WHAT'S WAPPENING?

It’s Time to Tackle Your OEP Plan

Posted by Jean A. Lentsch on 11/26/19 3:01 PM

open-enrollment-period

It’s nearly December and Medicare Annual Enrollment Period (AEP) will soon be coming to an end. That means it’s time to start planning ahead to tackle your OEP plan.

The Open Enrollment Period (OEP) will run from January 1 to March 31. 

During the OEP, ONLY beneficiaries who are enrolled in an MA/MAPD plan that is effective January 1 will be able to:

  • Change from a Medicare Advantage (MA) or a Medicare Advantage Prescription Drug Plan (MA-PD) to a different MA or MA-PD plan
  • Drop MA or MA-PD coverage and return to Original Medicare (with or without Part D)

In addition, NEWLY eligible Medicare beneficiaries who enroll in MA/MAPD plan can use the OEP, but ONLY during the first three months in which they have both Part A and B.

According to the Deft Research 2019 OEP study “Approximately 75% of the OEP switchers had also switched during AEP” This is a great opportunity for you to get in front of your clients after their new MA/MAPD plan is in effect to educate, and engage them on the plan they chose during AEP. If members say they are unhappy or have had trouble with their services after the effective date, it is your opportunity to educate them of their OEP options.

In August 2019, CMS released a memo with some updates to the Medicare Communications and Marketing Guidelines for 2020, instructing Plans and agents to refer to the 2019 Regulations. See the memo here and the 2019 MCMG here.

The regulations (40.7 Prohibition of Open Enrollment Marketing) clearly prohibit marketing the Open Enrollment Period, or to promote change.

During the OEP, plans and agents MAY NOT:

  • Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP;
  • Specifically target beneficiaries who are in the OEP because they made a choice during Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification;
  • Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales; or
  • Call or otherwise contact former enrollees who have selected a new plan during the AEP.

During the OEP, plans and 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)
  • Marketing by 5-star plans
  • Marketing to dual-eligible and LIS beneficiaries who, in general, may only make changes once per calendar quarter during the first nine months of the year
  • Send marketing materials when a beneficiary makes a proactive request
  • At the beneficiary’s request, have one-on-one meetings with a sales agent

Your GOAL is to make sure that you communicate with your clients during the OEP to ensure they are educated and comfortable with their AEP plan change. If not, it is your duty to educate them on their options. 

WAP is here to support your efforts every step of the way. If you have any questions, contact us!

Topics: oep, open enrollment period

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