AEP 2027 Compliance Training

Annual Enrollment Period — Plan Year 2027

Estimated time: ~10 minutes

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For licensed agents only | The Health Experts Insurance | Confidential

Module 1

What is AEP?

Understanding the Annual Enrollment Period

What Beneficiaries Can Do During AEP

Switch from one Medicare Advantage (MA) plan to another
Switch from Original Medicare to a Medicare Advantage plan
Drop MA and return to Original Medicare (with or without Part D)
Join, switch, or drop a Medicare Part D prescription drug plan

Important Rule

Beneficiaries can only make ONE election during AEP. The last enrollment submitted is the one that takes effect — "last one wins."

Module 2

Who Can Enroll?

Eligibility requirements for AEP enrollment

Basic Eligibility Requirements

Must be enrolled in both Medicare Part A and Part B
Must live within the plan's geographic service area
Must not be currently enrolled in end-stage renal disease (ESRD) — with certain exceptions under ESRD rules effective 2021

SEPs — Outside AEP

Special Enrollment Periods (SEPs) allow qualified beneficiaries to make changes outside the standard AEP window. Always verify SEP eligibility before enrolling outside Oct 15 – Dec 7.

Verify Before You Enroll

Always confirm the beneficiary's Medicare Part A & B status and service area before completing an enrollment. Submitting ineligible enrollments can result in compliance violations.

Module 3 — NEW for 2027

SOA Requirements

Scope of Appointment — Critical compliance update

What Changed

Same-day appointments now permitted after SOA is obtained
Electronic signatures accepted
Effective October 1, 2026 for PY2027 enrollments

What Stayed the Same

SOA is STILL required before every personal marketing appointment
SOA valid 12 months if product scope unchanged
New SOA required when adding products outside original scope

Source: CMS Final Rule 42 CFR §§ 422.2264(c)(3) and 423.2264(c)(3)

Module 4

CMS Marketing Rules

Required standards for all marketing activities

Only use CMS-approved and carrier-approved materials
No door-to-door solicitation unless the beneficiary initiates the contact
No cold calling unless the prospect has given prior expressed permission
No marketing in healthcare settings (exam rooms, pharmacy counter, etc.)
No providing meals as inducements to enroll
Events must be educational in nature — not sales appointments
All marketing materials must include required CMS disclaimers

Approved Materials

Access all approved materials through your carrier portals and YourFMO. Never modify or alter approved materials. Using unapproved materials is a CMS violation.

Module 5

What You CAN Do

Permitted activities during AEP 2027

Permitted Activities

Conduct appointments after SOA is obtained — same-day is now OK for PY2027
Discuss only the products listed on the signed SOA
Use approved marketing materials from carrier portals
Hold educational events following CMS event rules
Follow up with leads who have provided expressed interest / permission
Use Sunfire or carrier portals to complete enrollments

Reminder — Certifications Must Be Current

AHIP certification and all required carrier certifications must be completed and approved BEFORE you begin any marketing or sales activities for PY2027.

Module 6

What You CANNOT Do

Prohibited activities — violations carry serious consequences

Prohibited Activities

Market or sell products outside the documented SOA scope
Promise or guarantee benefits not confirmed by the carrier
Use misleading, altered, or unapproved marketing materials
Contact prospects by phone without prior expressed interest/permission
Conduct marketing in prohibited settings (healthcare facilities, pharmacies)
Offer gifts, meals, or other inducements to influence enrollment decisions

Consequences of Violations

CMS violations can result in agent contract termination, civil monetary penalties, and CMS sanctions. Protect your license — always follow the rules.

Module 7

Enrollment Process

Step-by-step guide to compliant AEP enrollments

1

Obtain SOA Before the Appointment Get a signed Scope of Appointment from the beneficiary before any marketing meeting. Electronic signatures accepted.
2

Conduct the Compliant Marketing Appointment Same-day meetings now permitted for PY2027. Follow all CMS marketing guidelines.
3

Present Only Approved Plan Materials Use only carrier-approved materials. Discuss only products listed on the SOA.
4

Complete Enrollment via Sunfire or Carrier Portal Submit the enrollment accurately through Sunfire or the appropriate carrier portal.
5

Confirm Enrollment Confirmation Sent to Beneficiary Verify the beneficiary receives their enrollment confirmation from the carrier.
6

Retain All Documentation Keep SOAs, appointment notes, and materials used per CMS retention requirements.

