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Open Enrollment Period Guidance

OEP Compliance

The Medicare Open Enrollment Period (OEP) occurs annually from January 1 – March 31. It provides a great opportunity for agents and brokers to grow their business. But it also carries specific guidelines for how agents must conduct their marketing efforts.

Let’s break down the OEP Marketing Compliance Guidelines as dictated by the Center for Medicare and Medicaid Services and explain in more detail what they mean for you and your business!

CMS Guidelines

During the OEP, agents may not:

  • Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP. Agents can’t send mailers to beneficiaries with specific information about OEP. It must remain generic (e.g. a mailer with your name and contact information, asking beneficiaries to call you with any questions.)
  • Specifically, target beneficiaries who are in the OEP because they made a choice during the Annual Enrollment Period (AEP) by the purchase of mailing lists or other means of identification. Agents are prohibited from contacting beneficiaries who made a plan change during the previous AEP from purchased lead lists.
  • Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales. Agents can’t promote events or other activities that specifically mention the OEP intending to sell to new clients
  • Or call or otherwise contact former enrollees who have selected a new plan during the AEP. Agents cannot reach out to former clients who chose to move to a new plan under a new agent during the previous AEP.

During the OEP, agents may conduct marketing activities that focus on other enrollment opportunities, including but not limited to:

  • Marketing to age-ins (who have not yet made an enrollment decision). Agents can market to beneficiaries who have reached age 65, as long as they have not yet made a plan decision.
  • Marketing by 5-star plans regarding their continuous enrollment SEP. Agents can promote their highest rated plans to beneficiaries during their continuous enrollment Special Enrollment Period.
  • Marketing to dual-eligible and LIS beneficiaries who, in general, may make changes once per calendar quarter during the first nine months of the year. Agents can explicitly market their plans during OEP to enrollees who qualify for the low-income subsidy or dual-eligibility.
  • Send marketing materials when a beneficiary makes a proactive request. Agents may market to beneficiaries that reach out first. For example, if a beneficiary contacts you to ask questions about Medicare or returns a lead card to be contacted by you.
  • At the beneficiary’s request, have one-on-one meetings with a sales agent. Agents can give out marketing materials to beneficiaries who request an in-person or one-on-one appointment.
  • Or at the beneficiary’s request, provide information on the OEP through the call center. Agents who work in a call center may give an enrollee information specific to the OEP but only if requested by the enrollee.