What is the definition of Abuse? - correct answer Abuse includes any practice that results in the provision of services that are not medically
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An agent should only enroll a consumer in a product: - correct answer That is suitable for the consumer's needs, goals and financial resources.
When marketing UnitedHealthcare Medicare Advantage plans to consumers, which of the following must an agent do? - correct answer Provide current marketing materials that have been approved by CMS and UnitedHealthcare.
Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? - correct answer Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates her legal authority to enroll her father.
When can telephonic contact with a Medicare eligible consumer be made? - correct answer When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
An individual with Power of Attorney is an example of what authority? - correct answer Legal authority under state law to act on behalf of another individual.
Janine, currently enrolled in a 3-star plan, discovers there is 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: - correct answer Josh should tell Janine that she can only change her current plan to a 5-star plan during the Annual Election Period.
Educational events allow for which of the following to occur? - correct answer Provide objective information about the Medicare program and/or health improvement and wellness.
Dino, an agent, received a phone call on September 29 from a consumer interested in Medicare Advantage plans for the new plan 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 October 15. What did Dino do that was NOT compliant? - correct answer Dino presented a plan prior to October 1.
Annual Election Period (AEP) is a time when: - correct answer Consumers can elect to join a Medicare Advantage Plan or switch to a different plan.
What type of events must an agent report to UnitedHealthcare? - correct answer Formal and informal marketing/sales events
Which of the following are the ways to report potential FWA? - correct answer Producer Help Desk (DHP)
Fraud, Waste and/or Abuse hotline
What is the definition of Fraud? - correct answer Fraud is intentionally misrepresenting or concealing facts to obtain something of value.
What is the purpose of the Statement of Understanding? - correct answer It ensures that when consumers sign the Medicare Advantage and/or Part D Enrollment Application they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling and standard disclosures.
In what product should agents enroll consumers? - correct answer A product that is suitable for the consumer's needs, goals and financial resources.
As an agent, you must not do which of the following when marketing UnitedHealthcare Medicare Advantage plans to consumers? - correct answer Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval.
To sign an Enrollment Application on behalf of a consumer, what authority must the individual have? - correct answer The individual must be legally authorized in the state in which the consumer resides to act on behalf of the consumer (e.g. Power of Attorney).
In which of the following situations can telephonic contact be made with a Medicare eligible consumer? - correct answer When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and that the permission has not yet expired.
Julie, a consumer, is having difficulty understanding the information her agent, Victor, is presenting at her in-home appointment. She provides Victor with her cousin's telephone number and email address and asks him to explain the plan to her cousin, who frequently assists with her health care decisions. The next day, Victor emails Julie's cousin. Has Victor been compliant? - correct answer No. Victor violated UnitedHealthcare permission to contact guidelines by emailing Julie's cousin without the cousin's permission.
When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire? - correct answer Once contact is made or 9 months from the date the consumer provided permission (e.g. consumer signature date on BRC) or 90 days if on federal do not call list, whichever comes first.
Agent Brenda is presenting Medicare Advantage plan options to her consumer, Melanie. During the presentation, Brenda tells Melanie that Medicare gives each plan a Star Rating. Which of the following is not an appropriate response when Melanie asks what the Star Rating means? - correct answer Brenda should tell Melanie that the Star Rating is the same for every plan and it does not accurately reflect a plan's performance in certain categories.
Providing objective information about the Medicare program and/or health improvement and wellness at public venues is the purpose of which of the following? - correct answer Educational events
Kira has scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When she arrives at the appointment, a friend of the consumer who is Medicare-eligible is present to hear your presentation. What should Kira do? - correct answer Before Kira can start the presentation with both consumers, she must ask the consumer's friend to complete an SOA.
Which of the following material is an agent NOT permitted to display and/or distribute at a marketing/sales event? - correct answer 5-dollar gift cards to an in-network pharmacy.
Which election period runs from October 15 to December 7 and allows consumers to elect to join a Medicare Advantage Plan or switch to a different plan? - correct answer Annual Election Period (AEP).
When completing a enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address? - correct answer The consumer/member would not receive plan related correspondence intended for him/her.In terms of events, which of the following is true?
