Top 5 MA OEP Compliance Tips

Top 5 MA OEP Compliance Tips
December 28, 2021

The Medicare Advantage Open Enrollment Period (MA OEP) is notorious for having very strict compliance rules. However, there are still lots of opportunities to keep growing your book of business in the first quarter of the year.

Our team has put together a quick guide to help you through the compliance challenges during the MA OEP.

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What Is the MA OEP?

The Medicare Advantage Open Enrollment Period (MA OEP) lasts from January 1-March 31 every year.

There is also a 3-month window for new Medicare beneficiaries who have Part A and B and enrolled in an MA plan during their ICEP. These individuals have an individualized MA OEP that includes the first 3 months of enrollment in Parts A and B.

ma oep

Photo Credit: National Council on Aging

During the first quarter, MA plan enrollees can enroll in a different MA plan or switch back to Original Medicare (with or without a Part D drug plan).

A few tips:

  • Individuals can only make one election during the MA OEP.
  • The effective date for MA OEP elections is the first day of the month following the enrollment request. For example, if a client enrolls in a different MA plan on February 18th, their new plan's effective date would be March 1st.
  • Individuals enrolled in Original Medicare cannot join an MA plan during the MA OEP—they'd need to wait until AEP.
  • The OEP is not available to those enrolled in a Medicare Medical Savings Account (MSA).

New to Medicare Advantage sales? Check out our guide about why you should start selling Medicare Advantage plans.

MA OEP Compliance Tips

During the MA OEP, the Centers for Medicare & Medicaid Services (CMS) prohibits agents and plans from knowingly targeting or sending unsolicited marketing materials related to the OEP (Medicare Communications and Marketing Guidelines).

You can't try to convince any individual to take advantage of the MA OEP by making an enrollment change. In simple terms, CMS does not want agents to use the OEP as an opportunity to make more sales. 

Here are our top 5 compliance tips to ensure you don't accidentally break the marketing guidelines set by CMS.

1. Don't engage in any activities that intend to target the OEP.

CMS states in the MCMG, section 40.7, that agents cannot engage in or promote any activities that intend to target the OEP as an opportunity to make further sales.

Here are a few examples of messages you cannot and should not send during the MA OEP:

  • Unhappy with your new Medicare Advantage plan? Call us to learn more about your disenrollment options.
  • Did you know you can switch Medicare Advantage plans from now through March 31st? Call me to schedule an appointment today.
  • Got buyer's remorse? Call us to learn about other Medicare Advantage plan options with richer benefits.

These types of messages clearly target the MA OEP as an opportunity to make more sales, so they would break compliance rules.

2. Wait for client-initiated conversations before ever referencing the MA OEP.

While you cannot knowingly target the MA OEP as an opportunity to make sales, you can help clients who reach out to you with concerns or questions.

If a client comes to you and expresses they're not happy with their new Medicare Advantage plan, you can help them. You can also answer client questions related to enrollment opportunities and timelines.

luke behind desk

Here are a few examples of client-initiated conversations:

  • Am I locked into my current Medicare Advantage plan until October 15th, or can I make any changes before then?
  • I'm not happy with the HMO plan I chose during AEP. Am I allowed to switch?
  • Are there any other Medicare Advantage plans available in my county?

If a client starts any conversations like these, you can talk about the MA OEP. You can also send plan marketing materials and have a one-on-one meeting.

3. Don't use the OEP as an opportunity to reach out to clients you didn't see during AEP.

For agents with massive books of business, it's difficult to help everyone during the 54-day window that is AEP.

That said, you still cannot contact your own clients during the OEP to promote other plan options and try to generate some sales. This is a clear violation of CMS guidelines. 

Remember: it's never compliant to target the OEP as an opportunity to make more sales—whether or not you're contacting your own clients.

4. Don't give up on all marketing activities during the MA OEP!

For fear of accidentally breaking a compliance rule, some agents stop all marketing activities during the MA OEP. They figure it's better safe than sorry, which we completely understand.

However, if you know the rules, you'll understand you can still conduct marketing activities with no fear of getting into hot water with CMS.

As long as you are not referencing the OEP or using the OEP as an opportunity to make further sales, you're good to go!

Here are some examples of things you can do during the MA OEP:

  • Conduct marketing activities that focus on other enrollment opportunities, such as marketing to age-ins
  • Send marketing materials when an individual makes the request
  • Have a one-on-one meeting at a beneficiary's request

5. Use our pre-approved Medicare Advantage marketing materials.

Our marketing team has developed fully compliant Medicare Advantage marketing materials you can use any time of year.

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This marketing materials library includes:

  • Flyers
  • Desk displays
  • Social media posts
  • Postcards

Rest assured that every marketing piece has been cross-checked for compliance by two incredible organizations. While you can't knowingly target people during OEP, you can conduct other marketing activities, such as reaching out to age-ins (typically people turning 65).

Our ICEP marketing materials are ideal to use during the first quarter, because they are entirely unrelated to the OEP and still help you grow your book of business.

Download Medicare Advantage Marketing Materials Now

Conclusion

While the Medicare Advantage Open Enrollment Period (MA OEP) has strict compliance rules, there are still ways to grow your book of business in Q1.

We hope this guide clears up any questions you have about the do's and don'ts of marketing during the MA OEP.

If you have any questions, leave a comment below!

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