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If an MAO or Part D sponsor receives an enrollment request that does not have all necessary elements required in order to consider it complete, the plan must not immediately deny the enrollment. The MAO or Part D sponsor must always check available systems (i.e., BEQ, MARx online query) for information to complete an enrollment before requiring the individual to provide the missing information. If the required but missing information is not available via CMS systems, the enrollment request is considered incomplete, and the MAO or Part D sponsor must follow the procedures outlined in § 50.3 in order to complete the enrollment request.

For paper, telephone and electronic enrollment requests, all required elements as listed in Appendix 2 must be included. The “Beneficiary Signature and/or Authorized Representative Signature” element for a paper request is satisfied with a pen-and-ink signature, for a telephone request it is satisfied with a verbal attestation of intent to enroll, and for an electronic request it is satisfied with an electronic signature or a clear and distinct step that requires the applicant to activate an “Enroll Now,” or “I Agree,” type of button or tool. Follow the procedures outlined in § 50.3 to address incomplete enrollment requests.

Electronic signatures have the same legal effect and validity as pen-and-ink signatures. An MAO or Part D sponsor utilizing electronic signatures in electronic enrollment must, at a minimum, comply with the HIPAA data security and privacy policies. For more information on the requirements for legally binding electronic signatures, see the Electronic Signatures in Global and National Commerce Act, 15 U.S.C. § 7001, and “Use of Electronic Signatures in Federal Organization Transactions” published by the Federal Chief Information Officers (CIO) Council.

As part of the enrollment mechanism, the plan may include the applicant’s acknowledgment of the following: • The plan has a contract with the federal government; • Emergency coverage (both within and outside the plan’s service area) and urgent care are always covered; and • Sales agents/brokers may be compensated if they are helping the individual to enroll.

Enrollment mechanisms may not include: • A question regarding binding arbitration; • Whether the individual receives hospice care (except MSA plans); or • Any other health screening information.

NOTE: Some exceptions apply for SNPs; please refer to § 20.8.4.

Enrollment mechanisms may not include any health screening information. However, MAOs may ask very limited health status questions related to a beneficiary’s eligibility to join an MA plan, such as whether the individual is enrolled in Medicaid. An exception also exists for certain MA-SNPs since the plan will need to establish that the individual has such a condition to be determined eligible for enrollment in that specific SNP.

40.1.1 – Paper Enrollment Forms