Medicare Compliance

Compliance Chronicles – Volume 1 – Q1 2023

Creating Advertising and Marketing Materials

We realize that advertising your business and marketing yourself as a trusted insurance advisor is critical in the success of your business. Unfortunately, doing so compliantly in the Medicare space can be a challenge as there are many regulations and guidelines set forth by CMS that govern what you can do in regards to your created materials. Below is a high-level summary on important items you should be aware of when creating (or even purchasing) your marketing and advertising materials.

  • Generic materials cannot include Company Names or Logos, Plan specific names, specific Plan Benefits, STAR ratings, etc. If it can be used to identify a Plan or Carrier it shouldn’t be included.
  • It must be clear to beneficiaries that you are not affiliated with or endorsed by the Federal Medicare program or the government.

Recommended disclaimer:

NOT AFFILIATED WITH OR ENDORSED BY THE GOVERNMENT OR FEDERAL MEDICARE PROGRAM

  • Marketing materials that include a phone number for the consumer to call should also include language near the phone number that makes it clear the consumer will be contacting a licensed insurance agent:

CALLING THIS NUMBER ABOVE WILL DIRECT YOU TO A LICENSED INSURANCE AGENT.

  • If your marketing piece contains a Business Reply Card (BRC) meant to gain permission to contact remember these helpful hints:
  • BRCs must include a statement informing the consumer that an agent may call them as a result of returning or submitting the BRC / Permission to Contact form, for example:

By providing the information above, I grant permission for a licensed insurance agent to contact me regarding my Medicare options including Medicare Supplement, Medicare Advantage, and Prescription Drug Plans.

  • BRCs should not ask for a consumer’s Date of Birth, but rather as for Age or Date of Medicare eligibility, or even Month and Year of birth.
  • BRCs must follow CMS retention standards (10 years)
  • DO NOT use the word “Entitled” when referring to plan benefits. Use “Eligible” instead. Can only use “Entitled” in relation to Part A for Federal Medicare Products.
  • Use caution when using the word “Senior”. Can’t limit your audience to those over 65, some Medicare beneficiaries are under 65.
  • Avoid use of absolute superlatives and exaggerative language – i.e. “the best”, “highest rated”, “the most”, “all”, etc.

Example: Instead of stating “I represent all the best plans in the area”, you should state, “I’m an independently licensed insurance agent and I represent multiple competitive plans in the area”

Obviously, there are various other rules and regulations in regards to your marketing and advertising materials but we’ve highlighted many of the common issues we see. Also, be aware that just because you buy a lead piece from a lead vendor doesn’t necessarily mean it’s compliant, so it’s important for you to know what to look for to identify any compliance concerns.

For more comprehensive guidance, please reference:

Agent Compliance Guide – Best practices in overall Medicare Compliance

If you have any questions, please don’t hesitate to reach out:

NF Compliance Officer
Bill Kauffman NF_Compliance@neishloss.com