⚠ Know This Cold
Protection Architects · Compliance

Compliance Reference

TCPA, CMS, HIPAA, state rules — everything you need to stay clean and keep your license.

Call Window
8am – 8:30pm
Local time in prospect's state. No exceptions.
Consent Records
5 Years
Keep all TCPA consent documentation for 5 years minimum.
Recording Disclosure
Every Call
"This call may be recorded" — required on every single call.
Medicare SOA
48 Hours
Scope of Appointment must be completed 48 hrs before Medicare sales call.
TPMO Disclaimer
Required
Must be read on all Medicare calls. Script is in the Medicare section.
E&O Insurance
$1M / $1M
Minimum $1M per occurrence / $1M aggregate. COI on file with PIC.
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TCPA Consent Requirements
Telephone Consumer Protection Act — the most important compliance rule you have
Required
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What TCPA Requires
Before contacting any lead via phone, text, or autodialer, you must have documented prior express written consent from that person. This means they opted in knowing they would receive calls/texts about insurance products.
✅ What You MUST Have
  • Written consent with date, time, and IP address logged
  • Consent language that specifically mentions insurance calls/texts
  • Opt-in checkbox that was NOT pre-checked
  • Statement that consent is not required to receive service
  • Records kept for minimum 5 years
  • Consent verified before first contact on every lead
❌ What You CANNOT Do
  • Call leads where you cannot document consent
  • Use a pre-checked consent box on any form
  • Require consent as a condition of service
  • Contact anyone on the National DNC Registry without consent
  • Call before 8am or after 8:30pm local time
  • Continue calling after someone requests to be on your internal DNC
Penalty: TCPA violations carry fines of $500–$1,500 per call/text. Class action lawsuits are common. This is the #1 legal risk in telesales. PIC requires full TCPA compliance — any violation is grounds for immediate termination.
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Compliant Opt-In Language
Exact language required on all lead capture forms
Required
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Required Form Language
"By checking this box (optional), I agree to receive SMS text messages and phone calls from Priority Insurance Concepts at the number provided above. Message and data rates may apply. I understand this consent is not required to receive a quote or purchase insurance. Reply STOP to opt out at any time."
Rules for the Checkbox
  • Checkbox must be unchecked by default
  • Checkbox must be optional — form submits without it
  • Language must say "consent is not required"
  • Must include opt-out instructions (STOP)
  • Must specify the business name
SMS Opt-In Confirmation Message
"You're confirmed for SMS updates from Priority Insurance Concepts. Msg & data rates may apply. Reply STOP to cancel, HELP for help."
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Calling Hours — State by State
8am–8:30pm local time in the prospect's state — always
Critical
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PIC Time Zone Rules (n8n Enforced)
StateTime ZoneCall Window (Local)Call Window (Las Vegas)
Virginia (VA)America/New_York (ET)8:00am – 8:30pm ET5:00am – 5:30pm PT
North Carolina (NC)America/New_York (ET)8:00am – 8:30pm ET5:00am – 5:30pm PT
South Carolina (SC)America/New_York (ET)8:00am – 8:30pm ET5:00am – 5:30pm PT
Texas (TX)America/Chicago (CT)8:00am – 8:30pm CT6:00am – 6:30pm PT
Nevada (NV)America/Los_Angeles (PT)8:00am – 8:30pm PT8:00am – 8:30pm PT
Important: These windows are enforced in all n8n automation workflows. AVA will not dial outside these windows. However, if you are manually dialing, you are personally responsible for checking the time in the prospect's state before calling.
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CMS / TPMO Requirements
PIC operates as a Third Party Marketing Organization — these rules are non-negotiable
Required
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TPMO Disclaimer — Read on Every Medicare Call
"We do not offer every plan available in your area. Currently we represent [number] organizations which offer [number] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options."
This disclaimer is required by CMS on ALL Medicare sales and marketing calls. If you skip this, you are out of compliance. Period.
Scope of Appointment (SOA)
  • SOA must be completed at least 48 hours before a Medicare Advantage or Part D sales appointment
  • SOA must be documented — PIC uses GHL forms for this
  • You may only discuss products that were listed on the SOA
  • Exception: walk-in appointments and the beneficiary requests the meeting
Medicare Marketing Rules
  • Do NOT call Medicare beneficiaries without a documented lead or referral
  • Do NOT conduct sales at educational events
  • Do NOT use the Medicare name/logo in misleading ways
  • Do NOT claim to be calling from Medicare or the government
  • Do NOT market door-to-door or in common areas of care facilities
  • Do NOT send unsolicited emails or texts about Medicare plans
Annual Requirements
  • Complete AHIP certification annually before AEP (typically July)
  • Complete all required carrier certifications annually
  • Maintain active appointments with all carriers you sell
