TPMO Disclaimer

Senior Health

August 19, 2022

How familiar are you with the new “TPMO” disclaimer requirement?

Below is the new guidance regarding the TPMO disclaimer:

§ 422.2267 Required materials and content.

(41) Third-party marketing organization disclaimer. This is standardized content. The disclaimer consists of the statement: ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800– MEDICARE to get information on all of your options.’’ The MA organization must ensure that the disclaimer is as follows:

(i) Used by any TPMO, as defined under § 422.2260, that sells plans on behalf of more than one MA organization unless the TPMO sells all commercially available MA plans in a given service area.
(ii) Verbally conveyed within the first minute of a sales call.
(iii) Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication.
(iv) Prominently displayed on TPMO websites.
(v) Included in any marketing materials, including print materials and television advertisements, developed, used or distributed by the TPMO.

TPMO Disclaimer Language

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information an all your options.

Q: So, what is a TPMO?
CMS defines TPMOs as “organizations and individuals that are compensated to perform lead generation, marketing, sales, and enrollment related functions as a part of the chain of enrollment, that is the steps taken by a beneficiary from becoming aware of a plan or plans to making an enrollment decision.”

Agents, Agencies, and Brokers are all considered a TPMO under this guidance.

Q: When and how do you use the disclaimer?
The TPMO Disclaimer must be prominently displayed on TPMO websites and on all “marketing” materials, including all print materials and television advertising that meet the definition of marketing. This includes television, radio, print materials, mailers, lead cards, emails, flyers, etc. If it’s a third-party website or a “marketing” material, it needs the disclaimer. (Note: Disclaimer is not required for TPMOs that truly offer every option in a service area).

Disclaimer must be provided verbally, electronically, or in writing, depending on how the TPMO is interacting with the Medicare beneficiary.

If telephonic interaction, disclaimer must be provided within the first minute of the call.

Q: What if I offer all Plans in my area?
While the regulation does provide a carve-out for TPMO’s (third-party marketing organization) that truly offer all plans in their area, it is exceedingly rare for an agent to truly be able to do this. In most areas, there are one or more plans that are offered only through captive agents, direct to consumer, or certain types of plans that agents and brokers cannot sell. Even if you do offer all plans in one county or service area, it is possible your marketing or referrals may extend to an area where that is not true, so the disclaimer would still be required.

Takeaways

  • Put this disclaimer on your website
  • Include the disclaimer on all your materials that meet the definition of “marketing”
  • Best Practice: Include on all your advertising materials (unless these exceptions apply – Banner and banner-like advertisements, Outdoor advertisements, Text messages, and Envelopes)
  • For telephonic interactions, state the TPMO disclaimer within the first minute of all sales and/or enrollment calls
  • Should be Empty:

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