Putting Together Your AEP Team

For Medicare plans, the 2016 Annual Enrollment Period (AEP) is quickly approaching. This means that preparations should be well underway to ensure that member marketing materials will be accurate, on schedule and in compliance. This includes all pre- and post-enrollment materials and the annual notification of change (ANOC) and evidence of coverage (EOC).

Plans have their work cut out for them in the coming months to create and distribute their ANOCs and EOCs prior to the September 30 deadline. At the top of this to-do list is establishing a strong team of professionals to manage the AEP materials creation process.

When putting together your AEP team, keep in mind the following:

WHO should be included?
This team should include subject matter experts from all relevant areas of the organization – product, compliance, member services, medical management, and pharmacy, to name a few. A team leader and/or project manager is critical. Ideally, this person will have limited work commitments aside from this project to ensure a dedicated focus. He or she must also have the authority to push the process forward, make decisions and obtain content and approvals from other team members.

WHAT must they do?
This cross-functional team will be tasked with providing timely creation and review of content, and approval of all materials to ensure they are accurate and compliant. This includes the review of model documents, as well as prior and current populations and benefit information. Effective interaction within this team is critical, as developing an efficient and smooth process workflow upfront is key to success.

WHEN should this be done?
Members of this team should be selected no later than June or July if health plans hope to meet all milestones and distribute compliant materials on time. If you have not yet established your team – don’t delay. Gather key stakeholders and determine who is most qualified to handle the tasks at hand.

WHY is this team important?
A successfully assembled AEP team will greatly increase the likelihood that ANOCs and EOCs are accurate, in compliance and completed on time. When not all departments are adequately involved in this process, plans risk distributing materials containing errors, thus, increasing the likelihood of costly fines from CMS.

For more tips on surviving the AEP materials creation season, see our “Lessons Learned” from last year.