events to carriers, the sooner you’ll be able to start advertising them.
What is sales event?
Sales events allow agents to try to direct potential enrollees or current members toward a plan or set of plans. Many marketing and lead-generating activities are allowed, but there are rules regarding the information you can collect. See what you can and cannot do at sales events below.
What are the two types of sales events?
There are two types of sales events: formal and informal. Here’s what sets them apart: Formal Sales Events: Agent presents plan-specific information to an audience invited to the occasion. Informal Sales Events: Agent offers plan info upon request only while at a table, booth, kiosk, or RV.
Do you have to disclose the products you plan on reviewing?
Additionally, you must include the following disclaimer on all advertisements and invitations for your event: “For accommodation of persons with special needs at sales meetings call <insert phone and TTY number>.”.
What are the two types of marketing events under Medicare?
There are two main types of Marketing/Sales events under Medicare regulations – Formal and Informal . 1- Formal marketing/sales events are typically structured in an audience/presenter style with a salesperson or plan representative formally providing specific plan sponsor information via a presentation on the products being offered.
Can educational events be advertised as sales?
Educational events ARE NOT marketing/sales events and can only be advertised as educational.
Is an educational event a sales event?
Educational events may not include any sales activities such as the distribution of marketing materials or the distribution or collection of plan applications. Educational events must be explicitly advertised as “educational,” otherwise they will be considered by CMS as sales/marketing events.
What is Medicare educational event?
Medicare educational events are an excellent way to gain the trust, and referral information, of enrollees in attendance. But before you host, present at, or attend an educational event for enrollees, there are some CMS guidelines (Medicare Communication & Marketing Guidelines, Section 50.1) you will have to follow.
Does CMS require educational events?
If you are hosting or reaching out to enrollees for an educational event, CMS requires you to explicitly market the event as “educational.”. Remember that an educational event does not include any of the following sales activities: Distributing marketing materials and any material with plan-specific information (such as plan-specific premiums, ...
How long before an event can you call Medicare?
If you do have permission, you may call to remind them at least 24 hours before the event.
What is a formal event for Medicare Advantage?
A formal event often requires that a full presentation is conducted for the Medicare Advantage carrier that you’re representing . Carrier protocols apply at formal events, so be sure you’re following the rules for the carrier that you’re representing.
What to do while conducting an event?
While conducting your event, be sure that you aren’t reading word-for-word from the presentation. It’s important to engage your audience and let them know that you are applying to be their agent. Remember, you only have one chance to make a first impression!
Can you give away a pen at Medicare Advantage?
Door prizes are not allowed at your formal Medicare Advantage events, however, giveaways are permis sible. Many agents will give away a pen or notepad. If you decide to have giveaways, you must provide them for every attendee at the event. Giveaways cannot exceed a $15 value per person.
