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2024 Medicare OEP Details

Posted by www.psmbrokerage.com Admin on Thu, Dec 07, 2023 @ 12:20 PM

Medicare OEP

The Medicare Open Enrollment Period (OEP), which runs from January 1st to March 31st each year, is an important time for Medicare beneficiaries. It allows individuals enrolled in Medicare Advantage plans to make certain changes to their coverage.

Here are key rules and guidelines for the Medicare OEP:

Medicare Advantage Plan Changes:
Beneficiaries enrolled in a Medicare Advantage plan as of January 1 can switch to another Medicare Advantage plan or return to Original Medicare (Part A and B). This can be done only once during the OEP.

Prescription Drug Plan Changes:
If a beneficiary switches to Original Medicare during this period, they can also join a Medicare Prescription Drug Plan (Part D) to add drug coverage.

No Changes for Standalone Part D Plans:
Beneficiaries who have Original Medicare with a standalone Part D plan cannot use this period to switch their Part D plan.

No Effect on Medigap Policies:
The OEP does not provide an opportunity to purchase or switch Medigap (Medicare Supplement) policies. Medigap enrollment rules are separate and not tied to the OEP.

One-Time Change:
Each beneficiary is allowed one plan change during the OEP. Once a change is made, the beneficiary cannot make another change until the next Annual Enrollment Period, unless they qualify for a Special Enrollment Period.

Coverage Effective Dates:
Changes made during the OEP take effect on the first day of the month after the plan receives the enrollment request. For example, a change made in February will take effect on March 1st.

No New Enrollments for Medicare:
The OEP is not for individuals who are newly eligible for Medicare to enroll in Medicare Advantage or Part D. New enrollees have separate initial enrollment periods.

Marketing Restrictions:
There are specific rules restricting insurance providers from actively marketing to beneficiaries during OEP. This includes no unsolicited marketing materials specifically about the OEP.

Royal Neighbors AnnuitiesUnderstanding these rules is crucial for anyone working with Medicare beneficiaries, especially insurance agents and healthcare advisors, to ensure compliance and provide accurate guidance.

After the Annual Enrollment Period (AEP), there are several effective sales strategies you can employ to maintain momentum and continue growing your business.

Check out a summary of ideas here.

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Tags: Medicare Advantage plans, OEP, Compliance

Essential MA OEP Reminders

Posted by www.psmbrokerage.com Admin on Thu, Dec 07, 2023 @ 12:18 PM


In January, some clients who recently enrolled in new Medicare Advantage plans may contact you, expressing uncertainty about their decision. Moving from a familiar plan to an unfamiliar one can be daunting. Fortunately for your client, they're not locked into their new coverage. Shortly after the Annual Enrollment Period (AEP), beneficiaries in Medicare Advantage plans have the option to reconsider their plan choice.

Today we'll look into what options beneficiaries have, as well as a few points to consider as it relates to restrictions on marketing during this time.

As you might be aware, the Medicare Advantage Open Enrollment Period (MA OEP) is designed for two specific groups:

  • Clients who are new to Medicare and have chosen to enroll in a Medicare Advantage (MA) plan during their Initial Coverage Election Period (ICEP). These beneficiaries are granted a three-month OEP, which initiates in the same month they become eligible for both Part A and B of Medicare.
  • Clients who have already enrolled in MA plans starting on January ,. For these clients, an OEP is available from January 1 to March 31.

This means that clients who contact you in January, expressing dissatisfaction with their new plan, have the opportunity to make a one-time switch in their coverage. So, what alternatives do they have?

Keep in mind that Part D changes during the MA 0EP are tied to MA plan changes. Clients can modify their drug coverage by switching to a different MAPD plan, transitioning from MA to MAPD, or returning to Original Medicare with a standalone Part D plan. However, if someone has Original Medicare with a Part D plan, they cannot switch to a different drug plan during the MA 0EP; they must wait for a Special Enrollment Period (SEP) or the next Annual Enrollment Period (AEP).

Restrictions on Marketing

One major point to consider is the restriction on marketing during the MA OEP window. 

Agents cannot knowingly target or send unsolicited marketing materials to MA or Part D enrollees during the MA OEP 0anuary 1 to March 31). It's important to note that "knowingly" takes into account the intended recipient as well as the content of the message.

SureBridge Dental PlansUnderstanding these rules is crucial for anyone working with Medicare beneficiaries, especially insurance agents and healthcare advisors, to ensure compliance and provide accurate guidance.