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Medicare Enrollment Periods
Know when you can and cannot enroll clients
Reference
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PeriodDatesWhat's Allowed
Initial Enrollment Period (IEP)3 months before / month of / 3 months after 65th birthdayAny Part A, B, C, D plan
Annual Enrollment Period (AEP)Oct 15 – Dec 7Switch MA plans, add/drop Part D
Open Enrollment Period (OEP)Jan 1 – Mar 31Switch MA plans once
Special Enrollment Period (SEP)Triggered by qualifying eventVaries by SEP type
Med Supp Open Enrollment6 months after Part B effectiveAny Med Supp, no underwriting
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HIPAA — Health Information Privacy
Protecting client health information — required by federal law
Required
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What is PHI (Protected Health Information)
Any health information that can identify a specific person — including names combined with health conditions, diagnoses, medications, medical history, or treatment information collected during the sales process.
✅ What You Must Do
  • Keep all client health information strictly confidential
  • Only share PHI with carriers as required for underwriting
  • Use PIC-approved systems (GHL, Airtable) — never personal email or notes apps
  • Lock your device when not in use
  • Report any suspected data breach to Jason immediately
❌ What You Cannot Do
  • Share client health information with anyone not involved in their coverage
  • Discuss client health details in public places
  • Store health information in unencrypted personal files
  • Use client information for any purpose other than their insurance
  • Leave client information visible on screen in public
Penalty: HIPAA violations range from $100 to $50,000 per violation with a maximum of $1.9M per year for repeated violations. Criminal penalties include up to 10 years imprisonment for intentional misuse.
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PIC Active States — Rules & Requirements
VA, NC, SC, TX, NV — know the rules for each state you work
Reference
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StateLicense RequiredKey RulesPriority
Virginia (VA) Life & Health Two-party consent for recordings. 8am–9pm call window (state rule, PIC uses 8:30pm). Priority
North Carolina (NC) Life & Health One-party consent for recordings. Standard TCPA rules apply. Priority
Texas (TX) Life & Health One-party consent. State DNC list in addition to federal. High volume market. Volume
Nevada (NV) Life & Health One-party consent. PIC home state. Standard federal rules. Supplemental
South Carolina (SC) Life & Health One-party consent. Pending scale — apply same standards as NC. Pending Scale
Virginia Two-Party Consent: In VA, all parties must consent to being recorded. Your recording disclosure at the start of every call ("this call may be recorded") handles this — but you must get their verbal acknowledgment before proceeding. If they object to recording, you may not record that call.
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Recording Requirements
All calls must be recorded — no exceptions
Required
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PIC Recording Policy
  • ALL phone-based marketing, sales, and enrollment calls must be recorded
  • ALL video closes (Whereby) must be recorded and stored
  • Recording disclosure required at the start of every call
  • Recordings stored in R2 and accessible for audit at any time
  • Unrecorded business may result in forfeiture of commissions
Required Disclosure — Every Call
"Thank you for calling [department] at Priority Insurance Concepts — this is [Your Name]. Just so you know, this call may be recorded for quality and training purposes."
Virginia — Two-Party Consent Additional Step
"Before we get started — do I have your consent to record this call for quality purposes?"
In VA only — if the prospect says no, you cannot record. Proceed with the call unrecorded and note it in GHL. Do not proceed with an application on an unrecorded VA call without documenting the refusal.
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Do Not Call (DNC) Requirements
Federal and internal DNC — both must be honored
Required
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National DNC Registry
You cannot call numbers on the National DNC Registry unless you have prior express written consent from that specific number. PIC scrubs all purchased leads against the DNC registry before distribution.
Internal DNC — Immediate Action Required
  • If a prospect says "don't call me" or "put me on your do not call list" — stop the call immediately
  • Add the DNC tag in GHL immediately after the call
  • Never call or text that number again from any PIC system
  • Internal DNC requests must be honored within 30 days (PIC honors immediately)
Script — When Someone Requests DNC
"Absolutely — I'll make sure you're added to our do not contact list right now and we will not reach out again. I apologize for any inconvenience. Have a good day."
Texas State DNC
Texas maintains its own state DNC list in addition to the federal registry. TX leads must be scrubbed against both the federal and Texas state DNC lists before contact.
Penalty: Violating DNC rules carries fines up to $43,792 per call (federal) and additional state penalties. Three violations can result in license revocation.