1. Event Compliance Training

2. Types of Events - Educational
Informational presentation on Medicare topics
Neither sales nor marketing are permitted to take place.

3. Types of Events - Informal
Marketing/Sales events, also referred to as “lead generation” activities
Events are typically conducted in a less formal environment that allow a beneficiary to walk up to an agent & learn more about product offerings with a less structured presentation
These events sometimes utilize a table, kiosk or a recreational vehicle (RV) that is manned by a plan sponsor representative who can discuss the merits of a plan’s products

4. Types of Events - Formal
Marketing/Sales events are usually structured in an audience/presenter style
Sales person or plan formally providing specific plan sponsor information via a presentation on the products being offered
The presenter usually presents to an audience that may have been invited to attend

5. Marketing/Sales Events
Sales seminar or presentation that a broker hosts aimed at promoting specific benefits and/or services
CAN accept & perform enrollments at event
These events must be submitted to compliance prior to advertising
These events must be submitted to AGA for submission to a carrier at least 7 days prior to the event (preferably by the 10th of the month prior)

6. Educational Events
Events designed to inform beneficiaries about Medicare information and programs
May not include any sales/marketing activities (e.g. giveaways, business cards, prize wheel)
Must be advertised as “Educational”
You have the option to submit these events to CMS

7. Provider Marketing Events
Marketing activities are permitted in common areas of health care settings
Marketing activities are prohibited in any areas where patients receive health services (e.g. exam/waiting room)
Appointments with beneficiaries residing in long term care facilities must only take place upon request of beneficiary

8. Health Fairs Marketing Educational Pre-enrollment materials are
permitted
You can accept enrollment forms
Can collect lead information from attendees
Can hand out business
Cards or marketing with
contact information
Educational
No marketing materials permitted
Cannot accept enrollment forms
Cannot accept lead information
Cannot hand out business card or any marketing materials with contact information

9. Definitions/ Permissible Activities Marketing/Sales Event
Personal/ Individual Sales Appointment
Marketing in the Health Care Setting
Educational Event
Health Fair
Principle Purpose
Selling Formal/Informal
Selling
Education
Educational/Selling
Reportable to CMS
Yes No
Yes/optional
Scope of Appointment (SOA)*
No (Unless they require a 1 on 1 following the presentation)
Ability to set up a future appointment
Yes (Scope required prior to appt, unless walk-in to sales office)
Yes (Scope required prior to appt, unless walk-in to sales office)
Educational – No Selling – Yes (Secure SOA)
“Future contact” Permission to Contact (Lead Card)
Yes, if prospect wants agent to contact them after a meeting
Educational-No Selling-Yes
Attendance Sheet
Formal-Yes (Can’t be a requirement) Informal-No
Light Snacks and refreshments only
Yes (Meals are permitted)
Educational-Yes Selling-Yes
Informational guides, promotional items and banners

10. Definitions/ Permissible Activities Marketing/Sales Event
Personal/ Individual Sales Appointment
Marketing in the Health Care Setting
Educational Event
Health Fair
Principle Purpose
Selling Formal/Informal
Selling
Education
Educational/Selling
Distribution of Business Cards Please Note: CMS clarified business cards may NOT be stapled to any marketing material. Stickers with agent contact information may NOT be applied to any approved materials, doing so is altering what was approved by CMS.
Yes No
Yes (Upon request by the beneficiary)
Educational – Yes (Upon request by the beneficiary) Selling – Yes
Ability to conduct plan-specific sales presentation
Formal - Yes (Full Presentation) Informal – No
Yes (Full Presentation)
Educational – No Selling – No
Marketing Materials approved by CMS
Educational – Yes Selling – Yes
Distribution of Benefits at a Glance
Educational-No Selling-Yes
Distribution of Pre-Enrollment Kits (SBs and Apps)
Yes (Complete Kit)
Educational – No Selling – Yes

11. Definitions/ Permissible Activities Marketing/Sales Event
Personal/ Individual Sales Appointment
Marketing in the Health Care Setting
Educational Event
Health Fair
Principle Purpose
Selling Formal/Informal
Selling
Education
Educational/Selling
Advertisement needs to include scope of product language and disclaimers
Formal – Yes Informal – No
Yes No
Educational – No Selling - Yes
Advertisement needs to include educational event disclaimer
Educational – Yes Selling - No
Advertisement needs to be approved by CMS
Educational-Yes Selling Yes
Compliant (e.g., non-steering) provider participation – Guest Speaker
Educational-Yes Selling-Yes
Accept enrollments
Educational-No Selling-Yes
*All producers are required to submit the completed Scope of Appointment for with each enrollment application (see page XX for an example).

12. Compliant Presentation Tips
Always identify the types of plans you will be covering (Formal)
Explain eligibility requirements (Formal, Informal, *Educational)
Explain enrollment/disenrollment periods (Formal, Informal, Educational)
Explain premiums, co-insurance & co-pays (Formal)
If using a PowerPoint or flipbook to guide you, be sure to cover all slides within your presentation
Benefits Information (Formal)
Medicare tips/Information (Informal)

13. Compliant Presentation Tips
Show up early and be where you said you’d be
Do not make absolute statements (e.g. “X plan is the best!” or “extraordinary”)
Do not use high pressure tactics
Do not make inaccurate statements
See guidebook for a more detailed listing of what to cover

14. Basic Medicare Comprehension
Part A [Hospital] coverage requires a monthly premium
Part B [Medical] coverage does not cover expenses outside the US
Part C [Medicare] plans must cover Part A & B expenses
Special Needs Plans (SNP) are only for beneficiaries with special healthcare needs and those with Medicare & Medical
There is financial assistance for Part B & D [Prescription Drug] premiums for low income households

15. Basic Medicare Comprehension
The earliest one may be eligible to submit an enrollment for Medicare Advantage is 64 years, 9 months old UNLESS they have ESRD or certain chronic illnesses
Annual Enrollment Period is October 15 - December 7
Understand how the Disenrollment Period works (January 1 – February)

16. Basic Medicare Comprehension
A senior may choose to solely be covered by Medicare and does not need to enroll on another type of plan
Make sure to check that the beneficiary’s doctors/specialists accept the plan FIRST
Not all Medicare Advantage plans cover prescription drugs
Compare drug plan costs and find the plan with the least out of pocket expense

17. Basic Medicare Comprehension
Understand the “donut hole” and how it works
Only RX amounts paid when in the hole apply towards TROOP (true out of pocket costs)
Catastrophic Coverage begins when the beneficiaries TROOP = $4,550
When in the hole, beneficiary will only be responsible for 50% of the brand name drugs’ manufacturer cost plus a $2 dispensing fee

18. Personal/Individual Appointments
Typically take place in a beneficiaries home
Face to face appointments are considered marketing/sales events by CMS
Scope of Appointment is required for all personal appointments
Remove this slide and add to events for “Lead Follow Up”

19. Questions