Emergency Order Prohibits Temporary Agents From Marketing Medicare Advantage Health, Prescription Drug Plans

AUSTIN – Under an emergency rule effective November 9, 2007, the Texas Department of Insurance (TDI) has established qualifying agent license types for persons marketing Medicare Advantage health and prescription drug plans under federal marketing guidelines published by the Centers for Medicare and Medicaid Services (CMS).

The annual enrollment period for Medicare Advantage plans begins November 15, 2007 and ends December 31, 2007.

The emergency rule prohibits marketing of Medicare Advantage plans by a temporary insurance agent as defined in the Texas insurance code. A temporary agent is appointed by an insurer, a health maintenance organization or another insurance agent to market insurance products. The Medicare Advantage plans are complex health care benefit plans which can have a significant impact on the ability of beneficiaries to obtain medical assistance. According to reports received by TDI, temporary insurance agents had solicited some Medicare beneficiaries to enroll in unsuitable Medicare plans.

TDI and CMS are acting cooperatively to eliminate abuses in the marketing of Medicare plans. The emergency rule incorporates a requirement in CMS guidelines that organizations give notice to TDI of licensed insurance agents they employ or contract with to market Medicare Advantage plans and to notify TDI when an agent is terminated for cause.

On November 8, 2007, TDI released a consumer alert resulting from complaints about the marketing of Medicare Advantage plans. This consumer alert is posted on the agency website at: http://www.tdi.state.tx.us/consumer/documents/Medadvalert.pdf

The emergency rule is posted on the agency website at: http://www.tdi.state.tx.us/rules/2007/parules.html

For more information contact: PIO@tdi.state.tx.us

Last updated: 11/15/2007