42 CFR 422.2260 – Definitions
The definitions in this section apply for this subpart unless the context indicates otherwise.
Advertisement (Ad) means a read, written, visual, oral, watched, or heard bid for, or call to attention. Advertisements can be considered communications or marketing based on the intent and content of the message.
Alternate format means a format used to convey information to individuals with visual, speech, physical, hearing, and intellectual disabilities (for example, braille, large print, audio).
Banner means a type of advertisement feature typically used in television ads that is intended to be brief, and flashes limited information across a screen for the sole purpose of enticing a prospective enrollee to contact the MA plan (for example, obtain more information) or to alert the viewer that information is forthcoming.
Banner-like advertisement is an advertisement that uses a banner-like feature, that is typically found in some media other than television (for example, outdoors and on the internet).
Communications means activities and use of materials created or administered by the MA organization or any downstream entity to provide information to current and prospective enrollees. Marketing is a subset of communications.
Marketing means communications materials and activities that meet both the following standards for intent and content:
(1) Intended, as determined under paragraph (1)(ii) of this definition, to do any of the following:
(i)(A) Draw a beneficiary‘s attention to a MA plan or plans.
(B) Influence a beneficiary’s decision-making process when making a MA plan selection.
(C) Influence a beneficiary’s decision to stay enrolled in a plan (that is, retention-based marketing).
(ii) In evaluating the intent of an activity or material, CMS will consider objective information including, but not limited to, the audience of the activity or material, other information communicated by the activity or material, timing, and other context of the activity or material and is not limited to the MA organization’s stated intent.
(2) Include or address content regarding any of the following:
(i) The plan’s benefits, benefits structure, premiums, or cost sharing.
(ii) Measuring or ranking standards (for example, Star Ratings or plan comparisons).
(iii) Rewards and incentives as defined under § 422.134(a).
Outdoor advertising (ODA) means outdoor material intended to capture the attention of a passing audience (for example, billboards, signs attached to transportation vehicles). ODA may be communications or marketing material.
Third-party marketing organization (TPMO) means organizations and individuals, including independent agents and brokers, who are compensated to perform lead generation, marketing, sales, and enrollment related functions as a part of the chain of enrollment (the steps taken by a beneficiary from becoming aware of an MA plan or plans to making an enrollment decision). TPMOs may be a first tier, downstream or related entity (FDRs), as defined under § 422.2, but may also be entities that are not FDRs but provide services to an MA plan or an MA plan’s FDR.