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.
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.
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:
New to Medicare Advantage sales? Check out our guide about why you should start selling Medicare Advantage plans.
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.
CMS states in the MCMG, section 422.2263(b)(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:
These types of messages clearly target the MA OEP as an opportunity to make more sales, so they would break compliance rules.
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.
Here are a few examples of client-initiated conversations:
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.
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.
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:
Our marketing team has developed fully compliant, CMS-approved Medicare Advantage marketing materials you can use any time of year.
This marketing materials library includes:
Rest assured that every marketing piece has been cross-checked for compliance by two incredible organizations and is CMS-approved.
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.
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!