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CMS Memo - 3rd Party Marketing - Oct. 8, 2021

Posted by www.psmbrokerage.com Admin on Tue, Oct 19, 2021 @ 11:01 AM

CMS Memo - Third Party Marketing

CMS Memo - 3rd Party Marketing - Oct. 8, 2021

A last-minute October surprise from CMS. Get ready for some lead disruption and intense carrier and CMS oversight this AEP.

MEMO:

CMS reminds Medicare Advantage Organizations (MAOs) that, under 42 CFR §§ 422.504(i), they are responsible for first tier, downstream or related entities (FDRs) adherence to all terms and conditions of the organization’s contract with CMS, including compliance with all applicable Medicare laws and regulations, when acting on the plan’s behalf. This includes, but is not limited to, the requirements that all marketing materials be submitted to CMS prior to use, pursuant to 42 CFR § 422.2261(a), and that Medicare Advantage (MA) plans may not mislead, confuse, or provide materially inaccurate information to current or potential enrollees, pursuant to 42 CFR 422.2262.

Advertisements intended to draw a beneficiary's attention to an MA plan or plans and include or address content regarding plan premiums, cost-sharing, or benefit information, including those not mentioning a specific plan by name (as well as instances where such advertisements are made on behalf of multiple MA organizations), are marketing as defined under 42 CFR §422.2260. Thus, these advertisements, as marketing materials, must be submitted to CMS prior to their use.

CMS is particularly concerned with national advertisements promoting MA plan benefits and cost savings, which are only available in limited service areas or for limited groups of enrollees, as well as using words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government. In addition, CMS receives complaints from beneficiaries and caregivers that highlight sales tactics designed to rush or push beneficiaries into enrolling into a plan.

MA organizations are accountable and responsible for their marketing materials and activities, including marketing completed on a MA plan’s behalf by an FDR. Where such marketing materials and activities fail to meet our requirements, the MA plan may be subject to compliance or enforcement actions. CMS has identified and strongly encourages MAOs to adopt the following best practices:


• Utilizing outbound phone calls to beneficiaries, as opposed to letters, when complying with 42 CFR §422.2272(b) to establish and maintain a system for confirming that enrolled beneficiaries have, in fact, enrolled in the MA plan, and understand the rules applicable under the plan.


• Reviewing rapid disenrollments to identify trends associated with “bad players.” In
addition to recouping agent/broker compensation for rapid disenrollments as required
under 42 CFR §422.2274(d)(5)(ii)(A), recouping any administrative payments paid to an
FDR where rapid disenrollment occurs.


• Reviewing actual marketing and enrollment calls between beneficiaries and call centers/agents to ensure compliance with the communications and marketing requirements under 42 CFR Subpart V.


• Requiring FDRs to identify the origin of the enrollment lead (e.g., call in based on TV ad,
response to mailing).


• Recording the entire sales call in additional to all telephonic enrollments, as described
under Section 40.1.3 (Enrollment via Telephone) of Chapter 2 - Medicare Advantage
Enrollment and Disenrollment of the Managed Care Manual.


• Requiring FDRs to disclose all contracted third-party relationships. CMS is monitoring the “chain of enrollment,” which includes the marketing materials, lead generating activities, sales talks, and enrollment process to ensure these activities are completed in accordance with all applicable requirements. We are also working with other federal agencies regarding the appropriateness of the content of certain advertisements.

End Memo

Download the memo

 


Additional Updates:

 

Tags: CMS

Best companies for Medicare Advantage in 2022

Posted by www.psmbrokerage.com Admin on Mon, Oct 18, 2021 @ 03:28 PM


us news ma rankings


The highest-ranked (US News) Insurance Company for Medicare Advantage Plans is defined as a company whose plans were all rated as at least three out of five stars by CMS and whose plans have an average rating of 4.5 or more stars within the state. 

U.S. News analyzed insurance companies’ offerings in each state based on their 2022 CMS star ratings, and below provides a list of the top-rated insurance companies for Medicare Advantage plans in each state.

Click the links to view the individual plans and their rating details.

