AEP Compliance Reminders

As you’re preparing for what we expect will be our most successful AEP yet, please take some time to review these best practices to ensure you’re running your business as compliantly and efficiently as possible:

1. Ensure you’re fully equipped to support your clients’ Medicare needs

  • Complete AHIP and current carrier certifications. Check your status by logging into CareFreeAgency.com or reaching out to carriers directly.
  • Do not set up appointments for 2019 sales prior to 10/1 – that would be considered marketing and a CMS violation.
  • You can continue to market and sell 2018 plans to age ins for 9/1, 10/1, 11/1, 12/1 effective dates but you cannot market for 2019 plans until 10/1.

2. Don’t market before 10/1

  • Do not send postcards or other marketing materials for 2019 plans / sales to your book of business or anyone who’s completed a 2019 Consent to Contact form for this AEP until after 10/1.
  • Review plans in your market to add carriers with a strong value proposition. You can request additional carriers on CareFree’s website or by calling us at (800) 306-1857.
  • Attend carrier product trainings to fully understand products

3. Marketing from 10/1 to 10/15

  • You can present plans to beneficiaries in this time period, but you may not proactively solicit / request applications.
  • Don’t turn in applications before 10/15 that are signed by the clients or agent and dated prior to 10/15. Collect applications after 10/15 from beneficiaries you’ve met with, or call them.

4. Submit marketing and sales events to carrier or CareFree Insurance

  • Sales seminars for a specific plan/carrier must be reported to the carrier within the carrier’s prescribed timeline.
  • Informal sales events that do not promote a specific plan must be reported directly to your CareFree Insurance leader at least 2 weeks before the event(s).
  • General event guidance can be found at: www.carefreeagency.com/pdfs/Medicare_Event_Guidance.pdf

5. Submitting Applications in AEP

  • As a general rule, turn in completed applications on the day they are completed, or within 24 hours of taking the application.
  • Follow each carrier’s rules for application submission. Rules can be found on the carrier’s broker portal.
  • Consider using carrier electronic enrollment tools to reduce errors that will pend or deny applications. Instructions can be found on the carrier’s broker portal.
  • Paper applications can be faxed directly to carriers or CareFree.

6. Preparing for the new OEP period

  • The Medicare Annual Disenrollment Period (1/1-2/14) has been replaced with the new Open Enrollment Period(1/1-3/31).
  • During this period any beneficiary with any type of MA plan can make one change to any plan combination they’d like: a different MAPD, an MA, or Original Medicare with a PDP (see table below).
  • Brokers cannot market during this Election Period, but they may conduct customer service calls inquiring about how satisfied beneficiaries are with their current plan. If beneficiaries are not pleased with their 2019 plan selection, brokers may use OEP to make the change once between 1/1 and 3/31.

OEP Quick Reference Table

If you are currently enrolled for 1/1/2019 in You CAN make this change from 1/1/2019 - 3/31/2019
Original Medicare CANNOT USE OEP*
PDP only CANNOT USE OEP*
Cost Plan CANNOT USE OEP*
MA Only
  • - Another MA only;
  • - MAPD;
  • - Original Medicare with or without a PDP.
MAPD
  • - Another MA-PD plan;
  • - AN MA-only plan;
  • - Original Medicare with or without a PDP

* You must be enrolled in an MA plan to use this OEP.

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