CMS' Final Rule includes Third Party Marketing Organization (TPMO) requirements to disclose subcontracted relationships. This requirement went into effect October 1, 2022. Based on CMS guidance § 423.2274(i), TPMOs must submit a report to Aetna disclosing any new, existing, or discontinued subcontracted relationships used for Medicare Advantage and Part D marketing, lead generation, and enrollment activities. This includes, and is not limited to, any entities that are compensated to provide these functions for their organizations and downlines, such as lead generation vendors.

As a TOH agency, you must complete this disclosure to indicate whether your organization uses any subcontracted relationships as outlined above. In addition, TOHs have oversight responsibility to ensure that their downline agents and agencies report subcontracted relationships. This includes any current, new or discontinued relationships used for marketing, lead generation, and enrollment activities as of October 1, 2022.

We are requesting your assistance to ensure that this requirement is complete for both your organization as well as your downline agencies.

For your downline agencies, you may either collect and report this information on their behalf or require your downlines to report this information directly to Aetna. Your organization may use the attached letter to send to your downlines advising them that they must complete this disclosure of any current, new or discontinued subcontracted relationships.

Action required

The subcontracted relationship disclosure must be submitted via the following link: https://forms.office.com/r/AE4TB1nDe2.

If no subcontracted relationships are used for Aetna Medicare marketing, lead generation or enrollment activities, please complete the disclosure indicating that your organization has no subcontracted relationships to report.

If subcontracted relationships are used for Aetna Medicare, please complete a form disclosing each relationship.

The form takes less than 30 seconds to submit. A form must be submitted for each subcontracted relationship.

The following information must be provided:

Your organization’s name (i.e., TOH name, downline agency/agent name, etc.)
Your organization’s NPN
Subcontracted entity name
TPMO functions performed – marketing, lead generation, enrollment activities
Contract effective date
Date contract ended, if applicable
Use of offshore functions, if applicable

The first report is due on or before November 15, 2022. It must include all subcontracted relationships as of October 1, 2022.

Going forward

Going forward, TPMOs MUST complete a new form for any discontinued or new subcontracted relationships they use for marketing, lead generation and enrollment activities within 30 days of the change.

Resources

We have provided you the attached template letter for you to send to your downlines advising them of this requirement. Please send this letter to them immediately.

Questions

If you have any questions, contact Agent Oversight at AgentOversight@aetna.com.