Agent Don plans to conduct a marketing/sales event at the local public library on October 28 at 2pm. He received permission to post an advertisement on the library bulletin board starting October 14. What is the latest date Don could submit a NEW Event Request Form to UnitedHealthcare in order to comply with UnitedHealthcare’s event reporting rules?
October 14 as events must be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the event
In terms of events, which of the following is true?
A) Agents must report formal marketing/sales events only to UHC
B) Agents must report informal marketing/sales events only to UHC
C) Agents must report all marketing/sales and educational events to UHC
D) Agents must report formal and informal marketing/sales events only to UHC
A) Agents must report formal marketing/sales events only to UHC
B) Agents must report informal marketing/sales events only to UHC
C) Agents must report all marketing/sales and educational events to UHC
D) Agents must report formal and informal marketing/sales events only to UHC
Dino, an agent, received a phone call on Sept. 29 from a consumer interested in Medicare Advantage plans for the new year. Dino proceeded to verify the consumer’s Medicare eligibility, describe the costs and benefit coverage of the plan, and explained that he could not accept an enrollment application until Oct. 15. What did Dino do that was NOT compliant?
A) Dino did nothing that was non-compliant
B) Dino refused to take the enrollment application until Oct. 15
C) Dino presented a plan prior to Oct. 1
A) Dino did nothing that was non-compliant
B) Dino refused to take the enrollment application until Oct. 15
C) Dino presented a plan prior to Oct. 1
You have scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When you arrive at the appointment, a friend of the consumer who is Medicare-eligible is present to hear your presentation. What should you do?
A) Before you can start the appointment with both consumers, ask the consumer’s friend to complete an SOA
B) Ask the consumer’s friend to complete the SOA and schedule a separate appointment
C) Tell the consumer that you will come back on another day
D) Ask the consumer’s friend to leave since she had not scheduled the appointment.
A) Before you can start the appointment with both consumers, ask the consumer’s friend to complete an SOA
B) Ask the consumer’s friend to complete the SOA and schedule a separate appointment
C) Tell the consumer that you will come back on another day
D) Ask the consumer’s friend to leave since she had not scheduled the appointment.
Janine, currently enrolled in a 3-star plan, discovers there is a 5-star plan available where she lives. She asks her agent, Josh, to enroll her in the 5-star plan. Josh can advise Janine of each of the following except:
A) Josh should tell Janine that she can change her current plan to a 5-star plan since one is available in the area where she lives.
B)Josh should tell Janine that she can only use the 5-star SEP once per calendar year
C) Josh should tell Janine that the new coverage will start the first month after she enrolls in the 5 star plan
D) Josh should tell Janine that she can only change her current plan to a 5 star plan during the Annual Election Period
A) Josh should tell Janine that she can change her current plan to a 5-star plan since one is available in the area where she lives.
B)Josh should tell Janine that she can only use the 5-star SEP once per calendar year
C) Josh should tell Janine that the new coverage will start the first month after she enrolls in the 5 star plan
D) Josh should tell Janine that she can only change her current plan to a 5 star plan during the Annual Election Period
Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant?
A) At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older
B) At each appointment he provides extra business cards to the consumer and asks that they pass them along to acquaintances
C) After enrolling a consumer, he mails a thank you card from the UHC Toolkit and encloses a few business cards for the new member to pass along to acquaintances.
A) At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older
B) At each appointment he provides extra business cards to the consumer and asks that they pass them along to acquaintances
C) After enrolling a consumer, he mails a thank you card from the UHC Toolkit and encloses a few business cards for the new member to pass along to acquaintances.
Agent Ralph wants to market Advantage Plans in his neighborhood – an area that consists of single-family houses, an assisted living facility, a church, and public library. Which of the following methods of contact is permitted?
A) Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail
B) Ralph puts a flyer inviting consumers to a marketing/sales event on the door of each house.
C) Ralph stands in the lobby of the assisted living facility and hands out to the residents a flyer inviting them to a marketing/sales event.
