Compliance FAQs
How long does a rep have to stay at a CMS scheduled event?
If the sales event is canceled within 48 hours of its originally scheduled date and time, the plan must have a representative at the site of the canceled sales event at the time the event was scheduled to occur to inform attendees of the cancellation and distribute information about the plan. The representative must remain for at least fifteen minutes after the scheduled start time before leaving and must include signage stating that the event was canceled. If appropriate, notice can include alternate event opportunities. Amendments to marketing/sales events (cancellations, updates and edits) must be updated with the Health Plan at least 48 hours prior to the scheduled event.
May an agent set up a booth at a church bazaar or an arts & crafts sale to distribute sales brochures and discuss Health Plan benefits without it being considered a sales event that must be reported to CMS?
No. Such an activity would be considered an informal sales event according to CMS guidance, and would therefore need to be reported to CMS.
Can a sales agent initiate contact with a passerby at an informal sales event?
Yes, if the passerby is within discrete speaking distance and the individual is looking at the table or the sales person. The sales person may speak to the passerby to confirm that the passerby is interested.
When at a group presentation, are we to submit the group sign in sheet with a scope of appointment form with the application for enrollment?
NO. Marketing/sales events, as described in the marketing guidelines do not require documentation of beneficiary agreement because the scope of products that will be discussed should be indicated on all event advertising materials. Therefore there does not need to be a Scope of Appointment submitted with the application from a marketing/sales event.
What is the different ways I can secure the Scope of Appointment?
Fax machines, recorded lines, email, pre paid return envelopes
What if I am in a prospects home selling a non-related health product such as life insurance and the prospect wants to discuss an MA or MAPD plan?
CMS requires a Scope of Appointment be completed and the agent must adhere to a 48 hour waiting period before presenting the MA or MAPD plan.
Is there ever a time when it is within compliance to complete the Scope of Appointment at the point of sale?
If the beneficiary visits a broker/agents office the agent should complete a Scope of Appointment form and secure the beneficiary’s signature prior to discussing MA/MAPD products.
