Events are categorized by which two things?
Type of event (educational or marketing/sales) and sponsor
Sponsor and whether it is formal or informal
Venue and type of event (educational or marketing/sales)
Type of event (educational or marketing/sales) and whether it is formal or informal
Type of event (educational or marketing/sales) and whether it is formal or informal
Louise wants to hold an event that helps consumers understand Medicare programs and perhaps improve their health/wellness knowledge, but she is not interested in completing enrollment applications at the event. She would like to staff a table at the public library and have consumers approach her. What type of event does Louise need to conduct?
Marketing/sales event, Formal
Educational event, Informal
Educational event, Formal
Marketing/sales event, Informal
Educational event, Informal
When conducting an event, agents should select a site that is compliant with the Americans with Disabilities Act (ADA). Which of the following is not an ADA requirement?
Handicap accessible restrooms
Handrails along stairways and/or ramps
Extra-wide sidewalks that accommodate wheelchairs
Walkways, entrances and hallways that are clear and dry
Extra-wide sidewalks that accommodate wheelchairs
Agent Don plans to conduct a marketing/sales event at the local public library on October 28 at 2pm. He received permission to post an advertisement on the library bulletin board starting October 14. What is the latest date Don could submit a NEW Event Request Form to UnitedHealthcare in order to comply with UnitedHealthcare’s event reporting rules?
October 14 as events must be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the event
September 30 as events must be reported to UnitedHealthcare no later than the last day of month
October 21 as events must be reported to UnitedHealthcare not less than 7 calendar days prior to advertising
October 25 as events must be reported to UnitedHealthcare not less than 3 business days prior to the event
October 14 as events must be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the event
To ensure an event is canceled in UnitedHealthcare’s event reporting application by the reporting deadline, what is the last recommended date for submitting a CANCEL Event Request Form?
Submit the CANCEL Event Request Form no later than 6 business days before the event
Submit the CANCEL Event Request Form no later than the day of the event
Submit the CANCEL Event Request Form no later than 1 business day before the event
Submit the CANCEL Event Request Form no later than 6 business days before the event
Which of the following statements is not a best practice for event scheduling, changing or canceling?
Submit a NEW Event Request Form after you have advertised your event to make sure you enter the right information.
Document all steps taken to notify consumers of an event cancellation and make documentation available upon request.
Make sure that the event details in the advertisement match those reported.
If the cancellation is due to inclement weather, ask the venue to post a sign if it is possible.
Submit a NEW Event Request Form after you have advertised your event to make sure you enter the right information.
Marcus is planning an educational event and has decided to place an advertisement in the local paper. What must the advertisement include?
A statement that makes it clear that only non-members are permitted to attend.
A statement that makes it clear that a sales person will be present with information and applications.
A statement that makes it clear that the event is for educational purposes only.
A statement that makes it clear that a meal may be served.
A statement that makes it clear that the event is for educational purposes only.
Which of the following food and giveaway combinations may be provided at an educational event?
Cheese, crackers and punch ($13/person) plus movie theater gift cards ($7/person)
Coffee, juice and pastries ($8/person) plus UnitedHealthcare tote bag ($8/person)
Coffee, juice and pastries ($8/person) plus UnitedHealthcare logo pens and notepads ($5/person)
Cheese, crackers and punch ($13/person) plus magnets listing symptoms of a stroke ($3/person)
Coffee, juice and pastries ($8/person) plus UnitedHealthcare logo pens and notepads ($5/person)
Which of the following individuals is permitted to present a short introductory presentation of educational content at the beginning of an informal marketing/sales event?
A non-licensed plan representative only
A licensed agent, a non-licensed plan representative, a provider
A licensed agent only
A licensed agent or a non-licensed plan representative only
A licensed agent, a non-licensed plan representative, a provider
Which of the following marketing materials must not be displayed, distributed, or provided to consumers attending a marketing/sales event?
Enrollment Guides
Non-health related product brochures
Scope of Appointment forms
Medicare Made Clear booklets
Non-health related product brochures
Which of the following food options may be provided at a marketing/sales event if the nominal retail value of the items when combined with other giveaways does not exceed $15 per person?
