Health plan marketing materials are largely formulaic. The Centers for Medicare & Medicaid Services (CMS) publishes standardized templates in the form of model documents. The provided language cannot be altered in any way. Even the order of the content must remain consistent. The only exception is selections or sections that are variable or where health plans are asked to create their own explanations and descriptions; these are clearly noted in the CMS model templates.

However, it can still be a challenge to understand each health plan document's primary differences and purposes. There are so many pages and acronyms that it can be difficult to keep it all straight, especially if you don't handle those documents regularly. In this article, we will look at the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents. We will explain what they are, how they are different from each other, and why it matters.

What Is the ANOC?

ANOC stands for Annual Notice of Change. The ANOC is prepared by Medicare Advantage plans and is sent to its members each year immediately before the plan’s enrollment period. It summarizes all the changes in plan costs and coverage for the coming year. Generally, the changes become effective as of January 1. However, in the case of an employer group plan, the plan year may fall off-cycle based on the employer’s open enrollment, such as a benefit period that runs from May through April of the following year. The purpose of the ANOC is to help members understand their coverage so they can make informed decisions to stay enrolled or seek out a new plan.

Individuals enrolled in a Medicare Advantage plan can expect to receive their ANOCs by September 30, each year. If there are any errors in the ANOC document, the health plan must file a correction called an “Errata,” which is a letter informing members of the error. Members must receive the errata by October 15.

What Is the EOC? 

EOC is an acronym for Evidence of Coverage. The EOC outlines everything a member needs to know about their health plan for the coming year. It details benefits information, any out-of-pocket costs, and information on how the plan works. For instance, if a member needs to figure out how to file an appeal, this document will explain how. The EOC also provides all necessary contact information for the health plan, specific departments for assistance, and how to contact Medicare directly.

Medicare Advantage and Part D plan sponsors are responsible for preparing this document. Plan sponsors are required to send the EOC out in September. Medicare requires that all members receive the EOC by October 15; if there are any errata, the plan has to send notice of those changes to members by November 15.

How are the ANOC and EOC Different?

Both the ANOC and EOC are standardized model documents. They look very similar from year to year and differ in approach. The ANOC is actually considered a marketing document providing comparative details of benefit changes year-over-year, whereas the EOC is primarily a member-facing material detailing the coming year’s benefits and how to use the plan.

The two documents are very different in scope and length. The EOC provides every single detail about a given health plan and often number hundreds of pages long. In contrast, the ANOC highlights the changes from one year to another — a task that is usually accomplished in much fewer pages.

Also, ANOC documents only vary slightly in size once populated. In contrast, the EOC changes more significantly in length (growing or reducing) as different fields are populated and non-applicable sections are removed.

Managing Health Plan Marketing Communications

The field of health plan marketing communications is highly nuanced. While required documents such as the ANOC and EOC are formed using templates, standardized language, and variable fields, managing those communications can be challenging. Aside from obvious issues relating to accuracy, many companies struggle to eliminate redundancies and maintain consistency. Maintaining accuracy and timeliness of delivery is not a choice, it is a matter of regulatory compliance.

It can be a lot to handle — and the dissemination of all of this information is on a tight schedule. Choosing a partner to help you manage your health plan marketing communications makes it easier. With Toppan Merrill Connect, we can help you develop automated, repeatable, and compliant document creation. Toppan Merrill's dynamic solutions help you increase consistency, maintain compliance, and shorten document review cycles. Learn more by contacting us at Toppan Merrill today to request a demo.

Resources

ANOC

• LINK: https://www.toppanmerrill.com/glossary/anoc/   
• MEDICARE: https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/upcoming-plan-changes

EOC

• LINK: https://www.toppanmerrill.com/glossary/eoc/  
• MEDICARE: https://www.medicare.gov/basics/forms-publications-mailings/mailings/costs-and-coverage/evidence-of-coverage

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Summer Beach, Associate Director, Medicare Compliance Solutions at Toppan Merrill

With over 25 years in the insurance industry, Summer’s focus is Medicare-related compliance. With past roles as Regulatory Compliance Manager and Director for state, regional and national insurers, her areas of SME include CMS-regulated documents and guidelines, agent/broker and sales compliance, designing CMS-approved investigation processes, audits and Corrective Action Plans, and training with re-education formats following CMS disciplines. Summer brings expertise in policies and procedures, auditing compliance programs, and has measurably reduced plans’ member complaints to CMS through remedial initiatives. Well-versed on CMS insights, Summer identifies risks to avoid, for staying compliant. Summer’s experience supports Toppan Merrill and our clients in staying compliant with CMS and regulatory requirements.