Beware: The Dos & Don’ts of OEP

January 1st through March 31st every year is Open Enrollment Period! It is critical that we go over the rules of OEP! The Senate Report states, complaints to the Centers for Medicare and Medicaid Services (CMS) more than doubled, from 15,497 complaints in 2020 to 39,617 in 2021. Nearly half of the Medicare Beneficiaries are enrolled in a Medicare Advantage plan. Those numbers are expected to climb to above 60% by 2026 according to Kaiser Family Foundation analysis of data from Medicare and the Congressional Budget Office.

With these climbing numbers in mind, we have to hold ourselves to the highest level of compliance! Below are friendly reminders of what is and what is not permitted when selling insurance during the Open Enrollment Period.

Agents cannot knowingly target or send unsolicited marketing materials to MA or Part D enrollees during the MA OEP (January 1 to March 31). You can however market to Dual Eligibles, those aging into Medicare, and those who have become entitled due to disability.

Do:

  • Host seminars over the 101s of Medicare! These appeal to beneficiaries who are new to Medicare!
  • Host marketing events focused on other plans outside of MAPD and Part D.
  • Market yourself to Dual eligibles. These beneficiaries can enroll into a plan once every quarter, during the first 3 quarters of the year. This includes those with LIS.
  • If there is a 5-star plan in the markets you serve, you can sell these as well during OEP. 5-star plans You can only use a 5-star enrollment period once per year between December 8th-November 30th!
  • Educate your clients who may qualify for a chronic special needs plan. This offers enrollment opportunity, for better benefits all year!
  • Only discuss OEP to beneficiary who asks you for more information!

Don’t:

  • Solicit to beneficiaries about the opportunity to make a one time change to a new MAPD or Part D Prescription Drug plan.
  • Contact former clients you lost during AEP due to them enrolling into a new plan.

OEP is designed to allow a Medicare beneficiary a one-time change to switch to a new MAPD, Part D plan, or back to Original Medicare. OEP is NOT designed for marketing initiatives!

REMEMBER: When you utilize OEP compliantly, the effective date of the new plan is the first day of the following month. It is always a good idea to reach out to your current clients during OEP to ensure they have a complete understanding of how their plan works! If they are dissatisfied with the plan they chose, you are there to get them into a plan that is better for them!