No food items regardless of value may be provided at a marketing/sales event
Coffee and pastries
Cheese, crackers, fresh fruit, and wine
Buffet dinner
Coffee and pastries
Paul is setting up a marketing/sales event at a community center where he is going to discuss UnitedHealthcare Medicare Advantage plans. He has placed a UnitedHealthcare logo pen ($3 value), Clarity Guide, and an Enrollment Guide at each seat. What, if anything, has Paul done wrong?
Paul should not provide any materials or logo items at a marketing/sales event.
Paul has done nothing wrong. The giveaway is under the $15 nominal value and he is providing approved marketing and plan-specific material.
The pen is permitted because it is under the $15 nominal value, the approved guide is fine, but Paul should not provide the Enrollment Guide unless someone is going to enroll.
Paul has done nothing wrong. The giveaway is under the $15 nominal value and he is providing approved marketing and plan-specific material.
Which of the following is not required when conducting a marketing/sales event?
Providing refreshments and giveaways
Introducing yourself and the plan sponsor you are representing
Stating a sign-in sheet is optional
Stating the plan name and type you are presenting
Providing refreshments and giveaways
Craig is conducting an informal marketing/sales event in a retail pharmacy. Which of the following rules does not apply?
Craig must not schedule personal/individual marketing appointments and obtain Scope of Appointments
Craig must not approach consumers; they must approach him
Craig must be present at his booth for the entire time he reported to UnitedHealthcare
Craig must set up his booth where directed by the pharmacy manager
Craig must not schedule personal/individual marketing appointments and obtain Scope of Appointments
Which of the guidelines listed below is not allowed when accepting an enrollment application at a marketing/sales event?
Offer to hold an enrollment application and submit it later
Provide an Enrollment Guide for the applicable plan
Confirm that the consumer has a valid election period
Offer to hold an enrollment application and submit it later
Which of the following is a purpose of conducting event observation and oversight?
To ensure agents are enrolling as many consumers as possible at events.
To assess the effectiveness of advertising in drawing consumers to an event.
To ensure consumers receive accurate and compliant information from agents.
To ensure consumers receive accurate and compliant information from agents.
Which of the following activities conducted at a marketing/sales event is not compliant?
Refreshments and giveaways did not exceed the $15 nominal retail value on a per person basis
All plan related materials were compliant and CMS approved
The agent stated his name, company he represents, and the plan name and type he was going to present
The agent displayed materials for non-health related products
The agent displayed materials for non-health related products
Warren, an agent, is working at the UnitedHealthcare MedicareStore. Beth, a consumer, approaches Warren and asks a question about Medicare Prescription Drug Plans. What is the most appropriate thing Warren should do first?
Thank her for her questions and explain that she will need to set up an in-home appointment to cover plan specifics.
Hand Beth an Enrollment Guide and begin covering the Summary of Benefits.
Complete a Scope of Appointment form with Beth prior to discussing plans.
Complete a Scope of Appointment form with Beth prior to discussing plans.
Which of the following must the agent review with the consumer during a Medicare Advantage or Prescription Drug Plan presentation?
The availability of interpreter services and where to find information in the Enrollment Guide for accessing the no-cost service
That all completed Scope of Appointment forms will be submitted to UnitedHealthcare
The ingredients of snack items served at the event in case any consumer has a food allergy
The number of members enrolled in the plan
The availability of interpreter services and where to find information in the Enrollment Guide for accessing the no-cost service
What type of event must agent conduct when she wants to be able to collect consumer information schedule future appointments and accept enrollment applications
marketing/sales event
Louise wants to hold an event that helps consumers understand Medicare programs and perhaps an prove their health/Wellness knowledge but she is not interested in completing enrollment applications at the event she would like to staff a table at the Public Library and how consumers approach her what type of event is Louise need to conduct
educational event informal
when conducting an event agents had selected a site that is compliant with the Americans with Disabilities Act ADA which of the following is not an ADA requirement
extra wide sidewalks that accommodate wheelchairs
which of the following elements does not need to be entered on the new event request form when reporting a new event
the event venue manager/contact person
Which of the following statements regarding united healthcare’s event cancellation reporting rules is true
event cancellation must be reported in united healthcare’s event reporting application at least one business day prior to the event except in the case of inclement weather
Which statement is an example of one that must appear on advertisements for educational events?
