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You are here: Home . bulletins . 2011 . cc42

COMMISSIONER'S BULLETIN # B-0042-11

October 07, 2011


To: ALL PERSONS MARKETING MEDICARE ADVANTAGE, 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, AND THE PUBLIC GENERALLY


Re: Medicare Marketing Guidelines and Agent Licensing Requirements Related to Certain Medicare Plans and Prescription Drug Plans

The Texas Department of Insurance (TDI) issues this bulletin to remind companies, agents, subcontractors, and consumers that the marketing of Medicare Advantage (MA), Medicare Advantage Prescription Drug Plans (MA-PDPs), Prescription Drug Plans (PDPs), and 1876 Cost Plans, is subject to the Medicare Marketing Guidelines (Guidelines) established by the Centers for Medicare & Medicaid Services (CMS). Any company marketing these products must ensure that its agents and subcontractors are in full compliance with the rules, the Guidelines, transmittals, and other CMS requirements. An electronic copy of the current Guidelines is available online at the following location: http://www.cms.gov/ManagedCareMarketing/01_Overview.asp#TopOfPage.

TDI also reminds carriers, agents, and all regulated entities to comply with agent licensing requirements for the marketing of Medicare-related products. Medicare Advantage organizations may only use agents who have been licensed under state law to sell Medicare plans in accordance with 42 U.S.C. 1395w-21(h). An agent may not sell, solicit, negotiate, or receive an application or contract for a Medicare-related product in this state, or represent an insurer in relation to a Medicare-related product in this state, unless an agent has completed a Department-certified professional training program related to a Medicare-related product in accordance with the Texas Insurance Code §4004.252(a) and 28 Texas Administrative Code (TAC) §19.1024 (relating to Medicare-Related Product Certification Course). This requirement applies to licensees that may qualify for the exemptions provided under 28 TAC §19.1004(b) or (c) (relating to Licensee Exemption from an Extension of Time for Continuing Education) in accordance with the Texas Insurance Code §4004.255 and 28 TAC §19.1024(g). After completing the course, a licensee must complete, during each subsequent reporting period, at least four hours of Department-certified Medicare-related products continuing education in accordance with the Texas Insurance Code §4004.253 and 28 TAC §19.1025 (relating to Medicare-Related Product Continuing Education).

If you have any specific questions regarding this bulletin, please contact Audrey Selden at (512) 475-1760 or at Audrey.Selden@tdi.state.tx.us. For general information, please contact ChiefClerk@tdi.state.tx.us.

Eleanor Kitzman
Commissioner of Insurance



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