< Agent Blog
Sep
23
,
2022

Highmark Third Party Marketing Organization Call Recording Requirements - UPDATED

September 23, 2022

Third Party Marketing Organization Call Recording Requirements Relevant to Individual Agents

On May 9, 2022 CMS published a final ruling announcing policy and regulatory revisions for Contract Year 2023. Among the changes are requirements for disclaimers and call recording. Required implementation of these measures begins October 1, 2022.

The Standard Disclaimer


When speaking with a prospective enrollee, third-party marketing organizations (TPMOs) MUST USE the following standardized disclaimer: “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.”

  • This disclaimer must be provided verbally, electronically, or in writing. When communicating via phone this must be disclosed within the first minute of the call.
  • This disclaimer must also be disclosed in face to face meetings.

Call Recording Requirements

TPMOs must record all sales calls in their entirety. Sales calls may include, but are not limited to, appointment setting, preliminary plan reviews, and enrollments.

  • In Pennsylvania and Delaware, all involved parties must consent to call recording to continue the call.
  • ̶ ̶I̶n̶ ̶W̶e̶s̶t̶ ̶V̶i̶r̶g̶i̶n̶i̶a̶ ̶a̶n̶d̶ ̶N̶e̶w̶ ̶Y̶o̶r̶k̶,̶ ̶o̶n̶l̶y̶ ̶o̶n̶e̶ ̶p̶a̶r̶t̶y̶ ̶m̶u̶s̶t̶ ̶c̶o̶n̶s̶e̶n̶t̶ ̶t̶o̶ ̶c̶a̶l̶l̶ ̶r̶e̶c̶o̶r̶d̶i̶n̶g̶ ̶t̶o̶ ̶c̶o̶n̶t̶i̶n̶u̶e̶ ̶t̶h̶e̶ ̶c̶a̶l̶l̶. (See further update below)
  • Call recordings must be retained in a HIPAA compliant manner for 10 years.

For a more detailed overview of these requirements, click here.

Update - October 24, 2022

Highmark would like to share some additional guidance that has recently come to their attention, regarding face to face virtual interactions and what to do if a prospect or member does not want to be recorded. Please be aware:

  • Face to face virtual interactions on platforms like Zoom MUST be recorded.
  • If the prospect or member does not want to be recorded, you should stop the recording and you MUST END the call
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