An agent in Salt Lake City, Utah, asks…

Q: How many people have to be in attendance for a meeting to be considered an “educational event” under CMS’s marketing guidelines?

A: Although there is no specific number of attendees that must be present for an educational event to be held, CMS officials have clarified that individual appointments with prospective beneficiaries are not educational activities. According to CMS, educational activities are events that are hosted by plan sponsors or a third-party entity in a public venue. Therefore, plan sponsors or their agents may not solicit prospective beneficiaries for individual appointments under the premise that the appointment is for educational purposes – even if a pitch or sales presentation is never made during that individual appointment. Additionally, plan sponsors may not conduct outbound calls to prospective beneficiaries to solicit educational appointments.

Appointments that are scheduled with a beneficiary, regardless of the intent, are considered sales appointments and must comply with CMS regulations for scope of appointment forms, cross-selling, etc. Plan sponsors and agents/brokers may provide educational content in addition to plan specific information during an individual appointment.

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