Bulletin, May 1, 2007, SeniorCare Prescription Drug Assistance Program

​Last Updated: May 1, 2007

Date: May 1, 2007
To: All Insurance Intermediaries and Insurance Companies Marketing Medicare Part D Prescription Drug Plans and Medicare Advantage Plans
From: Sean Dilweg, Commissioner of Insurance
Subject: SeniorCare Prescription Drug Assistance Program

​This bulletin is a reminder that all insurance intermediaries who market Medicare Part D prescription drug plans (PDPs) and/or Medicare Advantage Plans to Wisconsin Medicare beneficiaries are subject to Wisconsin insurance laws regarding intermediary marketing and sales activities.

It has come to our attention that some intermediaries may be contacting seniors and telling them that SeniorCare will end as of June 30, 2007, and that the seniors need to sign up for a Part D PDP right away. As of the date of this Bulletin, this information is misleading. SeniorCare is funded by both the State of Wisconsin and the federal government. The federal government announced it will discontinue its portion of SeniorCare funding. SeniorCare is continuing to accept applications and renewals. The State of Wisconsin is reviewing the options available for providing prescription drug coverage to SeniorCare participants, including transition from SeniorCare to Medicare Part D. Intermediaries should not be pressuring SeniorCare participants to immediately switch to a Part D PDP.

With all the discussions surrounding SeniorCare and Medicare Part D, we want to remind you that there are insurance laws that apply to marketing and sales activities. As you know, the OCI investigates all complaints involving intermediary contacts with Medicare beneficiaries, including complaints from beneficiaries covered by SeniorCare, and pursues enforcement action when deemed appropriate.

Wisconsin statutes and regulations prohibit certain types of marketing and sales activities, such as misrepresentation, high-pressure sales tactics and unsuitable sales. Wisconsin has home solicitation and competence and trustworthiness rules that govern intermediary behavior and marketing activity. In addition, Medicare has issued marketing guidelines that intermediaries and companies must follow regarding solicitation of Medicare beneficiaries.

The OCI will continue working with aging groups, Medicare beneficiaries and the federal Medicare program regarding any complaints involving marketing activities of Wisconsin insurance intermediaries. Enforcement action by the OCI can result in forfeitures (fines) and limitations on the intermediary's license and can lead to termination by insurance companies and damage to the intermediary's professional reputation.

If you have questions regarding this bulletin, please send your questions in writing to ocicomplaints@wisconsin.gov.

Thank you for your cooperation.