Important: CMS Guidance regarding Third Party Marketing and HPMS filing requirements

On October 8th, 2021, CMS issued guidance regarding Third Party Marketing and HPMS filing requirements (see Third Party Marketing, CMS). We as insurance agents and agencies are considered “Third-Parties” by definition under CMS. This significantly changes the guidance surrounding agent-created or agent-purchased advertising and marketing materials.

CMS now considers the following to be “Marketing,” and therefore would require HPMS filing:

  • Advertisements intended to draw a beneficiary’s attention to an MA plan or Plans and include or address content regarding:
    • plan premiums,
    • cost sharing, or
    • benefit information,
  • Even if the materials do not mention a specific plan by name and premiums, benefits, and cost sharing is listed in a general fashion.

This means that all materials used by any Sales Partner, including those uniquely created or purchased from a third-party lead source vendor, that meets the criteria above (also see examples below) must be filed in HPMS for CMS approval.

If your advertising materials (or ones you purchase) include any language similar to the examples below, please submit them here so they can be submitted to CMS for review and approval:

  • “you may be eligible for additional benefits like Dental, Vision, Hearing, etc.”
  • “Medicare Advantage Plans may come with OTC and Transportation benefits”
  • “Some Plans come with a $0 Monthly Plan Premium“
  • “copays as low as $0“
  • “You may be eligible to get your Part B paid back“

Basically, any advertisement or mailer that mentions a premium, a benefit, a cost/copay, or getting your Part B paid for (even if in a general fashion) needs to be sent in for approval.

ACTION REQUIRED: PLEASE SUBMIT ALL MATERIALS (ADS, TV/RADIO, COMMERCIALS, MAILERS, FLYERS, ETC.) THAT MEET THE CRITERIA ABOVE HERE.

This includes currently in use materials as well as any materials you plan to use in the future. All should be submitted.

NOTE: If you are an agency with downline agents, please reach out to them and have them submit their materials as well. Remember, you are responsible for their compliance with CMS regulations.

Questions? Call the GoldenCare Direct Team at 866-862-2325!
 

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