Humana Notice of CMS Guidance

October 12, 2021

AEP, CMS, Humana

Notice of CMS Guidance

On October 8, 2021, CMS issued guidance regarding Third Party Marketing and HPMS filing requirements (see Third Party Marketing, CMS).

CMS considers the following to be Marketing, thereby requiring HPMS filing prior to use:

  • Advertisements intended to draw a beneficiary’s attention to an MA plan or plans and include or address content regarding:

o   plan premiums,

o   cost sharing, or

o   benefit information,

  • Even if the materials do not mention a specific plan by name.

This means that all materials used by any Sales Partner, including those uniquely created or purchased from a third party lead source vendor, that meet this definition must be filed in HPMS.

Immediate Action Required

Sales partners must submit any marketing materials to HPMS without delay, as well as to Humana, as referenced in the Q&A below.

All TV commercials must be submitted to Humana on Monday, 10/11, and any other documentation as soon as practicable.

Note, CMS is particularly concerned with:

  • National advertisements promoting MA plan benefits or cost savings only available in limited service areas or for a limited groups of enrollees.
  • Using words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government

 

Sales Partners must consider these points while reviewing their own material.  If Sales Partner is concerned about any material(s), they must highlight those when submitting to Humana.

 

QUESTIONS AND ANSWERS

Q What materials are impacted?

A  All advertisements that do not mention a specific plan by name but are intended to draw a beneficiary’s attention to an MA plan or plans and include or address content regarding plan premium, cost sharing, or benefit information. This includes materials that do not identify a specific carrier or plan including those created by Sales Partner or purchased from third party vendors, such as leads from any third party.

Example 1:  If Sales Partner creates/produces a TV commercial, mailer or website, either in house or engages a marketing firm, the materials must be submitted.

Example 2: If leads are purchased from a third party vendor that produces a TV commercial or hosts a website, the TV commercial and/or website must be submitted.

Example 3: If mailers or leads from third party vendors are used to generate sales, the mailers and/or leads must be submitted.

 

Q Does it impact materials in use now?

A  Yes, it impacts all materials that meet the marketing definition that are in use now, or planned for use during AEP.

Q Are all partners impacted?

A Yes, all partners that create or use marketing materials are required to submit all such materials.

Q Should we wait for Humana to review prior to filing in HPMS?

A No, all partners should file with HPMS as soon as possible.

Q Does Humana require all marketing materials to be submitted for review?

A Yes, all partners should file with CMS via HPMS without delay, however, all materials must be submitted for concurrent review.

Q How do I submit materials to Humana?

A Because of the volume anticipated, Humana is asking all partners to identify their universe of materials and complete the fields identified on the attached spreadsheet.

  • The materials must be submitted with the Standardized Material Identification (SMIDs) on the materials, as well as listed on the spreadsheet.
  • TV Commercials and Websites

o   Submit links (and storyboards if available)

  • Direct Mail

o   Submit copy of mailer (front and back)

Submit the spreadsheet and materials to Salesintegrityreview@humana.com .

Q How do I submit materials in HPMS?

A Please see the HPMS Marketing User Guide attached.

  1. What if I do not have HPMS access?

A  You will need to create an HPMS account and request a Marketing Consultant user ID.

This video provides guidance on requesting a user ID: EFI Instructions for HPMS Consultant Users Requesting a CMS User ID – YouTube. Questions about the user ID process should be directed to HPMS_access@cms.hhs.gov.

Watch for Humana’s Multi Contract Entity code (Y0040) to appear in the drop down on the HPMS system

Once you get obtain a Marketing Consultant user ID, please submit the following information to Humana so access can be granted:

o   Agency Partner company name

o   Name of marketing consultant(s) user(s)

o   CMS User ID(s)

o   The type of consultant access needed: Multiplan Marketing Consultant

Please direct any questions to your Sales Executive or your Account Executive.