D) Ralph puts a flyer inviting consumers to a marketing/sales event on the windshield of each car in the church parking lot on Sunday morning.
A) Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail
B) Ralph puts a flyer inviting consumers to a marketing/sales event on the door of each house.
C) Ralph stands in the lobby of the assisted living facility and hands out to the residents a flyer inviting them to a marketing/sales event.
D) Ralph puts a flyer inviting consumers to a marketing/sales event on the windshield of each car in the church parking lot on Sunday morning.
John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan?
A) John may sign the Enrollment Application and must be able to provide documentation upon request by the plan that indicates his authority under state law to enroll his mother
B) John may sign the Enrollment Application, but does not need to provide documentation to support his claim of authority upon request by the plan
C) John may sign the Enrollment Application and must submit documentation that indicates his authority under state law to enroll his mother with the application
D) John may attend a personal.individual marketing appointment with his mother, but has no authority to sign the Enrollment Application
A) John may sign the Enrollment Application and must be able to provide documentation upon request by the plan that indicates his authority under state law to enroll his mother
B) John may sign the Enrollment Application, but does not need to provide documentation to support his claim of authority upon request by the plan
C) John may sign the Enrollment Application and must submit documentation that indicates his authority under state law to enroll his mother with the application
D) John may attend a personal.individual marketing appointment with his mother, but has no authority to sign the Enrollment Application
When can telephonic contact with a Medicare eligible consumer be made?
A) When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
B) When confirming receipt of mailed information
C) When a member has voluntary disenrolled from a plan
A) When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
B) When confirming receipt of mailed information
C) When a member has voluntary disenrolled from a plan
As an agent, you MUST NOT do which of the following when marketing UHC Medicare Advantage plans to consumers?
A) Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval
B) Review and complete the Enrollment Application with consumers
C) Provide current marketing materials that have been approved by CMS and UHC
D) Review out-of-pocket maximum with consumers and explain any exceptions
A) Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval
B) Review and complete the Enrollment Application with consumers
C) Provide current marketing materials that have been approved by CMS and UHC
D) Review out-of-pocket maximum with consumers and explain any exceptions
As an agent, you have an obligation to only enroll a consumer in a product:
A) That meets the interest you have in the transaction, for example commissions received for the sale
B) That is suitable for the consumer’s needs, goals and financial resources
C) That meets the sales goal of the Centers for Medicare and Medicaid Services, UHC and the SSA
D) That provides a financial advantage to a network of providers
A) That meets the interest you have in the transaction, for example commissions received for the sale
B) That is suitable for the consumer’s needs, goals and financial resources
C) That meets the sales goal of the Centers for Medicare and Medicaid Services, UHC and the SSA
D) That provides a financial advantage to a network of providers
By signing the Statement of Understanding the consumer:
A) Acknowledges that the agent may discuss Medicare Advantage and Prescription Drug Plans with the consumer
B) Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling
C) Acknowledges their understanding of standard enrollment and disenrollment procedures
A) Acknowledges that the agent may discuss Medicare Advantage and Prescription Drug Plans with the consumer
B) Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling
C) Acknowledges their understanding of standard enrollment and disenrollment procedures
What is the definition of Abuse?
A) Abuse includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources
B) Abuse includes any practice that results in the provision of services that are not medically necessary
C) Abuse is intentionally misrepresenting or concealing facts to obtain something of value
A) Abuse includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources
B) Abuse includes any practice that results in the provision of services that are not medically necessary
C) Abuse is intentionally misrepresenting or concealing facts to obtain something of value
Which of the issues below are examples of Fraud, Waste and/or Abuse? (Select 3)
A) The pharmacy splits the original prescription to receive additional dispensing fees
B) Using another person’s medical insurance information to obtain prescriptions
C) Billing for medical services or procedures that were actually provided or performed
D) Falsifying signatures or medical records
A) The pharmacy splits the original prescription to receive additional dispensing fees
B) Using another person’s medical insurance information to obtain prescriptions
C) Billing for medical services or procedures that were actually provided or performed
D) Falsifying signatures or medical records
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