Clarification on outbound telephonic enrollment

Based on CMS communications this year and guidance, telephonic enrollments may be conducted via outbound call with prospects in cases where the beneficiary or his or her authorized representative initiated contact. Examples include:

• the beneficiary completed and submitted a business reply card to be contacted by the agent 
• the beneficiary requested a call back
• inbound call was disconnected
• during the course of outreach to provide information to beneficiaries with whom they have an existing business relationship, the beneficiary expresses a desire to enroll in a plan.

All other standard telephonic enrollment process requirements must continue to be followed, such as the enrollment must be effectuated entirely by the beneficiary or his or her authorized representative, required disclaimers read, Scope of Appointment obtained prior to plan discussion, call must be recorded, etc. Unsolicited contact, i.e. cold calling without the beneficiary initiating contact, is still prohibited.

This communication is intended for use by brokers only and is not intended for distribution to Medicare beneficiaries. Any publication or distribution of this communication to unauthorized recipients without Aetna’s approval is prohibited.

Prior to engaging in the sale of Aetna Medicare products, producers must be ready to sell, which means certified, contracted, licensed in the applicable states, and appointed by Aetna in accordance with state law. As permitted in certain states, Aetna will order appointments after the first sale.

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