A Step-by-step Guide to Ensuring CMS Approves Your Marketing Materials

Develop standardized language
Believe it or not, there will be more new disclaimers to add to your marketing materials this year. The following are just a few examples of disclaimers and requirements to be aware of to keep your marketing materials compliant with the latest CMS regulations.

• You must include the plan type (e.g., HMO, PPO, PFFS, etc.) using CMS standard terminology. You will need to display the plan name and the plan type in this standard format on all of your marketing materials, including general advertising materials.
• If an agent’s phone number is included in marketing materials, then the plan sponsor’s customer service phone number must also be included. The materials should clearly indicate that calling the number will direct them to a licensed insurance agent and that calling the customer service number will allow them to obtain plan information or to enroll. All requirements in the marketing guidelines related to the customer service phone number must be met (e.g., listing the hours of operation).
• General advertising materials that provide basic benefit information to generate a response — such as including copayment amounts, monthly premium amounts, or mentioning specific coverage types — must include the following disclaimer: “The benefit information provided is not comprehensive. Additional information should be requested before making a decision about your coverage.”
• Review the latest CMS marketing guidelines in detail to make sure you have included all requirements and disclaimers, new and old. The best way to do this is to develop a best-practices document of all approved disclaimers for your organization with an explanation for how each should be used. Use this document as your checklist. In addition to the disclaimers and requirements, you may also want to standardize other descriptive marketing copy, such as health plan company descriptions and benefit descriptions. This way, once the copy is approved, you don’t have to worry.

Save time and prevent errors: Use templates and carets
Use templates when developing marketing materials, as they can cut down on the number of variations you need to develop. “Template material” is any marketing material that includes placeholders for variable data to be filled in at a later time. Using template materials allows you to develop one master document rather than submitting a new document for approval each time the variable data is changed. Examples of variable elements include date and location information for sales presentations or benefits that may vary between plans, including cost sharing, premiums, and health plan names.

It is important to show CMS how the placeholders will be filled in by inserting the name of the field within carets (e.g., <date>), or filling in the placeholder fields with all the variables within the carets (e.g., <$10.00 copay/$15.00 copay>). Template materials will have only one marketing identification number, regardless of the number and combination of variable elements.

Although these tips provide a good primer, this is just the beginning. Make sure that you have carefully reviewed the advertising section of the CMS guidelines to guarantee that your materials will be approved on the first review. Following these steps can help ensure a smooth transition into the 2010 selling season.

Diane Hollie is a senior consultant at Gorman Health Group, a national Medicare advisory firm providing health plans technology solutions and consulting services. She can be reached at 215-499-1417 or [email protected].