2021 United Healthcare - Ethics And Compliance Latest Solution Actual Quiz

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2021 United Healthcare - Ethics And Compliance Latest Solution Actual Quiz In terms of events, which of the following is true? Correct Answers: WRONG - Agents must report formal marketing/sales e... vents only to United Healthcare When completing an enrollment application in LEAN, why is an agent prohibited from entering their own email address in a field available for the consumer's email address? Correct Answers: The consumer/member would not receive plan related correspondence intended for him/her. Annual Election Period (AEP) is a time when: Correct Answers: Consumers can elect to join a Medicare Advantage Plan or switch to a different plan. 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? Correct Answers: Before you can start the appointment with both consumers, ask the consumer's friend to complete an SOA. Educational events allow for which of the following to occur? Correct Answers: Provide objective information about the Medicare program and/or health improvement and wellness. 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 Answers: 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. When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire? Correct Answers: 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. 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 Answers: No. Victor violated United Healthcare permission to contact guidelines by emailing the cousin without the cousin's permission. 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? Correct Answers: 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. Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and United Healthcare’s rules, policies, and procedures? Correct Answers: Mailing a marketing brochure to the consumer via postal mail. To sign an enrollment application on behalf of a consumer, what authority must the individual have? Correct Answers: 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). As an agent, you must not do which of the following when marketing United Healthcare Medicare Advantage plans to consumers? Correct Answers: Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval. As an agent, you have an obligation to only enroll a consumer in a product: Correct Answers: That is suitable for the consumer's needs, goals, and financial resources. What is the purpose of the Statement of Understanding? Correct Answers: 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. What is the definition of Fraud? Correct Answers: Fraud is intentionally misrepresenting or concealing facts to obtain something of value. Which of the items listed are examples of Fraud, Waste, and Abuse (FWA)? Correct Answers: - Submitting claims for services or supplies that were never provided - Consulting with a number of doctors in order to obtain multiple prescriptions for the same drug. - Billing for brand name drugs when generics were dispensed. Whose email address may the agent enter into the LEAN enrollment application? Correct Answers: Only the consumer's (or leave it blank). Which election period occurs from October 15 to December 7? Correct Answers: Annual Election Period (AEP) Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing /sales event? Correct Answers: 5 dollar gift cards to an in-network pharmacy. 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 Answers: Educational events Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant? Correct Answers: 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 his friend's telephone number and email address to agent Bethany. What should Bethany do? Correct Answers: 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. When can telephonic contact with a Medicare eligible consumer be made? Correct Answers: When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. Who has the authority to sign an Enrollment Application? Correct Answers: The consumer or the consumer's authorized legal representative (e.g. Power of Attorney). What is the definition of Abuse? Correct Answers: Abuse includes any practice that results in the provision of services that are not medically necessary. Which of the following are the ways to report potential FWA? (Select 2) Correct Answers: - Producer Help Desk (PHD) - Fraud, Waste, and/or Abuse hotline Agent Kim is conducting an event that has been advertised as educational. Which activities are permitted at an educational event? Correct Answers: Displaying and distributing business cards and lead cards, scheduling one-on-one marketing appointments, and obtaining scope of appointment forms. When 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 Answers: Leave any field requesting a consumer email address blank. Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? Correct Answers: 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? Correct Answers: Yes, he needs to obtain a SOA from both Mr. and Mrs. Nelson. 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 Answers: Education events Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant? Correct Answers: 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. 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 Answers: No. Victor violated United Healthcare permission to contact guidelines by emailing the cousin without the cousin's permission. An individual with Power of Attorney is an example of what authority? Correct Answers: Legal authority under state law to act on behalf of another individual. When can telephonic contact with a Medicare eligible consumer be made? Correct Answers: When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. CONTINUES... [Show More]

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