Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy
... [Show More] with his current plan. On the date of the call, what can Gene do about his coverage? - correct answer On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1.
Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? - correct answer Mrs. Violet can access the Star Rating for a plan on Medicare.gov or in the Enrollment Guide.
Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures? - correct answer Mailing a marketing brochure to the consumer via postal mail.
Which statement is true about discussing benefits with the consumer before an enrollment? - correct answer The agent must accurately and completely disclose any benefits discussed.
Which statement about discussing benefits with the consumer before an enrollment is true? - correct answer The agent must explain any provider and/or pharmacy network limitations.
While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - correct answer Leave the field requesting applicant email address blank.
What is the purpose of the Statement of Understanding? - correct answer It ensures that when consumers complete 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.
What is Scope of Appointment? - correct answer The agreement obtained from the consumer that identifies the scope of products that can be discussed at a personal/individual marketing appointment (in-person or telephonic)
Jane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Which option should Jane consider? - correct answer Jane should ask Albert if someone, such as an Authorized Legal Representative, helps him make health care or insurance-related decisions and should be present.
In which situation MAY the Medicare Advantage (MA) organization disenroll a member from an MA plan?
(if question says *must* it is not the same answer) - correct answer Premiums are not paid on a timely basis.
Dennis, a consumer, is currently enrolled in Original Medicare plus a Medicare Supplement Plan. His current plan is suitable for his medical needs, but he would like to add prescription drug coverage only. Since Dennis wants to keep his current coverage, which option is available to Dennis (assuming he is in a valid election period)? - correct answer Dennis should stay enrolled in Original Medicare and his Medicare Supplement Plan and enroll in a stand-alone PDP.
As an agent, you have an obligation to enroll a consumer in a product:
OR
An agent should only enroll a consumer in a product: - correct answer That is suitable for the consumer's needs, goals and financial resources.
An agent is explaining Medicare Advantage plan options to a consumer. During the conversation, the agent explains that Medicare gives each plan a Star Rating. Which statement is true? - correct answer The agent said that Medicare uses a 5-star rating system to illustrate the plan's performance and quality.
Before starting an enrollment, what benefit information are agents required to provide to the consumer? - correct answer The agent must accurately and completely disclose any benefits discussed
Whose email address may the agent enter into the applicant information section of LEAN enrollment application? - correct answer Only the consumer's email (or leave it blank).
The __________ ensures that when consumers provide their verbal agreement during the telephonic enrollment, they acknowledge and understand they are actually enrolling, in which plan they are enrolling, as well as the standard disclosures. - correct answer Statement of Understanding
Aries is currently a member of a stand-alone PDP. Aries would like to have additional medical coverage. A thorough needs analysis indicates a Medicare Advantage Plan would be a good fit, there are plans available in his area, and he is in a valid election period. Which option is available to Aries? - correct answer Aries can enroll into a Medicare Advantage plan with prescription drug coverage, which will disenroll him from his PDP.
To avoid confusing or misleading a consumer, what type of information must the agent provide when presenting a plan? (Select 3) - correct answer Factual
Accurate
Complete
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.
Why must an agent present accurate, complete, and factuals plan information to consumers? (select 3 - correct answer To help avoid misunderstandings
To help the consumer focus on plan-specific information, such as benefits and costs
To help avoid confusing the consumer
Which election period runs from October 15 to December 7 and allows consumers to join a Medicare Advantage Plan or switch to a different plan? - correct answer Annual Election Period (AEP)
A one-on-one marketing appointment, whether in-person or telephonic, is always considered a marketing/sales event, but it is not reported to UnitedHealthcare or CMS; instead the consumer must provide_____ agreement prior to the start of the appointment. - correct answer Scope of Appointment
To complete 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).
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? - correct answer The consumer/member would not receive plan related correspondence intended for him/her.
By agreeing to the Statement of Understanding, the consumer: - correct answer Acknowledges that they clearly understand they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling.
Jane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Which option should Jane consider? - correct answer Jane should ask Albert if someone, such as an Authorized Legal Representative, helps him make health care or insurance-related decisions and should be present.
Rosanna is enrolled in a Medicare Advantage Only (MA-Only) Private Fee-for-Service (PFFS) Plan. The plan is suitable for her needs and service area. She has decided she wants to add prescription drug coverage. Which option is available to Rosanna (assuming she is in a valid election period)? - correct answer Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone PDP.What is the definition of Abuse? - correct answer Abuse includes any practice that results in the provision of services that are not medically necesary
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 [Show Less]