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COMMISSIONER'S BULLETIN # B-0074-08

November 07, 2008


To: ALL PERSONS MARKETING MEDICARE ADVANTAGE PLANS, MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS, PRESCRIPTION DRUG PLANS, AND 1876 COST PLANS, INCLUDING INSURANCE COMPANIES, CORPORATIONS, HEALTH MAINTENANCE ORGANIZATIONS, EXCHANGES, MUTUALS, RECIPROCALS, ASSOCIATIONS, LLOYD'S, OR OTHER INSURERS IN THE STATE OF TEXAS AND THEIR AGENTS AND REPRESENTATIVES, ANDTHE PUBLIC GENERALLY


Re: Commissioner's Order No. 08-0922, concerning the adoption of new Subchapter B, §§19.101 - 19.103, Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Medicare Part D Plans

The Commissioner of Insurance, on November 3, 2008, by Commissioner's Order No. 08-0922 , has adopted new Subchapter B, §§19.101 - 19.103, concerning the marketing of Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Medicare Part D Plans ("Medicare plans"). The new sections specify qualified license types for persons marketing Medicare plans. The new sections also establish a requirement for reporting persons in violation of the licensing requirements for the marketing of Medicare plans.

The Department reminds all companies that the CMS Medicare Marketing Guidelines and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) §103(d)(1), which amends §1851(h) of the Social Security Act (42 U.S.C. 1395w-21(h)), require that Medicare Advantage organizations only use agents who have been licensed under state law to sell Medicare plans. This requirement applies to any individual that performs marketing on behalf of an organization, whether as an employee or under contract directly or downstream. The Department has specified the following two license types as the only license types available under state law for the marketing of Medicare plans: 1) a current permanent general life, accident, and health insurance agent license or 2) a current permanent general property and casualty insurance agent license, if the agent is acting for a property and casualty insurer authorized to sell Medicare plans in this state.

The text of new Subchapter B, §§19.101 - 19.103 is available online at the following location: www.tdi.state.tx.us/rules/2008/0829-059.html.

The federal marketing guidelines and a recent supplement to the guidelines are available online at the following locations respectively:

www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/FinalMarketingGuidelines.pdf

www.cms.hhs.gov/HealthPlansGenInfo/Downloads/MIPPA_Imp_memo091208Final.pdf

If you have any specific questions regarding this bulletin, please contact Matt Ray at (512) 463-8917 or at Matt.Ray@tdi.state.tx.us. For general information, please contact ChiefClerk@tdi.state.tx.us.

Mike Geeslin

Commissioner of Insurance



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