UHC Ethics & Compliance 2022 Exam Graded A

Document Content and Description Below

Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS Mailing a marketing brochure to the consumer via postal mail. Which statement is true about discussing benefits with the consumer before an enrollment? - THE CORRECT ANSWER IS The agent must accurately and completely disclose any benefits discussed. Which statement about discussing benefits with the consumer before an enrollment is true? - THE CORRECT ANSWER IS The agent must explain any provider and/or pharmacy network limitations. 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 with his current plan. On the date of the call, what can Gene do about his coverage? - THE CORRECT ANSWER IS On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1. 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? - THE CORRECT ANSWER IS Leave the field requesting applicant email address blank. What is the purpose of the Statement of Understanding? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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) - THE CORRECT ANSWER IS 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)? - THE CORRECT ANSWER IS 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: - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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. - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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) - THE CORRECT ANSWER IS 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: - THE CORRECT ANSWER IS 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 - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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. - THE CORRECT ANSWER IS Scope of Appointment To complete an Enrollment Application on behalf of a consumer, what authority must the individual have? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS The consumer/member would not receive plan related correspondence intended for him/her. By agreeing to the Statement of Understanding, the consumer: - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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)? - THE CORRECT ANSWER IS Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone PDP. [Show More]

Last updated: 2 years ago

Preview 1 out of 3 pages