AHIP TRAINING MODULE 4 MARKETING QUESTION AND ANSWERS ALL ANSWERS CORRECT

PRENTICE has many clients who are Medicare beneficiaries. He should review the Centers for Medicare and Medicaid Services' Marketing guidelines to ensure he is compliant for which type of products? Ans- MA and PDP A ...

PRENTICE has many clients who are Medicare beneficiaries. He should review the Centers for Medicare and Medicaid Services' Marketing guidelines to ensure he is compliant for which type of products? Ans- MA and PDP Another agent working for your agency claims that because you are not employed by the MA plans that you represent, you are not subject to the same requirements as the plans themselves. Ans- Your coworker is NOT correct. Marketing on behalf of a plan is considered marketing by the plan and requires that all contracted and employed agents comply with ALL Medicare marketing rules. You work for a company that has marketed Medigap products for many years. The company has added MA and Part D plans and you will begin marketing those plans this fall. You are planning what materials to use to easily show the difference in benefits, premiums and cost sharing for each of the products. What do you need to do with your materials before using them for marketing purposes? Ans- You must submit your materials to the plan you represent, so CMS can review and approve the materials to ensure they are accurate. Which of the following is a correct statement about state laws as they pertain to marketing representatives? Ans- Medicare health plans must comply with requests for information from state insurance departments investigating complaints about a marketing representative. You are seeking to represent an individual MA plan and an individual Part D plan in your state. You have completed the required training for each plan, but you did not achieve a passing score on the tests that came after the training. What can you do in this situation? Ans- You will NOT be able to represent any MA or Part D plan until you compete the training and achieve an adequate score, although you will NOT have to take a test if you exclusively market employer/union group plans and the companies do not require testing. Your colleague works at a third party marketing organization, TMO and she said she did not need to take the Medicare training for brokers and agents or pass a test to market Medicare plans since her contract is with the TMO, not the plans that have the products she sells. Ans- You could tell her she is wrong, and that only agents selling Employer/union group plans are permitted an exemption from testing, but some employer/union group plans may require testing to promote agent compliance with CMS marketing requirements. During a sales presentation to Ms. Daley for MA plan that has a 5 star rating in customer service and care coordination, and received an overall plan performance rating of a 4 star, which of the following would be the correct statement to say to her? Ans- The MA plan received a 5 star rating in customer service and care coordination with an overall performance rating of 4 stars. During a sales presentation, you client ask you whether the Medicare agency recommends that she sign up for your plan or stay in Original Medicare. Ans- Tell her that the Medicare agency does not endorse or recommend any plan. Medicare health plan establish provisions in marketing representative contracts to ensure compliance with applicable laws and policies. If non-compliance occurs, CMS can penalize a plan in which of the following ways? Ans- CMS requires plan sponsors to create and complete a corrective action plan and may terminate a sponsor's contract. You have set up an appointment for an in-home sales presentation with Mrs. Fowler, who expressed interest in the Medicare plans you represent. In preparation for the sales presentation, what must you do? Ans- Prior to conducting the presentation, obtain, and document having obtained her permission to visit, along wit her interest in the specific products you will present. LU is turning 65 in November and called to ask for your help deciding on a MA plan. She agreed to sign a scope of appointment form and meet with you October 15. During the appointment, what are you permitted to do? Ans- You may provide her with the required enrollment material and take her completed enrollment application. The scope of appointment forms must be retained for a period of ten years. Ans- A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the MA program. Before engaging in such a discussion, what should you do? Ans- You must have her sign a scope of appointment form, indicating which products she wishes to discuss, and note on the form that she is a "walk in. " You may then proceed with the discussion. You are meeting with Mrs. Hall in her home. On her scope of appointment form she asked to discuss MA plans. During the meeting, she asks to discuss a stand-alone Rx plan. She is leaving the next day to visit her family in another state, so it is important to her to make a decision before she leaves. What must happen before that additional discussion can take place? Ans- Since Mrs. Hall specifically asked that you discuss the stand-alone Part D plan, you may do so, as long as she signs a new scope of appointment form first, indicating that she wants to discuss the Part D plan. Third parties may NOT make unsolicited calls, visits, or emails to Medicare beneficiaries in order to set up such appointments, or for any othe