Geography for use

Is this campaign for a national audience? *

Contract/Submission type

This material includes or addresses any of the following content. *

Benefits - Document contains information about plan benefits.

Cost Share - Document contains information about beneficiary cost sharing. This could be C, D, or Optional Supplemental cost sharing.

PDM - For Part D Payment Modernization Model Content

PDSS - For Part D Senior Savings Model content

PDSS Other (non-R&I) - For marketing materials that contain Part D Senior Savings model information, excluding rewards and incentives (Please use the PDSS R&I for materials containing this content).

PDSS Updated Member Materials-CY2023 - A zipped file of all PDSS updated member materials per HPMS Memo "Updates to PDSS Model Communications and Marketing Guidelines for Contract Year 2023"

Plan Comparisons - Document compares plan benefits/cost sharing/premiums/provider network/etc. to other plan(s). This could also include "generic" comparison such as "We have the lowest premium in the area." Any type of comparison must be noted.

Premiums - Document contains information about plan premiums. This could be C, D, or combined premiums. Could also be Optional Supplemental Premiums.

Provider Network - Document contains information about provider network.

Ranking Standards, other - Document provides all ranking standards (e.g. private company ratings) other than CMS' Star Ratings or Plan Comparisons identified in "Plan Comparisons" Content Type.

Rewards and Incentives - Document provides information about potential rewards and/or incentives for completion of plan identified health "activities."

SSBCI - Document provides information regarding Special Supplemental Benefits for the Chronically Ill (benefits, cost sharing, etc.)

Star Ratings - Document mentions CMS Star Ratings

VBID - Document provides information regarding Value-Based Insurance Design benefits, cost sharing, etc. For non marketing materials containing VBID content, please submit under "CMS Required"

Communication Only - Does not address any of the above criteria.

Audience and Material Life Cycle Selection

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Current Members

Prospective Members

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Material Detail Information

Material ID

Material Description *

Material contains both Part C and Part D information? *

File Upload and Attestation

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Acknowledge before submitting:

Based on my knowledge, information, and belief, I attest that the material is complete, accurate, and truthful. This attestation applies to all requirements under the File and Use Certification process and other CMS guidance.