After the Annual Enrollment Period (AEP), there are several effective sales strategies you can employ to maintain momentum and continue growing your business.

Check out a summary of ideas here.

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Tags: Medicare Advantage plans, OEP, Compliance

Agent Compliance Guide: Staying Compliant Before the Sale

Posted by www.psmbrokerage.com Admin on Thu, Nov 02, 2023 @ 11:18 AM

Tags: Medicare Advantage, Medicare Part D, Compliance

Agent Compliance Guide

Posted by www.psmbrokerage.com Admin on Wed, Oct 11, 2023 @ 04:08 PM

Staying compliant during the Annual Enrollment Period (AEP) for Medicare sales is not only crucial for the reputation and integrity of your business but also for the well-being of Medicare beneficiaries.

Agents must ensure that all interactions with beneficiaries, from initial contact to the final enrollment, are transparent, ethical, and in full accordance with Medicare rules and regulations. This includes the proper use of the Scope of Appointment (SOA) process, which grants beneficiaries control over the topics discussed during meetings, preventing aggressive sales tactics.

It also involves providing accurate information about plan options, costs, and coverage, as well as respecting the Annual Enrollment Period deadlines. Compliance not only keeps you in good standing with regulators but, more importantly, it fosters trust with your clients, ensuring they receive the best possible guidance for their healthcare needs.


With the high stakes involved in helping seniors make critical decisions about their healthcare coverage, adherence to strict compliance is paramount.

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Tags: AEP, Compliance

Preparing for the 2024 Annual Enrollment Period

Posted by www.psmbrokerage.com Admin on Thu, Sep 07, 2023 @ 03:58 PM

Prepare for AEP

Preparing for the 2024 Annual Enrollment Period (AEP)

Preparing for the 2024 Annual Enrollment Period (AEP) in the Medicare market requires strategic planning and a proactive approach to effectively meet the needs of beneficiaries. As this critical period approaches, there are several key steps to consider in order to maximize your success and provide valuable services to your clients.

First and foremost, staying updated on changes to Medicare regulations, plan offerings, and industry trends is paramount. The healthcare landscape is constantly evolving, and being well-informed positions you as a reliable source of information for beneficiaries seeking the right coverage. Attend seminars, webinars, and training sessions provided by insurance carriers to ensure you're up-to-date with the latest developments.

Reviewing your marketing and outreach strategies is essential to engage potential clients during the AEP. Refresh your online presence by updating your website, social media profiles, and other digital channels. Consider creating informative content such as blog posts, videos, and downloadable guides that address common questions and concerns about Medicare plans. Tailoring your messaging to highlight the advantages of different plans can help beneficiaries make informed decisions.

Focusing on compliance is also crucial during the AEP. Familiarize yourself with the Medicare Marketing Guidelines issued by the Centers for Medicare & Medicaid Services (CMS). These guidelines outline the dos and don'ts of marketing Medicare plans. Ensuring that your marketing materials are accurate, transparent, and compliant will maintain your reputation and prevent potential legal issues.

Lastly, anticipate the surge in inquiries and be prepared to offer personalized assistance to beneficiaries. Consider implementing systems to manage incoming queries efficiently, whether through your website, email, or phone. Providing clear and concise information, as well as addressing concerns promptly, can set you apart as a trustworthy advisor. By offering exceptional customer service, you'll establish strong relationships with clients that extend beyond the AEP.

By strategically approaching this period, you'll not only serve your clients effectively but also position yourself as a knowledgeable and reliable Medicare advisor.


At PSM, we are committed to providing our agents with a range of resources and support to help them succeed. From personalized marketing materials to interactive sales strategies, our goal is to empower agents with the latest tools, technology and mentorship to achieve new levels of success this AEP.

AEP Resources:

Powerful Partnerships:

We are committed to providing our agents with a range of resources and support to help them succeed: Our powerful partnerships include:

Strong relationships with insurance carriers and industry experts to provide agents with access to the best products, tools, and support.

Capital infusion and acquisition strategies to help agents expand their business and reach their ultimate goals.

Dedicated service and mentorship from experienced professionals to help agents build a successful business.

Proprietary lead, training, marketing and enrollment platforms to streamline your sales process and business practices.

Compliance oversight to ensure agents are meeting regulatory requirements and operating ethically.

Succession planning and agency building support to help agents plan for the future and achieve long-term success.

