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