US · guidance
CMS Pub. 100-16, ch. 9, § 50.1.1
Rules for Direct Contract and “800 series” Plans
CMS has waived the prior review and approval requirements for marketing materials and
election forms contained in 42 CFR 422.2262 for all EGWPs. These waivers apply to “800
series” and Direct Contract plans.
As a result of this waiver, Direct Contract plans and MAOs offering “800 series” EGWPs or
employer-sponsored individual MA plans are not subject to the annual restriction on
communications directed to Medicare eligible beneficiaries prior to October 1st. Rather, CMS
strongly encourages employer/union sponsors and entities offering these plans to
employers/unions to communicate to beneficiaries early in the process and to continue to
communicate about their benefits frequently prior to their annual open enrollment period (which
may differ from Medicare’s annual coordinated election period. Employers/unions and/or entities
that offer employer-sponsored “800 series” or individual plans to employers/unions should direct
beneficiaries to available resources and explain their coverage and how it coordinates with
Medicare.
History
(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
ac1b00fa87a08fc7ab29c06c267f78fa4a3427fb18d9dfdd284e8e1d2ee77483
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.