UHC Ethics & Compliance 2022/2023 with complete solutions

Document Content and Description Below

What type of events must an agent report to UnitedHealthcare? - THE CORRECT ANSWER IS Only the marketing/sales events, both formal and informal. While using LEAN to complete an enrollment applicati... on with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - THE CORRECT ANSWER IS Leave any field requesting a consumer email address blank. Which election period occurs from October 15 to December 7? - THE CORRECT ANSWER IS Annual Election Period (AEP) Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? - THE CORRECT ANSWER IS 5 dollar gift cards to an in-network pharmacy. 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? - THE CORRECT ANSWER IS Before you can start the appointment with both consumers, ask the consumer's friend to complete an SOA. Which describes the purpose of educational events? - THE CORRECT ANSWER IS Educational events 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? - THE CORRECT ANSWER IS Erin should tell Mrs. Rose that the plan has received a "Below Average" rating. When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire? - THE CORRECT ANSWER IS 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. Consumer Gary gives his friend's telephone number and email address to agent Bethany. What should Bethany do? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS 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? - THE CORRECT ANSWER IS When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. To sign 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). Which of the following must you not do when marketing UnitedHealthcare Medicare Advantage or Prescription Drug Plans to consumers? - THE CORRECT ANSWER IS In what product should agents enroll consumers? - THE CORRECT ANSWER IS A product that is suitable for the consumer's needs, goals and financial resources. What is the purpose of the Statement of Understanding? - THE CORRECT ANSWER IS 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 Abuse? - THE CORRECT ANSWER IS 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) - THE CORRECT ANSWER IS Fraud, Waste and/or Abuse hotline & Producer Help Desk (PHD) Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? - THE CORRECT ANSWER IS Only the marketing/sales events, both formal and informal. Annual Election Period (AEP) is a time when: - THE CORRECT ANSWER IS Consumers can elect to join a Medicare Advantage Plan or switch to a different plan. 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? - THE CORRECT ANSWER IS Dino presented a plan prior to October 1. Providing objective information about the Medicare program and/or health improvement and wellness at public venues is the purpose of which of the following? - THE CORRECT ANSWER IS Educational events Agent Ralph wants to market Medicare 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? - THE CORRECT ANSWER IS Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail. Which of the individuals below would not likely have the authority to enroll a consumer in a Medicare Advantage Plan? - THE CORRECT ANSWER IS The consumer's spouse, who is neither a Power of Attorney or legal guardian. When can telephonic contact with a Medicare eligible consumer be made? - THE CORRECT ANSWER IS When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. As an agent, you must not do which of the following when marketing UnitedHealthcare Medicare Advantage plans to consumers? - THE CORRECT ANSWER IS 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: - THE CORRECT ANSWER IS That is suitable for the consumer's needs, goals and financial resources. [Show More]

Last updated: 2 years ago

Preview 1 out of 3 pages