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Let People Know Where the Grass Is Greenest

What can we expect with the reinstitution of the OEP? CMS has made it clear that “this isn’t your father’s OEP.” The difference is plans can’t actively – knowingly – market to (CMS term = solicit) consumers to switch. But it is a time that members can switch plans. So, it is important for all of us to pay attention and plan for its arrival.

Why? Because when marketing was allowed, consumers did switch. Looking back on some of our historical data, we saw application volume during the switching period at about 30% of the AEP (with only approximately 24% of the advertising budget). I realize this was a time of high switch rates, but it is still an indicator.

What can we expect without the ability to market? First let’s consider who is likely to take advantage of the new OEP rules as outlined in the Cures Act:

  • Consumers who didn’t realize their plan had changed until they used it
  • Consumers who switched during the AEP, but didn’t fully understand the benefits of their new plan and were surprised when they went to use it
  • Consumers whose situation changed and whose plan is no longer a good fit
  • Consumers who wanted to change during the AEP and procrastinated

These are the four types of switching candidates. But will they know they can change plans? Without insurance companies marketing, it will depend upon whether the government decides to advertise or conduct a public relations or educational push. I suspect they will – otherwise, why bother to reinstitute the OEP? There will surely be columnists, senior organizations, and others that will highlight the change.

What should you do? Focus on two key areas: retention and acquisition. (Yes, acquisition.)

Retention: Don’t Lose the Members You Already Have!

Retention has always been a good idea, but is now more important than ever – particularly during the AEP and a member’s first months with you. Remind your members that they’re already enjoying the greenest grass there is.

A few ideas for current and new members:

Current members:

  1. Get in touch. In October, follow-up with an easy-to-understand post-ANOC (annual notice of change) message. I realize many already do this, but I also know it isn’t as wide-spread as it should be. The post-ANOC thanks them for being a member, explains any changes (BOTH good and not so good), reinforces all the advantages of being a member, and encourages them to call if their needs have changed. If appropriate, compare their current plan to other plans so that they are aware you have other plans that might better suit them. Also, call your most vulnerable members and host member-only meetings/events – in person or virtually.

  2. Give them reasons to stay. Try to save members you learn are planning to leave during AEP by taking a page from other industries. Quickly reach out to these individuals and confirm their intentions. Inform them that they will be no longer covered by your plan as of December 31st, but also that they can still change their mind and stay with you. Be prepared with reasons to convince them they should stay. It’s “win back” – but before they ever leave.

  3. Train your Member Services team well. The OEP allows members to switch plans within the same contract. Listening for opportunities will be critical to minimize switchers. Just as importantly, if well trained, they will be guiding members compliantly.

For more retention strategies for current members, read Justin Stauffer’s blog:

New members:

Ensure prospective members select the right plan. It begins before consumers become members. Review both their medical and drug needs.

Confirm receipt immediately when an application is received. And not just with a generic “Thank you, your application has been received.” Thank them and give them a confirmation number so they know their decision is “real.” (And final. Remember, last app in wins). Also let them know their application is being processed, how quickly it will be approved, and after approval when they will receive their new card. Make them feel welcome. They have just made a big decision – let them know they made the right decision.

Welcome new members. Call new members to welcome them and make sure they are all set. This isn’t a sales call. It is a friendly “we are here to help” call.

Send a welcome kit and/or email. Provide an overview of the benefits (e.g., prescriptions) we as an industry know can be confusing.

Continue the conversation with communication through a new members’ first 90 days. Give them reasons to be delighted, not reasons to consider taking advantage of the new OEP. All of this will help with your CAHPS scores as well.

Acquisition: The New OEP IS a Time for Marketing (with Limitations)

This may surprise you, but the new OEP is a time for marketing. Let everyone know that the grass they’re standing on isn’t as green as yours – give them reason to switch to your side of the fence. Compliantly, of course.

Based on preliminary guidelines, it is OK to advertise – with limitations. CMS has made it clear they do not want this to be a time when plans knowingly solicit individuals already on a plan. But CMS has also made it clear that New to Medicare marketing is permissible. Many of the plans we partner with have for the last several years (due to the lower AEP switch rates) successfully employed a fully integrated new New to Medicare program – including DRTV, digital, and direct mail. This includes late retiree efforts.

Medigap marketing is also permissible during the OEP. And it would seem that brand advertising is also OK.

Lastly, CMS also makes clear that an individual must initiate the inquiry. In my opinion “search” falls under that “inquiry” umbrella. If someone is searching for a Medicare plan, insurance organizations should be there as they always have been with their strong Google and Bing campaigns. Maybe investing even more than before – because more individuals will be searching if they know they can switch. The key is that they ads cannot call out the OEP or encourage switching.

More details are sure to come when CMS releases their final guidance. We’re here to help you. But seriously, don’t wait. Start planning now.