As we enter 2025, it is essential for anyone hosting educational and sales events to comply with the Centers for Medicare & Medicaid Services (CMS) guidelines. These events play a vital role in informing Medicare beneficiaries about their options, but they are subject to strict rules that ensure transparency and fairness. Understanding the do’s and don’ts will help you avoid common pitfalls and make your events both effective and compliant.

Educational Events

The 2025 CMS rules for educational events are designed to ensure they remain informative and non-promotional. Here are the key guidelines:

What You Can Do

• Educate About Medicare: Provide information on Medicare, Medicare Advantage, Prescription Drug Plans, and other Medicare programs.
• Collect Permission to Contact Forms: Distribute and collect forms, such as Business Reply Cards (BRCs), to obtain permission to contact attendees.
• Distribute Business Cards: Hand out your business cards or contact information.
• Answer Questions: Respond to attendee questions, provided your answers remain within the scope of the inquiries.
• Offer Light Refreshments: Serve meals, snacks, or light refreshments that meet the $15 nominal value requirement.
• Promotional Items: Offer promotional items of nominal value that do not include specific benefit information. These items can feature the plan name, logo, toll-free number, and/or website.
• Display Banners: Showcase banners with the plan name and/or logo, avoiding specific product information.

What You Cannot Do

• No Sales Presentations: Conducting sales presentations or distributing marketing materials during the event is prohibited.
• No Enrollment Forms: You cannot distribute or collect enrollment forms.
• No Scope of Appointment Forms: Distributing or collecting Scope of Appointment forms is not allowed.
• No Follow-Up Sales Meetings: You cannot conduct a sales or enrollment meeting with a beneficiary within 48 hours after the educational event.

Venue and Advertising

• Public Venue: Educational events must occur in a public venue, such as a hotel or library, accessible without an entrance fee.
• Clear Advertising: Events must be clearly advertised as educational and not as sales events.

By adhering to these guidelines, you can ensure your educational events comply with CMS rules and effectively inform Medicare beneficiaries. If you have specific questions or need further details, feel free to ask!

Sales Events

The 2025 CMS rules for sales events are designed to ensure transparency and compliance while protecting beneficiaries. Here are the key guidelines:

What You Can Do

1. Disclose the Nature of the Event: Clearly inform attendees that the event is a sales event discussing specific Medicare plans.
2. Collect Scope of Appointment Forms: Obtain and retain Scope of Appointment forms before discussing specific plans.
3. Provide Approved Materials: Use only CMS-approved marketing materials during the event.
4. Answer Questions: Respond to attendee questions, ensuring compliance with CMS guidelines.
5. Offer Light Refreshments: Provide light refreshments that meet the nominal value requirement.

What You Cannot Do

1. No Sales Events Within 12 Hours of Educational Events: A sales event cannot take place within 12 hours of an educational event at the same location.
2. No Unapproved Materials: Do not use any marketing materials that have not been approved by CMS.
3. No Enrollment Forms Without Scope of Appointment: Distributing or collecting enrollment forms is not allowed without first obtaining a Scope of Appointment.
4. No Misleading Information: Ensure all information provided is accurate and not misleading.

Venue and Advertising

• Public Venue: Sales events must be held in a public venue that is accessible without an entrance fee.
• Clear Advertising: These events must be clearly advertised as sales events.

By following these guidelines, you can ensure your sales events comply with CMS rules and effectively serve Medicare beneficiaries. If you have specific questions or need further details, feel free to ask!

ACA Updates

It is crucial to stay informed about updates from CMS regarding Marketplace topics. Here are a few important points:

• Redesigned Agent and Broker FAQ Website: The redesigned Agent and Broker FAQs website launched last month. This should be your primary resource for Marketplace questions.
• NPN Override Feature FAQs: Recently published FAQs clarify when the NPN override tool can and cannot be used. Remember, this tool cannot be used to circumvent state appointment rules.
• Client Social Security Number Concerns: An FAQ provides guidance for agents and brokers whose clients may hesitate to provide their SSNs during the Marketplace application. The Marketplace is legally required to collect SSNs from all applicants who have them, but alternative solutions are available for clients unwilling to share this information.

Don’t forget to complete the PY 2025 Returning Agent FFM training by October 1, 2024, to ensure you can offer 2025 plans!

Conclusion

Maximizing your client outreach during AEP requires a multi-faceted approach. By leveraging direct mail, digital marketing, educational webinars, email campaigns, community engagement, valuable content, and continuous optimization, you can effectively connect with more clients and drive success this season. Start implementing these strategies today and watch your client base grow!