CMS Required Disclosure
Scope of Appointment (SOA)
This Scope of Appointment confirms the Medicare products that the beneficiary
has agreed to discuss with a licensed insurance agent. The beneficiary
understands that:
- The discussion is limited to the product types selected.
- No obligation to enroll exists.
- Current or future Medicare enrollment status is not affected.
- The beneficiary may request additional product discussions with a new SOA.
Products authorized to be discussed:
- ☑ Medicare Advantage (Part C)
- ☑ Prescription Drug Plans (Part D)
- ☐ Medicare Supplement (Medigap)
The beneficiary acknowledges that this appointment may be conducted
by telephone or electronically and may be recorded as required by
CMS regulations.
This Scope of Appointment is valid for twelve (12) months from the date
of consent unless revoked by the beneficiary.
By continuing, the agent attests that all CMS marketing and communication
guidelines have been followed, including no steering, no pressure,
and accurate representation of plan benefits.