For accommodation of persons with special needs call 555-555-1234 tty 711
which of the following food and beverage options may be provided at an educational event if the nominal retail value of the items when combined with other giveaways does not exceed $15 per person select two
coffee juice fresh fruit and pastries
buffet dinner and coffee
which of the following individuals is permitted to present a short introductory presentation of educational content at the beginning of an informal marketing/sales event
a license agent a non license plan representative a provider
Which of the following marketing materials must not be displayed, distributed, or provided to consumers attending a marketing/sales event?
Non-health related product brochures
Agent Rita Garcia must not do which of the following while conducting a marketing/sales event __ .
State the plan she’s presenting is the best plan on the market
which of the following is not required when conducting a marketing/sales event
providing refreshments and giveaways
add an informal marketing/sales event which of the following activities is not permitted
approaching consumers as they pass by your booth/kiosk/table
agent Santana has developed a relationship with doctor Westberry a primary care physician contracted with several Medicare Advantage plans doctor Westbury is asked to attend a formal marketing/sales event conducted by agent Santana which of doctor Westberry’s actions is non compliant
offers blood pressure screenings as consumers wait for the event to begin
Marge is conducting a formal marketing/sales event and suspects a gentleman in attendance is evaluating her conducting the event what action should Marge take
she should conduct the event as she normally would
Which of the following statements describes compliant activity during a formal marketing/sales event?
the agent explained that each consumer’s needs are different therefore they should each enroll in a plan that best meets their needs
which of the following statements is true about conducting a formal marketing/sales event in a conference room inside a united healthcare Medicare store
all rules relating to formal marketing/sales events apply including event reporting and providing a complete plan presentation
which of the following must the agent review with the consumer during a Medicare Advantage or prescription drug plan presentation
the availability of interpreter services an where to find information in the enrollment guide for accessing the no cost service
what type of event is an agent conducting when he presents plan information that includes benefits and cost sharing and audience presenter format
formal marketing/sales event
which of the following does not describe a personal/individual marketing appointment
it needs to be reported to united healthcare prior to advertising and not less than 7 calendar days prior to the date of the event
according to united healthcare policy when must in marketing/sales event be reported to united healthcare
prior advertising and not less than 7 calendar days prior to the event
t
s
Marcus is planning an educational event and has decided to place an advertisement in the local paper what must the advertisement include
a statement that makes it clear that the event is for educational purposes only
Which of the following giveaways is not permitted at an educational event (assume nominal retail value is met)?
Gift card to local movie theater
which of the following food options may be provided at a marketing/sales even if the nominal retail value of the items when combined with other giveaways does not exceed $15 per person
coffee and pastries
Paul is setting up a marketing/sales event at a Community Center where he is going to discuss united healthcare Medicare Advantage plans he has placed a united healthcare logo pen $3 value clarity consumer workbook an enrollment guide at each seat what if anything is Paul done wrong
pause done nothing wrong the giveaway is under the $15 nominal value and he is providing approved marketing and plan specific material
Craig is conducting an informal marketing/sales event in a retail pharmacy which of the following rules does not apply
Craig must not schedule personal/individual marketing appointments and obtain scope of appointments
Which of the guidelines listed below is not allowed when accepting an enrollment application at a marketing/sales event?
offer to hold an enrollment application and submit it later
which of the following is a purpose of conducting event observation and oversight
to ensure consumers receive accurate and compliant information from agents
warren an agent is working at the United healthcare Medicare store Beth a consumer approaches Warren and ask a question about Medicare prescription drug plans what is the most appropriate thing Warren should do first
complete a scope of appointment form with beth prior to discussing plans
When must an agent inform the consumer of the availability of no cost interpreter services
whenever the agent is presenting a Medicare Advantage or prescription drug plan
advance are categorized by which two things
type of event educational or marketing/sales and whether it is formal or informal
Larry wants to hold an event that covers dual special needs plans SNP he will use the slide presentation provided by united healthcare to explain the plan benefits and will help consumers complete enrollment applications at the end what type of event does Larry need to conduct
marketing/sales event formal
when selecting a venue for your educational or marketing flash sales event what feature is not one you need to consider
conveniently located snack and beverage vending machines
according to united healthcare policy when must a marketing/sales event be reported to united healthcare
prior to advertising and not less than 7 calendar days prior to the event
To ensure an event is cancelled in united healthcare’s event reporting application by the reporting deadline, what is the last recommended date for submitting a cancel event request form?
