Managed Care

Universal Scope of Appointment

  • 1.  Universal Scope of Appointment

    Posted 11-04-2015 05:10 PM


    Im looking for the CMS guidance that states a sales agent can use the Universal CMS approved Scope of Appointment form if they do not have a plan specific copy. 

    I've read in several webpages that this is acceptable but cannot find the actual guidelines.

    Thank You,

    Wanda Amador

    Wanda Amador AAS
    Medicare Specialist
    Community Care Alliance of Illinois
    2020 HCCA Managed Care

  • 2.  RE: Universal Scope of Appointment

    Posted 11-04-2015 05:15 PM



    The guidance is in Section 70.9.3 of the Medicare Marketing Guidelines, which are posted on the CMS website at:


    No standard form is required; as long as the below requirements are met:


    70.9.3 – Scope of Appointment

    42 CFR 422.2262, 422.2268(g) and (h), 423.2262, 423.2268 (g) and (h)


    SOA documentation is subject to the following requirements:

    • The documentation may be in writing, in the form of a signed agreement by the beneficiary, or a recorded oral agreement. Any technology (e.g., conference calls, fax machines, designated recording line, pre-paid envelopes, and email) can be used to document the scope of appointment.

    • Date of appointment

    • Beneficiary contact information (e.g., name, address, telephone number)


    Documentation of beneficiary or appointed/authorized representative agreement

    • The product type(s) (e.g., MA, PDP, MMP) the beneficiary has agreed to discuss during the scheduled appointment

    • Agent information (e.g., name and contact information)

    • An explanation why the SOA was not documented 48 hours prior to the appointment, if applicable

    • A statement clarifying that:

    - beneficiaries are not obligated to enroll in a plan

    - current or future Medicare enrollment status will not be impacted

    - that the beneficiary is not automatically enrolled in the plan(s) discussed




    Annie Hsu ShiehSenior Compliance CounselCentral Health Plan of California 1540 Bridgegate Drive, Diamond Bar, CA 91765Phone (626) 388-2390 ext. 2885Fax (626)


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    2020 HCCA Managed Care