Which entity defines guidelines for prohibited unsolicited contact for Medicare plans?

• A. No guidelines exist
• B. The state insurance department's guidelines alone
• C. The plan's internal marketing policy only
• D. CMS regulations and UnitedHealthcare's rules, policies, and procedures

Answer: (D)

The main idea here is that marketing practices for Medicare plans are governed by federal rules that specify what kinds of outreach are allowed or prohibited, and these rules are put into action by the plan’s own procedures. CMS provides the overarching regulations for Medicare products, including restrictions on unsolicited contact, and UnitedHealthcare implements those requirements through its own rules, policies, and procedures. This combination ensures consistent, compliant outreach across all states and plans.

State insurance department guidelines exist, but for Medicare products the federal CMS rules take precedence, and a plan’s internal policy alone cannot define the prohibited practices. The correct framework is CMS regulations paired with UnitedHealthcare’s internal rules and procedures.