AEP Helpful Guides:

AHIP Certificationmedicare enrollment periodsSEP Guide

Best Practices for Medicare Sales or Educational EventsSell Medicare Plans Onlinean agents guide to dual eligible special needs plans (DSNP) 

Cross-Selling Hospital Indemnity Plans GuideSelling Medicare Supplement PlansSelling Medicare Advantage Plans

We are here to support!

As a reminder, We pride ourselves on a "Do the Right Thing" approach and will go above and beyond to service the needs of our agents. We look forward to having a successful AEP and supporting you with products, technology and the personalized service you have come to expect from PSM. We appreciate the opportunity to earn your business and wish you the best!


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Tags: Medicare Advantage plans, CMS, AEP, medicare supplement insurance, Compliance, Marketing, Best Practices, 2024

BULLETIN NO. 10-2023: New Medicare Supplement Enrollment Requirements for Oklahoma

Posted by www.psmbrokerage.com Admin on Thu, Sep 07, 2023 @ 02:14 PM

New Medicare Supplement Rules for Oklahoma-1

Effective September 1, 2023, amendments to the Oklahoma Insurance Department (“OID”) Medicare supplement regulations create new enrollment requirements for Medicare supplement issuers.

OAC 365:10-5-129(f)

Amendments to Oklahoma Administrative Code (“OAC”) 365:10-5-129(f) create new enrollment opportunities for Medicare supplement policyholders. The regulation requires Medicare supplement issuers to provide new supplement policies with the same or lesser benefits to current Medicare supplement policyholders—regardless of current issuer—who have had no gap in coverage greater than ninety (90) days since initial enrollment. Previously, these policyholders have had no opportunity after initial enrollment to move to any other Medicare supplement policies or issuers, trapping the policyholders in policies with rising premium costs and no opportunity to search for lower premium rates.

Issuers offering a new (i.e., succeeding) supplement policy shall waive medical underwriting or preexisting exclusions if the new supplement policy offers the same or lesser benefits. Issuers of the current (i.e., prior) policy are required to furnish a statement of benefits or other pertinent information sufficient to permit verification of benefit determination to any new issuer upon request.

OAC 365:10-5-129(g)

Amendments to OAC 365:10-5-129(g) require issuers of Medicare supplement policies to provide notice to individuals under the age of sixty-five (65) enrolled in Medicare by reason of disability of their eligibility for open enrollment to Medicare supplement policies upon reaching the age of sixty-five (65). Issuers must provide this notice sixty (60) to ninety (90) days prior to the first day of the first month in which the individual becomes sixty-five (65) years of age.

About OID

The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.


If you have any questions or would like additional guidance on this topic, please call us at (800) 998-7715 and speak with one of our experienced Marketing Representatives. We will gladly assist you.

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Tags: Medicare Supplement, Compliance

Medicare Marketing Changes in 2024: New TPMO Disclaimer

Posted by www.psmbrokerage.com Admin on Wed, Aug 30, 2023 @ 10:44 AM

TPMO DisclaimerAnother Year, Another New Rule from CMS…

Yes, we feel your pain.

It seems like every year there’s a new set of compliance rules that agents must follow when selling Medicare Advantage and Part D plans. Some are a minor nuisance; others require scrambling to find and put new systems in place before the deadline (call recording, anybody?).

Remember why CMS does this: They are trying to protect Medicare beneficiaries against misleading and confusing sales and marketing tactics, and make sure these consumers get the right help to end up with the appropriate plan for their needs. This is the same goal that most independent agents have when selling Medicare plans.

While most independent agents focus on providing the best service possible, there are some bad actors. According to CMS, the number of consumer complaints rose from 15,497 in 2020 to 39,617 in 2021.

Medicare Marketing Changes in 2024: New TPMO Disclaimer

There are many resources you can turn to that dive into the changes for 2024. We won’t go over all of them here. But there is one specific rule that directly affects AgentMethodscustomers and the service we provide: the TPMO (Third Party Marketing Organization) Disclaimer.