 

STATE COMPANIES BEST MEDICARE ADVANTAGE COMPANY
ALABAMA
VIVA MEDICARE
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ARIZONA
CIGNA
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ARKANSAS
CIGNA
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CALIFORNIA
ESSENCE HEALTHCARE
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KAISER PERMANENTE
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SCAN HEALTH PLAN
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SHARP HEALTH PLAN
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WELLCARE
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COLORADO
KAISER PERMANENTE
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CONNECTICUT
ANTHEM BLUE CROSS BLUE SHIELD
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CAREPARTNERS OF CONNECTICUT
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DISTRICT OF COLUMBIA
KAISER PERMANENTE
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DELAWARE
UNITEDHEALTHCARE
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FLORIDA
AHF
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AETNA MEDICARE
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BAYCARE HEALTH PLANS
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CAPITAL HEALTH PLAN
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CAREPLUS HEALTH PLANS, INC.
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CIGNA
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DEVOTED HEALTH
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FLORIDA BLUE HMO
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FREEDOM HEALTH, INC.
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HEALTHSUN HEALTH PLANS, INC.
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OPTIMUM HEALTHCARE, INC.
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SIMPLY HEALTHCARE PLANS, INC.
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GEORGIA
KAISER PERMANENTE
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HAWAII
HMSA AKAMAI ADVANTAGE
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KAISER PERMANENTE
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IDAHO
SELECTHEALTH
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ILLINOIS
ESSENCE HEALTHCARE
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HEALTHPARTNERS UNITYPOINT HEALTH
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QUARTZ MEDICARE ADVANTAGE
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INDIANA
INDIANA UNIVERSITY HEALTH PLANS - MEDICARE
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IOWA
HEALTHPARTNERS UNITYPOINT HEALTH
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MEDIGOLD
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QUARTZ MEDICARE ADVANTAGE
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UNITEDHEALTHCARE
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KANSAS
UNITEDHEALTHCARE
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KENTUCKY
UNITEDHEALTHCARE
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LOUISIANA
ATRIO HEALTH PLANS
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PEOPLES HEALTH
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VANTAGE HEALTH PLAN
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MAINE
AETNA MEDICARE
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MARTIN'S POINT GENERATIONS ADVANTAGE
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UNITEDHEALTHCARE
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MARYLAND
KAISER PERMANENTE
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MASSACHUSETTS
BLUE CROSS BLUE SHIELD OF MASSACHUSETTS
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COMMONWEALTH CARE ALLIANCE, INC
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FALLON HEALTH
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SENIOR WHOLE HEALTH
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TUFTS HEALTH PLAN
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MICHIGAN
BLUE CARE NETWORK
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BLUE CROSS BLUE SHIELD OF MICHIGAN
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HAP SENIOR PLUS
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HAP SENIOR PLUS (PPO)
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PHP MEDICAREE
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MINNESOTA
ALLINA HEALTH AETNA MEDICARE
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BLUE CROSS AND BLUE SHIELD OF MINNESOTA
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BLUE CROSS BLUE SHIELD OF MINNESOTA
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BLUE PLUS
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HEALTHPARTNERS
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PRIMEWEST HEALTH
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QUARTZ MEDICARE ADVANTAGE
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SOUTH COUNTRY HEALTH ALLIANCE
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UCARE
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UCARE'S MSHO
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MISSISSIPPI
CIGNA
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MISSOURI
ESSENCE HEALTHCARE
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NHC ADVANTAGE
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MONTANA
HUMANA
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NEBRASKA
BLUE CROSS AND BLUE SHIELD OF NEBRASKA
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NEVADA
ATRIO HEALTH PLANS
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SELECT HEALTH
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NEW HAMPSHIRE
MARTIN'S POINT GENERATIONS ADVANTAGE
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NEW JERSEY
UNITEDHEALTHCARE
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NEW MEXICO
HUMANA
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NEW YORK
ARCHCARE ADVANTAGE
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CDPHP MEDICARE ADVANTAGE
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EXCELLUS HEALTH PLAN, INC
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HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NEW YO
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INDEPENDENT HEALTH
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MVP HEALTH CARE
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VNSNY CHOICE MEDICARE
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NORTH CAROLINA
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA
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CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA
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NORTH DAKOTA
HEALTHPARTNERS
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OHIO
MEDICAL MUTUAL OF OHIO
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MEDIGOLD
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PRIMETIME HEALTH PLAN
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SUMMACARE MEDICARE ADVANTAGE PLANS
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UNITEDHEALTHCARE
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UPMC FOR LIFE
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OKLAHOMA
AETNA MEDICARE
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OREGON
KAISER PERMANENTE
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PROVIDENCE MEDICARE ADVANTAGE PLANS
badge
REGENCE BLUECROSS BLUESHIELD OF OREGON
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PENNSYLVANIA
AETNA MEDICARE
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CAPITAL BLUE CROSS
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HIGHMARK INC.
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INDEPENDENCE BLUE CROSS
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GATEWAY HEALTH MEDICARE ASSURED
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UPMC FOR LIFE
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UPMC FOR LIFE COMPLETE CARE
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VISTA HEALTH PLAN INC.
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RHODE ISLAND
BLUE CROSS & BLUE SHIELD OF RHODE ISLAND
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SOUTH CAROLINA
NHC ADVANTAGE
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SOUTH DAKOTA
HEALTHPARTNERS
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TENNESSEE
ATRIO HEALTH PLANS
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BLUECROSS BLUESHIELD OF TENNESSEE
badge
NHC ADVANTAGE
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TEXAS
BAYLOR SCOTT & WHITE HEALTH PLAN
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DEVOTED HEALTH
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KELSEYCARE ADVANTAGE
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UTAH
REGENCE BLUECROSS BLUESHIELD OF UTAH
badge
SELECTHEALTH
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VERMONT
MVP HEALTH CARE
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VIRGINIA
KAISER PERMANENTE
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WASHINGTON
ASURIS NORTHWEST HEALTH
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KAISER PERMANENTE
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PROVIDENCE MEDICARE ADVANTAGE PLANS
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REGENCE BLUECROSS BLUESHIELD OF OREGON
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WEST VIRGINIA
HIGHMARK INC.
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WISCONSIN
AETNA MEDICARE
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DEAN ADVANTAGE, PREVEA360 MEDICARE ADVANTAGE
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HEALTHPARTNERS.
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MY CHOICE WISCONSIN HEALTH PLAN
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NETWORK HEALTH MEDICARE ADVANTAGE PLANS
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QUARTZ MEDICARE ADVANTAGE
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SECURITY HEALTH PLAN OF WISCONSIN, INC.
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UNITEDHEALTHCARE
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WELLCARE BY ALLWELL
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Tags: Medicare Advantage News

