Prohibited use of unapproved beneficiary self-service online platform for Devoted sales

We are writing to notify you of a compliance matter requiring your immediate attention.

It has come to our attention that agents are purchasing ‘ready-to-enroll’ leads from third-parties and are submitting enrollments without conducting CMS-compliant sales presentations. The lead generation process involves the beneficiary being directed to a self-service online platform (e.g., NexaEnroll or Benetech) where they are asked to provide personal data, go through plan selection, and sign a disclaimer allowing an agent to evaluate plans and enroll them.  The agent is then using this completed form to submit an enrollment on the beneficiary’s behalf.

At this time, Devoted Health does not have sufficient information to validate whether these lead generation practices operate in full compliance with applicable regulations and whether appropriate beneficiary protections are adequately in place to support informed enrollment decisions. Specifically, we have not received confirmation on whether this lead generation platform: 

• Enables agents to conduct comprehensive sales presentations that meet all regulatory requirements prior to enrollment submission
• Gives sufficient opportunity for beneficiaries to ask questions and make fully informed enrollment decisions
• Gives beneficiaries the opportunity to receive, review, and acknowledge a completed enrollment application prior to submission
• Provides adequate documentation of beneficiary consent and understanding
• Aligns with all CMS compliance requirements and Devoted’s sales presentation and enrollment standards

Until Devoted Health can complete a thorough review and validation of these platforms’ compliance status and beneficiary protections, we cannot authorize their use for Devoted enrollments. 

To ensure beneficiaries have the information necessary to make informed decisions and to maintain our compliance obligations, all Devoted enrollments must be completed through processes that:

• Enable comprehensive beneficiary review of all enrollment materials
• Provide clear documentation of informed consent
• Have been reviewed and approved by Devoted
• Align with CMS-compliant enrollment standards

We ask that you immediately take the following actions:

1. Communicate this prohibition to all downstream and affiliated agents
2. Ensure that no agents within your organization are using this or any other unapproved processes, software, tool, or system for Devoted enrollments
3. Ensure that all enrollments are conducted using Devoted-approved, CMS-compliant processes and systems

If any agent, TPMO or subagency in your hierarchy is using these lead generation processes or tools, please self-report this activity to agencyoversight@devoted.com along with the corrective actions you have taken or plan to take.  

Please use the subject line “Unapproved Online Platform and Reporting” for either reporting activity or any questions regarding this issue.

As a reminder, any agents / TPMO’s engaging in non-compliant lead generation or non-compliant sales and marketing practices are subject to disciplinary action, up to and including immediate termination, as this use is a material breach of the TPMO agreement between your organization and Devoted Health.

Thank you for your prompt attention to this matter. We appreciate your partnership as we work together to uphold compliance standards and protect our members. 

CONFIDENTIAL — For broker use only. Not for distribution to Medicare beneficiaries.