To make sure it’s clear to customers what companies and plans an agent can offer them, CMS has provided an updated TPMO disclaimer that agents must use in communication and marketing materials such as email, online chat, advertisements, and websites. The new disclaimer is:

“We do not offer every plan available in your area. Currently, we represent [insert number of organizations] organizations which offer [insert number of plans] plans in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.” (source: https://www.ecfr.gov/current/title-42/part-422/subpart-V#p-422.2267(e)(41))

But there’s one tiny problem with the new disclaimer…

The New Disclaimer Doesn’t Work on Websites

While this new disclaimer is helpful for direct mail campaigns and one-on-one communications, it creates a problem when communicating with anonymous website visitors who don’t know their local area. In that case, you aren’t able to provide a correct number for organizations you work with and plans you offer within their area.

We are seeing creative solutions, such as:

  • Some agents are simply stating the number of organizations and plans they work with in their area. However, this is often misleading and inaccurate. If you are located in Texas and someone from New York visits your site, you are providing them misleading information that could create the impression that you can offer more plans to them than you actually do.
  • Other agents are replacing the “in your area” with “in my area.” While this makes the number accurate, it doesn’t provide useful information to the consumer. Again, this can easily be misread, leading to customer confusion.

The Correct TPMO Disclaimer to Use on Insurance Websites Marketing Medicare Plans

To make sure we are getting this right, Agent Methods went to the source and asked CMS directly what TPMO disclaimer agents should use on their websites. Here is what they said:

“It is acceptable for plans to use the old generic TPMO disclaimer on landing pages where no zip code can be provided, as long as they use the new disclaimer on the page where beneficiaries can input the zip code.”

They further confirmed that the old disclaimer can even be used on screens where the zip code can be entered because the consumer has not yet been located and identified. CMS also confirmed the previous, generic TPMO disclaimer that should be used on websites with anonymous traffic:

"We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

PSM is proud to be a partner with AgentMethods and the resources they make available to our agents. To learn more, please go here.

Source: https://www.agentmethods.com/blog/selling-medicare-products-here-s-the-tpmo-disclaimer-you-should-use-on-your-insurance-website-in-2024 

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Tags: Medicare Advantage, Part D, Compliance, TPMO, AgentMethods

Countdown to AEP!

Posted by www.psmbrokerage.com Admin on Mon, Jul 17, 2023 @ 04:30 PM

countdown to AEP-1

July 7 marked 100 days until the start of Medicare's Annual Enrollment Period – affectionally known as AEP – and it's time to get excited! With new rules and regulations from CMS taking affect and new carrier products to learn and master, it's important that all of us to stay up to date and think through our collective strategies. According to recent statistics, more than 30 million Americans are enrolled in Medicare Advantage plans, making them eligible to sign up or renew their coverage during this AEP and start their new Medicare benefits on Jan. 1, 2024.

The best way to stay informed and prepared for the upcoming enrollment period is through research and leaning in to all the available resources at your fingertips. Make sure to review the new CMS rules and regulations as they are released and familiarize
yourself with the available products. Our CMS Task Force, led by our compliance and legal teams, is hard at work deciphering, analyzing and understanding processes for all of us to remain successful, while keeping compliant. As a reminder, our CMS FAQ webpage is your one-stop resource for rules interpretation, as well as for answers to question many colleagues have already submitted.

Get to know the Medicare products you are selling! Become knowledgeable about the benefits of the different plans available, rate changes heading into 2024, and competitiveness of the offerings in the areas you serve. Check out the new 2024 Medicare Advantage and Part D Rate Announcement Fact Sheet and the 2024 Medicare Advantage and Part D Final Rule – both available on the CMS.gov website.

Now is the time to reconnect with key clients ahead of the AEP 2024 selling season. Take
the opportunity to educate and reaffirm your relationships, while also establishing new ones. Aligned with new CMS marketing rules, this is also a great opportunity to follow best practices in informing clients of any new ancillary products that will be available when the enrollment period begins.

At the same time, now is also the time to start strategizing for how you’ll achieve your objectives this AEP, noting the important role this selling season plays in setting the tone for the new year. It starts with recruiting and certifications, and then fleshing out your game plan for how you’ll drive productivity throughout the AEP selling season.

Figure out which platforms you want to use, create and organize your promotional materials and plan out how you’ll drive activity. Doing this ahead of time will ensure that you are well prepared when the enrollment period begins. And don’t forget about our AEP Resource Page as your one-stop shop.

We are prepared to help you execute your AEP objectives

The complexity of the AEP process and the everchanging landscape of health care requires a comprehensive understanding of different types of plans and coverage options, timelines, and deadlines associated with AEP. Preparing your team for AEP is key! PSM’s approach - crafted and fine-tuned - takes a holistic approach to insurance distribution, one that allows us to create tailored partnership models with our agents and financial professionals and their affiliated companies to deliver what they and their clients need.

