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Special ProgramsUse this page to answer your compliance-related questions. If you have an urgent request or need to report an issue, email compliance@sparkadvisors.com
Submitting documents for compliance approval
Marketing Checklist for Materials
When reviewing educational and marketing materials, make sure to check the following:
The material has the correct disclaimer. If you are including any specific carrier information that would make it a “marketing material”, make sure to use the latest (as of Fall 2023) TPMO disclaimer. See Disclaimers
You are using compliant titles (you cannot say “Medicare agent”). Go to the page here:
You are not publishing a detailed Medicare card. If you are including the Medicare card, make sure it follows the guidelines here Medicare card
Adding a SMID: Does the piece mention plan(s)-specific benefits or carriers? If so, add an SMID (stands for “Standardized material identification”) code in the format MULTIPLAN_[name_of_your_piece_edit_this]_[MMYY]_M and submit to us so we can submit it to CMS . These marketing assets DO NOT require SMIDs:
- Envelopes
- Radio Ads
- Outdoor Advertisements
- Banners
- Banner-like Ads
- Social Media comments and posts
California materials only: your license # is included on the piece
Anyone planning to sell in Florida: your company name cannot have the words “Medicare” in it. You may use it in other states, but you will be at risk of states changing their rules in the future to disallow “Medicare”. We recommend renaming your company and using DBAs (doing-business-as) where appropriate.
Spark policies
Compliance P&P_Spark.docx56.1KB
Key topics
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2024 updates
In 2024, CMS is introducing significant changes to the CMS Marketing Guidelines. The changes are aimed at improving the quality of healthcare services and ensuring that patients receive the right information. They will become effective September 30, 2023.
The primary changes you should be aware of:
- Call recording is limited to the point of enrollment: you no longer need to record appointment scheduling or retention activities
- 48-Hour SOA rule: you will need a signed Scope of Appointment (SOA) form 48 hours prior to the appointment. Exceptions include: the beneficiary is 4 days within the end of a valid election period, or the beneficiary is a walk-in
- Updated disclaimer on Marketing assets: Please use this disclaimer We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products 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." Build your disclaimer HERE.
- You may no longer use the Medicare Name, Logo or Card misleadingly: we recommend not using images of the Medicare card until CMS gives further guidance
These are the additional changes per the Federal Register:
- Plans must notify enrollees annually, in writing, of the ability to opt out of phone calls regarding MA and Part D plan business.
- Agents must explain the effect of an enrollee's enrollment choice on their current coverage whenever the enrollee makes an enrollment decision.
- Limit the time that a sales agent can call a potential enrollee to no more than 12 months following the date that the enrollee first asked for information.
- Prohibit a marketing event from occurring within 12 hours of an educational event at the same location.
- Clarify that the prohibition on door-to-door contact without a prior appointment still applies after the collection of a business reply card (BRC) or scope of appointment (SOA).
- Prohibit marketing of benefits in a service area where those benefits are not available, unless unavoidable because of the use of local or regional media that covers the service area(s)
- Prohibit the marketing of information about savings available 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.
- Require TPMOs to list or mention all the MA organizations or Part D sponsors that they represent on marketing materials.
- Require MA organizations and Part D sponsors to have an oversight plan that monitors agent/broker activities and reports agent/broker non-compliance to CMS.
- Modify the TPMO disclaimer to add SHIPs as an option for beneficiaries to obtain additional help
- Prohibit the collection of Scope of Appointment cards at educational events.
- Prohibit the use of superlatives (for example, words like "best" or "most") in marketing unless the material provides documentation to support the statement and the documentation is based on data from the current or prior year.
- Clarify the requirement to record calls between TPMOs and beneficiaries, such that it is clear that the requirement includes virtual connections such as video conferencing and other virtual telepresence methods.
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Previous Years & Rule Updates
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Scope of Appointment Rules & Forms
Scope of Appointment: 48 Hour RuleSOA Forms & Recordings
- The Spark platform supports sending digital SOAs to clients. However, should you find yourself in need of a physical form, you may use the form below.
- Furthermore, if you are unable to use the digital or paper form, you may record an SOA, following script below on page 4.
Humana Multiplan Sales+Enrollment Script PY 2024 FINAL 6.13.23 (1).docx66.1KB
Detailed SOA Rules (2023)548.4KB
Scope of Appointment Cheat Sheet.pdf697.1KB
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Marketing Titles, Disclaimers, and Scripts
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Carrier Policy Guidelines & Logo Approvals
Humana (6/5/23)446.9KB
Humana Agency Partner Request for Marketing Review Intake Form 3.13.23 (1).docx93.5KB
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If you want to use a carrier’s logo, it must go through the carrier approval process. These are the steps for each carrier:
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Open Enrollment Period
- Prohibition on Open Enrollment Period Marketing:
- Agency Partners/agents are prohibited from knowingly targeting or sending unsolicited marketing materials to any MA enrollee or Part D enrollee during the continuous Open Enrollment Period (OEP) (January 1 to March 31).
- During the OEP, agency partners/agents may:
- Conduct marketing activities that focus on other enrollment opportunities including but not limited to:
- Marketing to age-ins (who have not yet made an enrollment decision),
- 5-star plans marketing the continuous enrollment SEP, and
- Marketing to dual-eligible and LIS beneficiaries who, in general may make changes once per calendar quarter during the first nine months of the year.
- Send marketing materials when a beneficiary makes a proactive request
- At the beneficiary’s request, have one-on-one meetings with a sales agent
- At the beneficiary’s request, provide information on the OEP through the call center
- Partners may include general information on their website about enrollment periods, including the OEP, as long as it is educational in nature, and a call to action is not present.
- During the OEP, agency partners/agents may not:
- Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP
- Specifically target beneficiaries who are in the OEP because they made a choice during Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification
- Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
- Call or otherwise contact former enrollees who have selected a new plan during the AEP
- Words to avoid during in OEP/ROY marketing:
- Using the word NEW in a context that gives the impression that new plans are being released by plan sponsors.
OEP.pdf275.8KB
Frequently Asked Questions
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