Coverage Effective Date

Enrollments submitted by December 7, 2026 take effect January 1, 2027.

Module 8

Key Deadlines

Critical dates for AEP 2027 — mark your calendar

October 1, 2026

New SOA Rules Take Effect — 48-hour waiting period eliminated. Same-day appointments now permitted after SOA is obtained.

October 15, 2026

AEP Opens — Annual Enrollment Period begins. Agents may begin submitting PY2027 enrollments.

December 7, 2026

AEP Closes — Last day to enroll for January 1, 2027 coverage. No late exceptions.

January 1, 2027

Coverage Effective Date — PY2027 plans begin for all AEP enrollees.

Before You Market — Certifications Required

AHIP certification and all required carrier certifications must be completed and approved BEFORE conducting any marketing or sales activities for Plan Year 2027. Do not begin marketing without confirmed certification status.

Module 9

Compliance Reminders

Final guidance before your knowledge check

Golden Rule

When in doubt, don't. Check the YourFMO compliance portal before taking any action you're uncertain about. It's always better to pause and verify.

Document Everything

Retain SOAs, appointment notes, and records of all materials used. CMS retention requirements apply. No documentation = no proof of compliance.

Compliance Resources

CMS Helpline: 1-800-MEDICARE
THEI Compliance Support: compliance@healthexps.com
YourFMO Compliance Portal — available in your agent dashboard

Violations Have Consequences

Non-compliance can result in agent contract termination, civil monetary penalties, and CMS sanctions. Your license is your livelihood — protect it by following every rule, every time.

Knowledge Check

AEP 2027 Quiz

Answer all 6 questions. You need 5 or more correct to pass.

Question 1 of 6

When does AEP 2027 open for enrollments?

September 15, 2026

October 15, 2026

November 1, 2026

October 1, 2026

AEP opens on October 15, 2026. Note: October 1 is when the new SOA rules take effect — different from when AEP opens.

Question 2 of 6

The 48-hour SOA waiting period for PY2027:

Is still required for all appointments

Has been extended to 72 hours

Has been eliminated starting October 1, 2026

Only applies to phone appointments

Correct! CMS Final Rule eliminated the 48-hour waiting period effective October 1, 2026. Same-day appointments are now permitted once the SOA is obtained.

Question 3 of 6

Do you still need an SOA before conducting a personal marketing appointment?

No — the SOA requirement was eliminated along with the waiting period

Only if the client is new to Medicare

Yes — SOA is still required before every personal marketing appointment

Only for MA plans, not PDP

The SOA requirement is still in effect. Only the 48-hour waiting period was eliminated — not the SOA itself. You must obtain an SOA before every personal marketing appointment.

Question 4 of 6

How long is an SOA valid?

30 days

6 months

Until the end of AEP

12 months, as long as the product scope does not change

An SOA is valid for 12 months, provided the product scope documented in the SOA remains unchanged. A new SOA is required if you need to discuss products not listed on the original SOA.

Question 5 of 6

Which of the following is NOT allowed during AEP?

Conducting a same-day appointment after the SOA is obtained

Using carrier-approved marketing materials

Offering a free meal to a prospect to encourage enrollment

Following up with a lead who expressed interest

Providing meals or gifts as inducements to influence enrollment decisions is explicitly prohibited by CMS. This is a common compliance mistake. Options A, B, and D are all permitted activities.

Question 6 of 6

When does AEP 2027 coverage take effect for beneficiaries who enroll during AEP?

December 7, 2026

January 1, 2027

October 15, 2026

February 1, 2027

Coverage for all AEP 2027 enrollments takes effect January 1, 2027 — regardless of when during Oct 15 – Dec 7 the enrollment was submitted.

Congratulations

Course Complete

You have successfully completed AEP 2027 Compliance Training

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Agent Name

AEP 2027 Compliance Training

Annual Enrollment Period — Plan Year 2027

Completed: —

October 15 – December 7, 2026

48-Hour Waiting Period ELIMINATED