Agents must only report formal marketing/sales events United Healthcare.
Agents must only report informal marketing/sales events to United Healthcare.
Agents must only report formal and informal marketing/sales events to United Healthcare. - correct answer ...
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or her own email address in a field available for the consumer's email address?
The consumer/member would not receive plan related correspondence intended for him/her.
The enrollment application may be denied.
The agent may experience commission payment processing issues. - correct answer The consumer/member would not receive plan related correspondence intended for him/her.
Which election period runs from October 15 to December 7 and allows consumers to elect to join a Medicare Advantage Plan or switch to a different plan?
Open Enrollment Period (OEP)
Special Election Period (SEP)
Initial Coverage Election Period (ICEP)
Annual Election Period (AEP) - correct answer Annual Election Period (AEP)
Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event?
Medicare Made Clear brochures from the UnitedHealthcare Toolkit.
Pens and notepads that contain the agent's contact information.
5-dollar gift cards to an in-network pharmacy.
Generic business reply cards for Medicare products. - correct answer 5-dollar gift cards to an in-network pharmacy.
Mr. and Mrs. Nelson, who are current members, unexpectedly walk into Jake's insurance agency office and ask him to discuss Medicare Advantage Plans. Does Jake need to obtain a Scope of Appointment (SOA) form?
Yes, but just one because the Nelsons are husband and wife.
Yes, he needs to obtain an SOA from both Mr. and Mrs. Nelson.
No, because the Nelsons are current members.
No, because the Nelsons walked into his office instead of scheduling an appointment in their home. - correct answer Yes, he needs to obtain an SOA from both Mr. and Mrs. Nelson.
Educational events allow for which of the following to occur?
Provide objective information about the Medicare program and/or health improvement and wellness.
Provide an opportunity to review benefits, premiums, and product information with consumers.
Provide an opportunity to steer a consumer toward a specific or limited number of plans.
Provide an opportunity to give an introductory presentation followed by an informal marketing/sales event. - correct answer Provide objective information about the Medicare program and/or health improvement and wellness.
How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 stars?
Erin should let Mrs. Rose know that the rating is for agent use only and has accidentally been printed in the Enrollment Guide.
Erin should tell Mrs. Rose that the plan has received a "Below Average" rating.
Erin should tell Mrs. Rose that each plan has the same Star Rating and it does not accurately reflect an individual plan's performance in certain categories. - correct answer ...
Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant?
After enrolling a consumer, he mails a thank you card from the UnitedHealthcare Toolkit and encloses a few business cards for the new member to pass along to acquaintances.
At each appointment he provides extra business cards to the consumer and asks that the consumer pass them along to acquaintances.
At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. - correct answer At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual.
Consumer Gary gives his friend's telephone number and email address to agent Bethany. What should Bethany do?
Bethany may accept the contact information and telephone or email Gary's friend to schedule a face-to-face meeting.
Bethany may accept the information but must observe permission to contact and unsolicited contact guidelines, which will limit her to using postal mail to contact Bethany's friend.
Bethany should ask for Gary's friend's address so she can visit him while she is in the neighborhood. - correct answer Bethany may accept the information but must observe permission to contact and unsolicited contact guidelines, which will limit her to using postal mail to contact Bethany's friend.
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?
John may sign the Enrollment Application and must submit documentation that indicates his authority under state law to enroll his mother with the application.
John may attend a personal/individual marketing appointment with his mother but has no authority to sign the Enrollment Application.
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.
John may sign the Enrollment Application but does not need to provide documentation to support his claim of authority upon request by the Plan. - correct answer 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.
In which of the following situations can telephonic contact be made with a Medicare eligible consumer?
When confirming receipt of mailed information.
When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
When a member has voluntarily disenrolled from a plan. - correct answer When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father?
Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates her legal authority to enroll her father.
Jacob must explain that Emily will sign the Enrollment Application and that no further action on her part is required.
Jacob must explain that Emily will sign the Enrollment Application and must submit documentation with the application that indicates her legal authority to enroll her father.
Jacob must explain that Emily is not authorized to complete the Enrollment Application on behalf of her father. - correct answer jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation upon request by the Plan that indicates her legal authority to enroll her father. [Show Less]