Marketing
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show | 1) Intent
2) Content
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What is marketing intent? | show 🗑
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show | marketing activities and materials like info on benefits or premiums/cost sharing, comparisons to other plans, rankings, Star ratings etc.
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How are marketing activities regulated? 5 main ways | show 🗑
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Provide just 2 examples of marketing activities | show 🗑
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Explain the regulation of marketing materials in terms of content and the review/approval process | show 🗑
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show | if the materials are developed for us with employer/union group members
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What are the 5 types of medicare health plans and Part D plans that the CMS rules apply to? | show 🗑
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show | MMP
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show | False, same rules apply up and down stream from plan
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True or False: Plan sponsors who wish to market in a specific state must contract with or employ marketing representatives who are licensed by the state in question | show 🗑
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What continuing education criteria do marketing reps employed (or contracted) need to meet? What is the exception? | show 🗑
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What unsolicited activities are marketing reps prohibited from doing? | show 🗑
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What unsolicited activities are marketing reps not prohibited from doing? | show 🗑
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show | False, there must be documented express permission at the event in question in order to call
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show | False, that is unsolicited and a sales rep is considered a marketing rep
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What are some reasons a marketing rep would call current benes ? | show 🗑
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show | - held in public, hosted by plan/part D sponsor or outside entity
- put on by providers or other groups and sponsored by one ore more health plans
- immediately following an education event (in the same general location) ok to start marketing event
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What can a sales agent do at an ed event if approved by CMS? | show 🗑
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show | require contact info, RSVP conditions, conduct health screenings or like activities, provide meals or multiple snacks/refreshments bundled and provided as if a meal, regardless of value
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What can a marketing agent do at an ed event? | show 🗑
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show | conduct sales presentations, discuss/display/distribute plan specific info, engage in marketing activities, distribute/collect enrollment apps
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show | $15 or less (combined not per item) and not in cash or cash equivalents
multiple gifts - $75 or less
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show | distribute plan materials (kits, marketing materials), provide educational info, provide and collect enrollment forms
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What can't marketing reps do during individual appointments? | show 🗑
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show | True
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What must be included when documenting the SOA for Plans/Part D sponsors? | show 🗑
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show | PHI and HIPAA
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True or False: HIPAA authorization from enrollee in question if firm wishes to use his/her personal data to market non-health related items/services | show 🗑
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show | evidence of coverage, summary of benefits, annual notice of change, provider directory, pharmacy directory, formulary
q's: whether bene providers are in network, whether drugs a bene takes are on plans formulary, whether the plan matches bene needs
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What three items must be received by the bene is provided with enrollment instructions/form? What about for D-SNPs? | show 🗑
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show | False, the bene must receive plan ratings info, summary of benefits, pre-enrollment checklist BEFORE the completion and submission
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show | getting appts/care quickly, whether members got various screening tests, vaccines and other check-ups to help them stay healthy, how members rate the plan, and customer service
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show | False, no matter what, that info must be clear as day
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Why is it important to always check the star ratings in the callers area and not keep them on a notepad somewhere? | show 🗑
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True or False: the rep must avoid using the word "Free" when talking about zero dollar premium plans | show 🗑
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show | True
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True or False: an agent asks a family member to give their cards to patients at the hospital where they work, that is not a violation because the family member is the one giving it out, not the agent | show 🗑
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Created by:
cmazzariti
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