The TPMO Disclaimer Moved: Before Benefits, Not the First Minute

For Contract Year 2027 marketing, the TPMO disclaimer no longer has to be read "within the first minute" of a sales call. Under the CY2027 Medicare Advantage and Part D final rule, it must be "verbally conveyed during sales calls prior to the discussion of any benefits" (42 CFR 422.2267(e)(41)(ii) and 423.2267(e)(41)(ii)). CMS says the rule's marketing changes apply to all CY2027 marketing and communications beginning October 1, 2026, so this is the standard for your AEP sales calls.

Picture an AEP morning. Your agent is still confirming a ZIP code and date of birth, with the scorecard's first-minute timer running in the back of their head. So the plan count gets squeezed in before anyone knows whether the caller even has a valid election period. If you've ever had to score that call, you'll recognize the problem CMS describes below.

The CY2027 rule also changed the disclaimer's wording and cut retention for marketing and sales call recordings from 10 years to 6. Scripts, scorecards and training written for the old rule still test the first minute, so check yours before October 15. ACA Marketplace scripts aren't affected: both changes are in the Medicare Advantage and Part D rules (42 CFR parts 422 and 423).

What exactly changed?

The final rule (FR Doc 2026-06600, 91 FR 17384) changed two things: timing and wording.

Wording. The disclaimer is still "standardized content," but the State Health Insurance Program reference is gone. If you don't sell for every MA organization (for Part D, every Part D sponsor) in the service area, the statement is now:

"We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."

If you do sell for all of them, it ends: "You can always contact Medicare.gov or 1-800-MEDICARE for help with plan choices."

Unchanged. Paragraphs (i), (iii), (iv) and (v) stay as they were. Paragraph (i) still limits the disclaimer to any TPMO "that sells plans on behalf of more than one MA organization" (in the Part D rule, "more than one Part D sponsor"). Covered TPMOs still use it in email and chat, on websites and in marketing materials. Our reading: if you sell for only one MA organization (and, for Part D plans, only one Part D sponsor), (i) doesn't require it. Check your plan contract before dropping it.

Quick aside: the State Health Insurance Program line is the habit to break first. Agents who've read the old version on every call can say it on autopilot. Yes, that means new laminated cards.

Why did CMS move it?

CMS said many calls begin with "basic demographic information," and some end there because the caller has no valid election period. A first-minute plan count, CMS concluded, "does not always promote clear communication with the beneficiary."

The phrase I'd underline is "basic demographic information." That's CMS describing the same opening stretch where the old rule wanted the plan count.

My take: the new timing follows the order a well-run call already takes. Who's calling, whether they can enroll, and only then the plans. Reading a plan count before that check was like reading someone the whole menu before finding out whether they can order today.

When does the new timing apply?

The amended text took effect June 1, 2026. For marketing, the rule states: "the new marketing and communications policies in this rule are applicable for all contract year 2027 marketing and communications, beginning October 1, 2026."

One gap: the rule doesn't address calls after October 1 that market 2026 coverage, such as a special enrollment period sale effective in 2026. Our reading: a disclaimer read in the opening minute, before any benefits talk, meets both timing rules. The rule doesn't say which wording applies to those calls (the old version includes the State Health Insurance Program line), so ask your plan partners.

Small consolation: if our reading holds, the old first-minute timing habit still earns its keep on these straddle calls. The wording is what you'll need to confirm.

What counts as a discussion of benefits?

CMS's answer: the "mere mention of a benefit, for example pointing out that nearly all MA organizations offer routine dental care," is not a discussion of benefits. "Discussing the specificity of a benefit with the intent to draw a beneficiary's attention to an MA or Part D plan(s)" could be.

CMS's examples include talking about "the benefits listed in a plan's Evidence of Coverage document" or how out-of-pocket cost sharing might work for the caller. CMS also agreed a discussion of benefits "can align with the definition of marketing" in 42 CFR 422.2260 and 423.2260: content about "the plan's benefits, benefits structure, premiums, or cost sharing," intended to draw attention to a plan or influence a choice.

This is where scorecards get interesting. A practical way to draw the line:

• Usually before benefits (CMS's examples): collecting basic demographic information and checking for a valid election period.

• Past the line: plan-specific benefits, premiums, copays, drug costs, or anything from a plan's Evidence of Coverage.

• Gray zone: general remarks about what plans tend to offer. CMS says a "mere mention" is not a discussion of benefits, but the conservative choice is to read the disclaimer before any benefit comes up.

CMS hasn't placed consent-to-record, identity checks or Scope of Appointment capture, but says it "will continue to gauge industry's need for more examples."

Say your agent, mid-intake, repeats CMS's own example, that "nearly all MA organizations offer routine dental care." CMS calls that a mere mention. If the next line is "and the plan I want to show you covers cleanings with no copay," that's specific and points at one plan: the kind of detail CMS says could be a discussion of benefits.

