Holding an educational presentation is a fantastic way to grow your client base, but you must make sure to stay compliant.

The Centers for Medicare and Medicaid Services (CMS) have set forth rules on what you can and cannot do when holding events. We’ll cover the ones you need to know as we walk you through how to host a compliant educational event on Medicare.

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Establishing Your Event

If you’re planning on hosting an educational event, first, 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’s guidelines for a sales event.

Once you’re confident you’d like to inform, not sell, then you must determine your type of educational event: prospective enrollee or enrollee-only. There are certain actions you can take at an enrollee-only event that you cannot take at prospective-enrollee events. We’ll go into more detail on that below.

As for the when and where, these gatherings must be held in a public venue. Under no circumstance should you hold them in in-home or one-on-one settings.

Marketing Your Event

All educational events, even ones held at health fairs and expos, must be clearly marketed as “educational” to beneficiaries. Advertising methods depend on whether the event is for prospective enrollees or enrollees-only.

Prospective Enrollee Events:

You may advertise prospective enrollee educational events via most forms of marketing, including newspaper and radio ads, flyers, and direct mailers.

Enrollee-Only Events:

You may not advertise enrollee-only events through mass marketing channels, such as the newspaper or radio. Instead, you must utilize marketing methods that will only reach current enrollees, such as direct mailers.

Giving Your Presentation

Remember, at 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 and you’ll be golden.

Educational Event Do’s and Don’ts

Do’s Don’ts
Hand out objective educational materials on MA, Part D, and other Medicare programs Display a sign-in sheet or collect contact info (e.g., names, addresses, phone numbers) of attendees
Give your business card or contact info to any attendee who requests it Hand out materials that contain specific plan info (e.g., premiums, copayments, etc.)
Answer questions posed by attendees Give your business card or contact info to attendees who do not request it
Give away promotional items that include plan name, logo, toll-free number, and/or carrier website1 Attach your business card to educational materials
Provide meals, refreshments, or light snacks2 Answer questions beyond what attendees ask
  Give away money, gift certificates, gift cards, or anything with your contact info on it
  Provide or collect enrollment forms, Scope of Appointments, or permission-to-contact cards
  Discuss any carrier-specific plan or benefits or distribute plan materials UNLESS it’s an enrollee-only event
  Ask for or accept referrals
  Schedule a follow-up call or appointment with an attendee
  Give an educational presentation in a one-on-one situation
  Hold a sales event right after your educational event in the same general area (e.g., same building)

1,2Items must comply with CMS’ nominal gifts ordinances.

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’ Medicare Marketing Guidelines, you could be subject to:

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

Medicare eligibles and Medicare beneficiaries depend on health insurance agents like you to help them with what can be a confusing and complicated endeavor. They’re vulnerable, and regulations exist to ensure nobody leads them astray. Play it safe and you won’t be sorry.