Once the enrollment is completed, you can save a copy of the application for your reference.
False
Which elements are available as part of Wellcare’s sales support model?
All of the above.
Centene requires all contracted brokers/agents to read, understand, and agree to Centene’s Business Ethics and Code of Conduct Policy.
True
Communication of PHI can be:
(Select all that apply.)
-Written
-Electronic
-Verbal
Prior to completing the enrollment form, you should always confirm the beneficiary’s primary care physician (PCP) and/or specialists.
True
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing.
Select one:
True
A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal.
False
Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution.
True
A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
False
The NEW online Centene Workbench self-service portal enables you to:
All of the above
What are some examples of what can trigger a beneficiary complaint?
Select All!
a.Did not consent to enroll in the plan.
b.Received incorrect plan benefit information or were dissatisfied with plan benefits.
c.Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement).
d.Were misled about which providers were in-network.
Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud.
False
What type of inquiries can Wellcare’s Corporate Sales Support team assist with?
All of the above
Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity?
All of the above
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments.
True
Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are:
All of the above
Low-Income Subsidy (LIS)/Medicaid Lookup status verification in Ascend is:
Select All!
a.Available for LIS level searches in all states.
b.Available for Medicaid status searches in select states.
c.A way to assist brokers/agents with enrolling beneficiaries into the right plan based on their extra help status.
The beneficiary (or their authorized representative) must indicate the product types to be discussed during the appointment on the Scope of Appointment (SOA).
True
Value Script and Value Plus PDP products have a _-tier formulary structure for 2023.
6
The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023.
True
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order).
True
The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on all Value Script, Value Plus PDPs, and select Wellcare MAPD plans.
True
Centene’s 2023 product expansion represents a __% increase from 2022.
3
For 2023, Ascension Complete added 27 new counties to their footprint.
True
Which standalone Prescription Drug Plan is best for a dual-eligible chooser?
Classic
For PDP Medication Home Delivery, the __ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions.
Value Plus
__ PDPs will be offered across all 50 U.S. states and Washington, D.C.
Three
__ PDPs will be offered across all 50 U.S. states and Washington, D.C.
True
All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies.
True
Wellcare added _ counties to their footprint for 2023.
209
During an appointment, you may not discuss any products not agreed to in advance by the beneficiary.
a. True
b. False
True
When a paper SOA form is used, it must be completed __ hosting the sales presentation.
a. Prior to
b. During
c. After
A. Prior to
Brokers/Agents can submit a support ticket online through their Centene Workbench portal.
Select one:
True
False
True
Wellcare does not need to be informed of all marketing/sales events at which plans or materials will be presented or distributed (Formal & Informal).
Select one:
True
False
False
Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity?
a. Speak with the investigator as quickly as possible.
b. Answer all questions honestly and completely.
c. Offer information and documents important to the investigation.
d. All of the above
D. All of the above
Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for quality are:
a. Member Satisfaction/Experience
b. Complaints
c. Rapid Disenrollment
d. All of the above
D. All of the above
Noting the correct enrollment period on enrollment applications helps in preventing delayed enrollment processing.
Select one:
True
False
True
Health plan fax numbers vary for health plans that offer fax enrollment submissions.
Select one:
True
False
True
Centene requires all contracted brokers/agents to read, understand, and agree to Centene’s Business Ethics and Code of Conduct Policy.
Select one:
True
False
True
A grievance request, or any evidence concerning a grievance, must be filed orally or in writing no later than _ calendar days from the date of the event or the date the member is made aware of the issue.
a. 30
b. 45
c. 60
d. 90
C. 60
Any request or distribution of PHI should contain only the minimum amount of PHI required to complete the intended task.
Select one:
True
False
True
Beneficiary-facing content that includes generic or plan-specific product or benefit information must be submitted for review and CMS submission, as well as acceptance or approval, prior to distribution.
Select one:
True
False
True
A broker/agent may be terminated for cause if they fail to comply with a compliance investigation, encourage others to avoid the compliance interview process, or fail to provide truthful or complete information.
Select one:
True
False
True
Failure to inform a beneficiary that a trusted provider is out-of-network or is not available in the newly selected plan can cause a sales allegation.
Select one:
True
False
True
A Health Risk Assessment (HRA) can be completed for C-SNP and D-SNP plans only, before the enrollment application process in Ascend through the Value Based Enrollment (VBE) portal.
Select one:
True
False
False
What are some examples of what can trigger a beneficiary complaint?
(Select all that apply.)
a. Did not consent to enroll in the plan.
b. Received incorrect plan benefit information or were dissatisfied with plan benefits.
c. Had enrollment/disenrollment issues (e.g., disenrollment/cancellation requests, late enrollment penalty, loss of entitlement).
d. Were misled about which providers were in-network.
All (A,B,C,D)
A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action Plan.
Select one:
True
False
False
Prior to completing the enrollment form, you should always confirm the beneficiary’s primary care physician (PCP) and/or specialists.
Select one:
True
False
True
The _ plan is expected to have one of the lowest premiums in the country!
a. Classic
b. Value Plus
c. Value Script
C. Value script
Wellcare added _ counties to their footprint for 2023.
a. 122
b. 209
c. 284
d. 327
B. 209
The Wellcare preferred pharmacy network includes Walgreens, CVS, and many grocery chains in 2023.
Select one:
True
False
True
__ PDPs will be offered across all 50 U.S. states and Washington, D.C.
a. Two
b. Three
c. Four
d. Five
B. Three
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through CVS Medication Home Delivery (Mail Order).