2022 AEP Kick-Off!

Posted by www.psmbrokerage.com Admin on Mon, Oct 11, 2021 @ 12:09 PM

 

 

Tags: AEP, 2022

MyMedicareBot - Voice Signature Enrollment Tool for Medicare Advantage & PDP Sales

Posted by www.psmbrokerage.com Admin on Mon, Oct 11, 2021 @ 11:14 AM


mmb logo

 

Tags: Medicare Advantage, Enrollment Tools, MyMedicareBot, Voice Signature

Aetna Supplemental: Your reward, your way

Posted by www.psmbrokerage.com Admin on Thu, Oct 07, 2021 @ 08:42 AM

 

 

Tags: Aetna Supplemental, Bonus Program

Wellcare Announces Largest Medicare Advantage Expansion to Date

Posted by www.psmbrokerage.com Admin on Wed, Oct 06, 2021 @ 04:24 PM

 

wellcare health plans logo-1

 

Tags: WellCare

Medicare Advantage and Prescription Drug Premiums for 2022

Posted by www.psmbrokerage.com Admin on Wed, Oct 06, 2021 @ 04:23 PM


Medicare Advantage and Prescription Drug Premium$ for 2022

Agents Can Help Seniors Better Understand Medicare Advantage


CMS recently released premiums and cost-sharing information for Medicare Advantage(MA) and Prescription Drug Plans.

The average premium for MA plans will be lower in 2022 at only $19 per month, compared to $21.22 in 2021. As previously announced, the average 2022 premium for Part D coverage will be $33 per month, compared to $31.47 in 2021.

Enrollment in MA in 2022 is projected to reach 29.5 million people compared to 26.9 million enrolled in a Medicare Advantage plan in 2021.

MA plans will continue to offer a wide range of supplemental benefits in 2022, including eyewear, hearing aids, both preventive and comprehensive dental benefits, access to meals (for a limited duration), over-the-counter items, fitness benefits, and worldwide emergency/urgent coverage.

In addition, the percentage of plans offering special supplemental benefits for chronically ill individuals will increase from 19% to 25%.
CMS will continue to test the Part D Senior Savings Model in more than 2,100 plans in 2022, increasing access and affordability to select insulins for seniors.

Over 500 new MA and Part D prescription drug plans, and two new pharmaceutical manufacturers of insulin, are joining the model this year to provide even more opportunities for eligible seniors to reduce their out-of-pocket spending on insulin.

Read the full report - https://www.cms.gov/newsroom/press-releases/cms-releases-2022-premiums-and-cost-sharing-information-medicare-advantage-and-prescription-drug

 

Tags: Medicare Advantage Premium, Part D Premium

UnitedHealthcare No Limits Sales Incentive

Posted by www.psmbrokerage.com Admin on Tue, Sep 28, 2021 @ 02:16 PM

 
 

Tags: Incentives

Introducing the AEP Sales Playbook - Free Download

Posted by www.psmbrokerage.com Admin on Tue, Sep 28, 2021 @ 10:10 AM

 

 

Tags: Sales Leads, prospecting, Agent Methods

New Mutual of Omaha Med Supp Plans in Michigan

Posted by www.psmbrokerage.com Admin on Thu, Sep 23, 2021 @ 09:32 AM

 

 

Tags: Mutual of Omaha Medicare Supplement

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