What does this mean for your QA program?

Now for the part that lands on your desk.

• Rewrite the TPMO scorecard question. Replace "within the first minute" with a test you can grade from a transcript, such as: "Did the agent read the TPMO disclaimer, as written, before discussing any plan's specific benefits, premiums or cost sharing?"

• Write down where "benefits" starts. Decide how consent-to-record, identity checks and SOA capture sit relative to the disclaimer, grade every call the same way, and use your own calls to recalibrate reviewers and retrain agents.

• Add a not-applicable path. A call that ends before any benefits discussion shouldn't fail the disclaimer question.

• Update scripts and quick-reference cards. Remove the State Health Insurance Program line from both versions, and confirm your organization and plan counts are current for 2027.

• Check other channels. Chat, email, websites and print need the new wording too.

• Review Scope of Appointment questions. The same rule dropped the 48-hour SOA wait, and CMS says inbound and unscheduled calls that are personal marketing appointments need an SOA.

• Update your retention policy. Marketing and sales recordings: at least 6 years, audio for the first 3. Enrollment portions: 10.

• Talk to your plan partners. These duties reach you through plan contracts, and carriers may set their own scripts.

Honestly, writing down where "benefits" starts is the hard part. It looks like a quick decision until two good reviewers score the same call differently. That disagreement is your first calibration agenda.

Also in this rule: how long must you keep sales call recordings?

At least 6 years for marketing and sales calls, in audio for the first 3. Enrollment portions still need 10. Plan contracts must require TPMOs to follow the new text of 42 CFR 422.2274(g)(2)(ii) and 423.2274(g)(2)(ii):

"All marketing and sales calls, including the audio portion of calls conducted via web-based technology, must be recorded and retained in their entirety for a minimum period of 6 years. For the first 3 years of the retention period, records must be maintained in audio format. For years 4, 5, and 6, records may be maintained in either audio format or as complete and accurate transcript recordings."

The clock got shorter, but read these three catches before you change your storage policy:

• Enrollment portions keep 10 years. The old 10 years came from the general records rule (42 CFR 422.504(d)), and CMS kept "the requirement that enrollment records be retained for 10 years." The enrollment portion "begins when the beneficiary is advised that they are completing an enrollment request."

• Combined calls aren't resolved. Commenters said sales and enrollment often share one call; CMS called that out of scope. If your recordings aren't split, keeping the whole call 10 years is the cautious choice.

• Six years is a minimum. CMS noted a State Medicaid Agency Contract may require longer for dually eligible enrollees.

I'd argue the combined-call bullet is the one to read twice. A shorter clock is tempting, but a single recording that holds both the sales conversation and the enrollment is exactly the case CMS left open.

If you do one thing this week: rewrite your TPMO question as a before-benefits test with a not-applicable path, then have reviewers score the same few calls with it and compare.

Key dates

• April 2, 2026: CMS issues the final rule, published April 6 at 91 FR 17384 (FR Doc 2026-06600).

• June 1, 2026: Effective date. The new text enters the CFR.

• October 1, 2026: Applies to all CY2027 marketing and communications; six-year retention takes effect.

• October 15 to December 7, 2026: Annual Enrollment Period (42 CFR 422.62(a)(2)(iii)).

• January 1, 2027: The rule applies to coverage beginning this date.

FAQ

Is reading the disclaimer in the first minute still compliant?

For CY2027 marketing, yes, as long as it also comes before any discussion of benefits and uses the updated wording. For calls after October 1 that market 2026 coverage, the rule doesn't say which wording applies, so ask your plan partners.

Do agents have to read it on calls that never reach benefits?

CMS says: "If there is no discussion of benefits, CMS would not expect TPMOs to provide the disclaimer to beneficiaries." You can still read it on every sales call for consistency; just don't score its absence as a failure there.

Can we delete marketing and sales recordings older than 6 years?

The CMS requirement is now a 6-year minimum, down from 10. When proposing the change, CMS said marketing and sales portions older than 6 years "would no longer need to be retained." Before you purge, check plan contracts, enrollment portions (10 years), legal holds, open complaints or investigations, and state record rules, and get sign-off from counsel.

Can we replace audio with transcripts?

Only for years 4, 5 and 6 of a marketing and sales recording; years 1 through 3 stay in audio. The transcript must document "the full recording, reflecting all statements made by the participants as it originally occurred," and CMS said "transcript summaries are too limited." Enrollment portions are different: for phone enrollments, CMS says the recording "serves as the enrollment form," and it hasn't said a transcript can replace it.

A note for Calladhere customers

If you audit TPMO timing in Calladhere, that question belongs to your agency, so you can change it: swap a first-minute test for a before-benefits test in the question and its AI grading instructions, and choose how not-applicable answers score. Each AI answer comes with a written explanation and, where relevant, the transcript lines it relied on, so reviewers can check the call themselves.