When does OEP run
What is Jan 1 thru March 31
What is considered a common area in a healthcare setting
Common areas in a healthcare setting include, but are not limited to common entryways, vestibules, waiting rooms, hospital or nursing home cafeterias, and community, recreational, or conference room
What is the maximum cost a giveaway can be
What is $15
When asking for referrals what information can you request
Ask for referrals from current enrollees/members ‐ names and mailing addresses ONLY.
What can you not do when working a Table Top
DO NOT Approach individuals in common or public areas such as, but not limited to, parking lots, sidewalks, hallways, lobbies and restaurants.
DO NOT Call or approach a beneficiary without the beneficiary initiating the contact.
What can be done during OEP
What is make Like Plan changes or Disenroll from a MA Plan and go back to original Medicare and enroll in a stand alone Drug Plan
What is considered a Restricted Area
Restricted areas generally include, but are not limited to: exam rooms, hospital patient rooms, treatment areas where patients interact with a provider and his/her clinical team and receive treatment (including dialysis treatment facilities), and pharmacy counter areas (where patients interact with pharmacy providers and obtain medications).
What is the total cost a person can receive in giveaways for the year
What is $75
What are some of the rules under unsolicited contact. What can you not do
DO NOT Initiate any unsolicited outbound calls to beneficiaries.
DO NOT Call/visit beneficiaries after attendance at a sales event, unless the beneficiary gives express permission at the event for a follow‐up or visit and has completed a Scope of Appointment (SOA) form.
DO NOT Conduct unsolicited phone calls to beneficiaries (other than to current plan members or to an agent’s existing clientele).
DO NOT Conduct or allow unsolicited marketing calls to beneficiaries for other business (for example, a “benefits compare” meeting) and then provide those contacts to other plans for ultimate use in a MA or PDP sales appointment.
DO NOT Begin by selling a Medicare Supplement plan and then turn the conversation to MA or PDP products without the beneficiaries expressed request.
Can you use ANY CTC card that is signed and dated
DO NOT Use outdated consent forms to contact beneficiaries. Permission to contact is required to be product and event specific and cannot be treated as open‐ended permission for future contact.
What marketing activities can you do during OEP
• Send marketing materials when requested by a beneficiary • Conduct sales meetings IF requested by beneficiary (Note: Watch-out of “leading” bene to such request) • Provide information and respond to Questions on the OEP when asked • Market to individuals aging into Medicare (i.e. “Age-ins”), LIS and dual-eligible beneficiaries
What sales activities can you conduct in a healthcare setting
sales presentations, the distribution of marketing materials, and the distribution and collection of enrollment forms in common areas of a healthcare setting
True or False Gifts can be given in the form of cash or something that can be redeemed for cash
False
Nominal gifts may not be in the form of cash or other monetary rebates
Gift Cards are in a very grey area
Can You accept an appointment from a third party lead that was unsolicited
NO
DO NOT Accept an MA or PDP appointment from a third party lead that resulted from an unsolicited contact with a beneficiary.
How Does CMS define Marketing
CMS defines Marketing as the act of steering, or attempting to steer, a potential enrollee (prospect) towards a plan or limited number of plans, or promoting a plan or a number of plans
What marketing activities are restricted during OEP
Contact former members who made a decision during AEP
Promote or engage in agent activities that intend to use this OEP as an opportunity to make further sales
Send unsolicited marketing material advertising the MA OEP or additional opportunities
Target beneficiaries who made changes during AEP. This includes purchasing mailing lists of such individuals and marketing to those individuals
Call or otherwise contact former enrollees who have selected a new plan during the AEP.
True or False CMS allows agents to schedule appointments in long term care facilities
TRUE :CMS permits Plans/Part D sponsors to schedule appointments with residents of long-term care facilities (e.g., nursing homes, assisted living facilities, board and care homes) upon a resident’s request. If a resident did not request an appointment, any visit by an agent or broker is considered unsolicited door-to-door marketing.
Name a scenario where the giveaway exceed the $15 limitation
ex: Raffle where you may have numerous people there
Can you enroll someone making outbound calls telephonically
No
Enroll a beneficiary if the beneficiary makes a request to enroll via an inbound phone call
When it comes to marketing material (Brochures) What are some restrictions That can impact what we put out
DO NOT Use materials that have not been approved by CMS and WellPoint.
DO NOT Use materials that are out of date. DO NOT Alter anything outside the bracketed areas of template material.
DO NOT Use materials, presentations or give false impression that you, the business or product is recommended or endorsed by Medicare or any other government agency.