Select one:
True
False
True
There are _ LIS copay categories that could be assigned to a member, depending on the level of need.
a. two
b. three
c. four
d. five
C. Four
Which standalone Prescription Drug Plan is best for a dual-eligible chooser?
a. Value Script (not correct)
b. Value Plus
c. Classic
C. Classic
For 2023, Ascension Complete added 27 new counties to their footprint.
Select one:
True
False
True
For PDP Medication Home Delivery, the __ plan will continue to offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions.
a. Classic
b. Value Plus
c. Value Script
B. Value plus
Centene’s 2023 product expansion represents a __% increase from 2022.
a. 1
b. 2
c. 3
d. 5
C. 3
Centene has new PPO D-SNP product expansion in CT, IN, KS, KY, MS, OH, OK, PA, SC, and a new HMO D-SNP in LA.
Select one:
True
False
True
Value Script and Value Plus PDP products have a _-tier formulary structure for 2023.
a. 3
b. 4
c. 5
d. 6
D. 6
Wellcare offers a range of Medicare plans to provide members with affordable access to:
a. Doctors
b. Hospitals
c. Specialists
d. All of the above
D. All of the Above
What type of inquiries can Wellcare’s Corporate Sales Support team assist with?
a. Application and Enrollment
b. Onboarding and Certifications
c. Commissions
d. All of the above
D. All of the above
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments.
Select one:
True
False
True
From October 1st to October 14th, which activity is not permissible by brokers/agents?
a. Host events/1:1 appointments and discuss 2023 plan benefits.
b. Use CMS-approved 2023 sales material.
c. Assist with completing and collecting completed applications.
d. Leave an application and BRE with only your broker/agent information populated with the beneficiary.
c. Assist with completing and collecting completed applications.
Which of the following statements about Scope of Appointment (SOA) is FALSE?
a. A signed and completed Scope of Appointment (SOA) is required to be submitted for all agent-assisted enrollments.
b. You may not discuss any products not agreed to in advance by the beneficiary.
c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment.
d. SOAs are required for all personal and individual sales appointments, regardless of the venue or client relationship (e.g., in-home, conference call, library, walk-in to a broker/agent office).
c. An electronic SOA submitted in Ascend must be in a Pending status prior to beginning the appointment.
Low-Income Subsidy (LIS)/Medicaid Lookup status verification in Ascend is:
(Select all that apply.)
a. Available for LIS level searches in all states.
b. Available for Medicaid status searches in select states.
c. A way to assist brokers/agents with enrolling beneficiaries into the right plan based on their extra help status.
ALL APPLY
Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts SOAs in which of the following methods?
a. Ascend
b. Telephonic
c. Paper
d. All of the above
D. All of the above
Which of the following is not an example of Protected Health Information (PHI)?
a. Medical records
b. Payment history
c. Library card
C. Library Card
Wellcare must receive notice of an event change or cancellation as soon as possible, but no later than 30 minutes after the event start time.
Select one:
True
False
False
The Single Sign-On Portal provides access to several applications, including Centene Workbench.
Select one:
True
False
True
Once the enrollment is completed, you can save a copy of the application for your reference.
Select one:
True
False
False
Enrollment applications must be received by Wellcare no later than _ calendar day(s) following receipt from the beneficiary.
a. 1
b. 3
c. 5
d. 7
A. 1
Communication of PHI can be:
(Select all that apply.)
a. Written
b. Electronic
c. Verbal
All Apply
Brokers/Agents must meet all required contracting, training, and certification requirements to be eligible to sell Wellcare’s Medicare Products.
Select one:
True
False
True
Medicare Star Ratings and performance are at the forefront of Wellcare’s quality strategy. Wellcare’s quality focus consists of six drivers. Which of the following is not a Wellcare quality driver?
a. Member Service
b. Reputation
c. Member Payments
d. Serving Government Customers
C. Member Payments
Centene continues to expand its reach by offering more products in a wider geography. __ new Wellcare and Ascension Complete plans are going to market.
a. Thirty-three
b. Forty-eight
c. Fifty-two
B. 48
The Part D Senior Savings Model (SSM), which reduces member spending on insulin, will be offered on all Value Script, Value Plus PDPs, and select Wellcare MAPD plans.
Select one:
True
False
True
All PDPs will feature a $0 tier 1 benefit when filled at preferred pharmacies.
Select one:
True
False
True
Which of the following is not considered a grievance?
a. An agent contacting a beneficiary without consent.
b. Premium and copay complaints.
c. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination.
d. Enrollment or disenrollment concerns.
C. A dispute of the appeal of an organization determination, coverage determination or a Late Enrollment Penalty (LEP) determination.
The beneficiary (or their authorized representative) must indicate the product types to be discussed during the appointment on the Scope of Appointment (SOA).
True
The NEW online Centene Workbench self-service portal enables you to:
All of the Above
What are some examples of steps that can be taken when safeguarding and securing PHI and PII?
(Select all that apply.)
ALL
__ events are designed to inform the people that attend about Medicare Advantage, Prescription Drug, or other Medicare programs without going into the specifics of a particular carrier.
Educational
You can help prevent grievances by:
(Select all that apply.)
ALL APPLY
Which elements are available as part of Wellcare’s sales support model?
All of the above
A Health Risk Assessment (HRA):
All of the above
When discussing prescription drug coverage, you should:
(Select all that apply.)
All apply
The information contained within ACT will equip brokers/agents to certify, market, and sell which health plans?
All of the above
Brokers/Agents may be investigated after being suspected of noncompliant activity reported through a:
(Select all that apply.)
Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
Which resources are available for download from the Shared Resources section found within Centene Workbench?
All of the above
Member PHI can be stored on an external hard drive or a cloud storage service like Google Drive or Apple Cloud.
False
Enrollments through Ascend offer the following unique benefits:
(Select all that apply.)
ALL APPLY