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Action Benefits
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If you haven't heard, there's a ton of disruption in the Medicare Advantage market this fall. Even some of the most popular plans are reducing their service areas, cutting benefits, or raising premiums – and sometimes, all three.
And so, if you have a lot of your clients enrolled in one of these popular plans, you've got a big problem to solve: How will you ever talk to all of them?
If you're going to talk to a lot of clients at once, you've got two clear options in front of you: either a Medicare sales meeting or an Annual Notice of Change (ANOC) event. Each will have different audiences and different compliance requirements. They're outlined in the table below.
Medicare sales event |
ANOC meeting |
|
---|---|---|
Audience |
Both current and prospective enrollees for one carrier’s plans |
Only your current enrollees, preferably in the same plan |
Purpose |
Market (and enroll) a carrier's products |
Educate enrollees on their specific plan changes |
Reporting requirements |
Report to uplines, carriers, and CMS according to their individual guidelines |
No reporting requirement, barring attendance to your current enrollees with a valid Scope of Appointment |
Scope of Appointment requirements |
No Scope of Appointment required before attending, but may be collected afterwards for future appointments |
Required 48 hours prior |
Marketing concerns |
Use CMS and carrier-approved materials only |
Only personal invitations to current clients permitted |
Before you get knee-deep into planning an event, there's one key question to ask yourself. If the overall goal of your event is attracting new clients and securing more applications, a Medicare sales event is likely the right approach for you. While there are some different compliance hurdles to clear, you'll be able to present products to a broader audience and collect applications on the spot.
However, if your book is seeing significant changes this fall, a more defensive play might be appropriate. An intimate event, scheduled only for your current enrollees, is the perfect place to discuss their Annual Notices of Change and what comes next.
A Medicare sales event gives you the opportunity to present a carrier's products to both current and prospective clients. Here's what you need to know to execute one successfully.
Report your event to your upline and the carrier according to their specific guidelines. This must be done well in advance—carrier timelines vary, so check early. Your event will likely be single-carrier focused, since it must be reported to that specific carrier.
Market your event using only CMS-approved and carrier-approved materials. This includes flyers, social media posts, and any other promotional content. When in doubt, get approval before you distribute.
Prepare your presentation materials and have them reviewed. All content must comply with CMS guidelines and carrier requirements. Most carriers have pre-approved presentation materials available for agent use.
If you're hosting virtually, prepare your TPMO disclaimer to read in the first minute of the call.
Keep refreshments modest. You can provide light refreshments, but they count toward the $15-per-attendee gift limit and cannot constitute a meal (and yes, a pizza is a meal).
Present your content clearly, typically within an hour or so. While there's no strict time limit, please respect your attendees' schedules.
Make sign-in sheets available, but clearly mark them as optional. Attendees cannot be required to sign in.
You may collect applications during or after the event. If you do, all standard enrollment rules apply, including completion of the pre-enrollment checklist.
Follow up with attendees who did not complete a Scope of Appointment during the event. You can collect Scopes after the meeting for future appointments.
Schedule individual consultations as needed to complete enrollments or address specific client needs.
An ANOC meeting is designed to help your current clients understand how their plans are changing—and what they should do about it. Here's your roadmap.
Identify which clients to invite. Focus on enrollees in plans experiencing significant changes, and consider hosting separate meetings for different carriers' plans if you have substantial enrollment across multiple carriers. While you could cover several plans or carriers in one meeting, it may confuse beneficiaries.
Send personal invitations to your current clients only. You cannot publicly market or advertise an ANOC meeting.
Collect Scopes of Appointment from all attendees at least 48 hours before the meeting. This is critical. While you could technically accept a walk-in with a same-day Scope, that's difficult to justify for a pre-planned event. Best practice: get Scopes 48 hours in advance.
Gather the ANOCs for the plans you'll be discussing and prepare to walk through the key changes in plain language.
If hosting virtually, prepare your TPMO disclaimer to read in the first minute of the call.
Focus your presentation on educating clients about their specific plan changes. You have flexibility in what you discuss—there are no significant restrictions on topics.
You may compare their current plan to other options, but be mindful that other plans may not cover all of a member's needs. Make it clear that personal consultations will still be necessary to ensure proper coverage.
Provide refreshments if you'd like, but remember the $15-per-attendee limit applies here too, and refreshments cannot be a meal.
Make sign-in sheets available but optional, just as with sales events.
You may collect applications during the meeting if clients are ready to make changes, but all standard rules apply, including the pre-enrollment checklist.
Schedule individual follow-up appointments with clients needing personalized guidance. Changes to their coverage may require a more detailed review of their specific health needs and prescriptions.
Whether you choose a Medicare sales event or an ANOC meeting, Action Benefits is here to support you. We'll help you decide what best fits your needs at the moment, and make sure you understand the compliance to-dos surrounding your choices.
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