Rules for Hosting a Compliant Medicare Educational Event

Events are often a great way to generate leads. What is allowed at seminars for the 2024 Annual Enrollment Period?

The Centers for Medicare and Medicaid Services (CMS) have set forth rules on what you can and cannot do when holding Medicare education events.

We’ll cover these guidelines below.

Listen to this article:

The COVID-19 pandemic has led to numerous changes in our society: masks, hand sanitizer, social distancing, etc. While more events are being held, we still need to be cautious, especially with clients who have weakened immune systems and pre-existing conditions. Areas may still be restricting gatherings, so are Medicare educational seminars permitted for this AEP?

The answer is: It depends. States and counties are still affected by COVID differently, and therefore, are responding differently. 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. In some cases, you may be able to hold a compliant virtual Medicare educational event, but again, check with your carriers first.

Some retail sales programs may not be offered this AEP or will be offered with additional restrictions. Additionally, some carriers may make the decision to cancel in-person seminars for this AEP. If virtual meetings are not an option, you may have to explore other ways to help your prospective and current clients this AEP. We must all do our part right now to stay safe and protect each other from unnecessary health risks.

Establishing Your Event

Ready to start planning your event? Before you get too involved, make sure you review your motivation for putting on the presentation. Affairs like these serve to inform Medicare beneficiaries about Medicare Advantage, Part D, or other Medicare programs. 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.

What about a virtual Medicare event? Depending on the carrier and state, you may be able to compliantly hold a virtual education event for Medicare prospects or enrollees during the 2024 AEP. If you are holding a virtual presentation, you will need to choose an online platform (e.g., Skype, Zoom, Facebook Live), instead of a physical location, for your event. Your carriers will likely have specific rules for virtual events, so check with them first.

Looking for affordable ways to host workshops? Check out our budget-friendly T65 seminar tips and ideas

Promoting Medicare Educational Events

You can advertise these events via most forms of marketing, including newspaper and radio ads, flyers, and direct mailers. However, there are a couple guidelines you must follow when marketing educational events:

  • All educational events must be explicitly marketed as “educational” to beneficiaries.

  • Educational event advertisements and invitations must also contain the following disclaimer: “For accommodations of persons with special needs at meetings call <insert phone and TTY number>.”

When it comes to enrollee-only events, these may qualify as “marketing.” (Typically, enrollee-only events are held for a specific carrier’s current enrollees, and the intent is to retain the current enrollees in a plan.) Retention marketing or the mention of any benefits is considered “marketing”. Since enrollee-only events are conducted on behalf of a specific carrier, we would advise you to follow carriers’ guidelines to stay compliant.

Note: You can review the full Medicare Communications and Marketing Guidelines on CMS.gov and the Medicare Advantage and Part D Communication Requirements on the Federal Register site.

Giving Your Presentation

Remember, during educational events, your primary focus is to educate attendees. It is not to lead or attempt to lead attendees toward a specific plan or set of plans.

Follow the guidelines below to help ensure your compliance.

Educational Event Do’s and Don’ts

Do’sDon’ts
Hand out objective and generic educational materials on MA, Part D, and other Medicare programsDisplay a sign-in sheet or collect contact info (e.g., names, addresses, phone numbers) of attendees — this doesn’t constitute as permission to contact
Answer questions posed by attendeesHand out applications or marketing materials which contain specific plan info (e.g., premiums, copayments, etc.)
Provide generic business reply cards to attendeesAnswer questions beyond what attendees ask
Give out your business card and contact info for beneficiaries to use to initiate contactGive away cash or other monetary rebates
 Provide or collect SOAs and/or enrollment forms
 Discuss any carrier-specific plan or benefits or distribute marketing plan materials
 Give an educational presentation in a one-on-one situation
 Schedule future appointments
 Hold a marketing/sales event within 12 hours of the educational event in the same building or any adjacent buildings
 Lead or attempt to lead attendees toward a specific plan or set of plans

The Importance of Staying Compliant

CMS and carriers take compliance very seriously. We do too.

Keep in mind, carriers may send secret shoppers to your educational events. If you violate CMS guidelines, you could be subject to:

  • Administrative hearings
  • Administrative penalties
  • Cease and desist orders
  • License suspension or revocation

Read about the Medicare Advantage and Part D educational event compliance changes coming for 2024

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Medicare beneficiaries need your expertise, and you need their trust and business. As long as you follow the rules, there’s no reason why you and your clients can’t both benefit this AEP!

Editor’s Note: This post was originally published in May 2017. It has been updated to include information more relevant to the 2024 Annual Enrollment Period.

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