This includes a product portfolio of the nation’s best health and wealth solutions designed to meet the needs of consumers’ health and financial wellbeing, no matter where they are on their retirement journey.

The start of Medicare’s Annual Enrollment Period is just around the corner, and the time to prepare is now. Research the new rules and regulations, familiarize yourself with the different plans, and map out strategies that align with your goals. With the support and preparation from your PSM team, you will be ready and excited to help your clients make the best choices to live a happy, healthy retirement.

The AEP is right around the corner and there are some exciting opportunities on the horizon for 2024. Get prepared early to ensure a successful Annual Enrollment Period. We are here to help!


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Tags: Online Enrollment, Medicare Advantage, CMS, AEP, Compliance, 2024, Resources

Marketing Masterminds: Unlock qualified leads that call YOU

Posted by www.psmbrokerage.com Admin on Mon, Jul 17, 2023 @ 12:58 PM

Marketing Masterminds

Check out the latest Marketing Masterminds webinar to learn how our direct qualified leads can help you win big this AEP.

Recorded webinar link available here.

Join our masterminds of marketing as they demonstrate how to get qualified leads straight to you (with no middleman). You’ll learn all about sourcing leads, and how you can sell the highest intent customer leads via LeadStar Marketplace.

Marketing Masterminds: Mastering Inbound Calls with LeadStar Marketplace

William and Megan discuss the need to launch campaigns on a monthly basis and the benefits of using the Lead Star marketplace for inbound calls, highlighting cost savings for agents and agencies. They also highlight the platform's performance for Medicare data leads, with a better than average CPA.

Recorded webinar link available here. 

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Tags: CMS, Compliance, LeadStar, Medicare leads

Impacts of the 2024 CMS Final Rule

Posted by www.psmbrokerage.com Admin on Mon, Jul 17, 2023 @ 12:39 PM

Impacts of the 2024 CMS Final Rule

Before we dive in, it's crucial not to solely depend on these key points, as they are only a portion of the overall impact. We strongly advise reviewing the regulation and guidance thoroughly in order to gain a comprehensive understanding of each requirement and the potential changes you may need to implement. Also, be sure to visit https://yourfmo.com/cms-faqs which is frequently updated as we receive guidance from CMS and our carrier partners. 

Sales and Marketing Activities 

  • Visiting a beneficiary without an appointment is always prohibited, even when the beneficiary has expressed an interest in MA products.

  • You may no longer set up future personal marketing appointments or have beneficiaries complete Scope of Appointment forms at educational events.

  • Marketing events are prohibited from taking place within 12 hours of an educational event in the same location. The same location is defined as the entire building or adjacent buildings.

  • You must wait 48 hours between the completion of the Scope of Appointment and the start of the personal marketing appointment except when:
      • SOAs are completed during the last four days of a valid election period.
      • Unscheduled in-person meetings (walk-ins) are initiated by the beneficiary.
      • Note: CMS has indicated that this 48-hour period is not required for inbound calls from enrollees. At this time, unless CMS provides further clarification, this requirement applies to outbound calls.

  • The pre-enrollment checklist (PECL) must be provided prior to enrollment, including telephonic enrollments. "Effect of current coverage" has been added to the PECL.

  • TPMOs must provide the number of plans and products it offers, as well as SHIP contact information in its disclaimer. TPMOs who offer all plans and products must also provide a version of this disclaimer.

  • TPMOs must record all marketing, sales, and enrollment calls, including the audio portion of calls via web-based technology, in their entirety. Other types of calls have been excluded.

Marketing Materials 

  • Authorized TPMOs must submit multi-plan materials to HPMS after pre-review by MA organizations.

  • The use of superlatives such as "best" or "most" is prohibited unless specific criteria for supporting documentation are fulfilled.

  • Do not use the Medicare name and CMS logo in a misleading way. Use of the Medicare ID card image must be authorized for use by CMS.

  • The MA organization name or marketing name(s) as listed in HPMS must be identified in the marketing of any products, plans, benefits or costs.

  • Marketing communications may not include information regarding potential savings that are based on a comparison of typical expenses borne by uninsured individuals, unpaid costs of dually eligible beneficiaries, or other unrealized costs of a Medicare beneficiary.


For Agent Use Only.


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Tags: Medicare Advantage, CMS, Compliance

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