Submit the cancel event request form no later than six business days before the event.
Which of the following statements is not a best practice for event scheduling changing or canceling?
Submit a NEW event request form after you have advertised your event to make sure you enter the right information
which of the following food and giveaway combinations may be provided at an educational event
coffee juice and pastries $8.00/person plus united healthcare logo pens and notepads $5/person
For accommodation of persons with special needs call 555-555-1234 tty 711 is an example of this disclaimer that must appear in advertising for what type of event
formal and informal marketing/sales
which of the following food options may be provided at marketing/sales event if the nominal retail value of the item when combined with other giveaways does not exceed $15 per person
coffee and pastries
when conducting a formal marketing/sales event there are elements that you must cover in order for your presentation to be compliant listed below are several required elements related to star ratings which one is not required
providing a list of plans that have the same star rating
which of the following rules does not apply to aging staffing in united healthcare Medicare store
educational event rules
Elaine is considering conducting an event in a lower level conference room of a local fraternal organization the room has a podium with a microphone available for use there are handicap parking stalls sidewalk ramps automatic entrance doors handicap accessible restrooms and elevator Lastly the manager has given a Lane permission to put a sign at the entrance to direct consumers to the lower level for the event what else should a lion consider prior to conducting an event at this venue
Elaine must make certain that the fraternal organization will allow the public non members access to the facility in order to attend her meeting
At an informal marketing/sales event which of the following activities is compliant?
Waiting for consumers to approach the table/boot/kiosk
Louise wants to hold an event that helps consumers understand Medicare programs and perhaps improve their help/Wellness knowledge but she is not interested in completing enrollment applications at the event she would like to staff a table at the Public Library and have consumers approach her what type of event does Louise need to conduct
Marketing/sales event informal
Jessica just submitted a cancel event request form to cancel an event she is scheduled to conduct three weeks from today the only advertising she is done is to post a flyer at the event venue select the cancellation procedure she does not need to follow
be at the venue at the time the event had been scheduled to start and remain there for 30 minutes in case any consumer arrives
if you conduct an educational event and invite a provider or vendor to be part of the event the provider/vendor must not do which of the following
provide free health screenings such as blood pressure checks or hearing tests as a marketing activity
agent John Rogers is planning a formal marketing/sales event and has decided to place an advertisement in the local paper what disclaimers was drawn including the advertisement
for accommodations of persons with special needs at sales meetings call 555-555-1234 TTY 711 and attend with no obligation to enroll
Agent Don plans to conduct a marketing/sales event at the local public library on October 28 at 2pm. He received permission to post an advertisement on the library bulletin board starting October 14. What is the latest date Don could submit a NEW Event Request Form to UnitedHealthcare in order to comply with UnitedHealthcare’s event reporting rules?
October 14 as events must be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to the event
(wrong)September 30 as events must be reported to UnitedHealthcare no later than the last day of month
(Wrong) October 25 as events must be reported to UnitedHealthcare not less than 3 business days prior to the event
(WRONG) October 21 as events must be reported to
UnitedHealthcare not less than 7 calendar days prior to advertising
Roger is conducting an educational event and has asked a couple of providers to be present at his booth. The hearing aid representative has general information on hearing loss, business cards and logo coffee mugs (worth $8). Has the hearing aid representative followed all required guidelines?
No, he must not provide his business cards or giveaways.
(wrong) Yes, he can provide general information, his contact information and logo items that are under $15.
No, he can provide general information and his contact information, but is not permitted to offer giveaways.
Janine is conducting a marketing/sales event in a senior center cafeteria. The cafeteria generally provides a dinner meal from 5pm to 6pm. Can Janine conduct her marketing/sales meeting in the cafeteria between 5pm and 6pm?
No, she can conduct an event that ends no later than 5pm or wait until after 6pm. (Events should not be during regular meal time)
At a formal marketing/sales event, an agent presented information about prescription drug coverage. Which statement is not accurate?
Members and providers are not able to ask the plan for exceptions to any utilization management rules
Marge is conducting a formal marketing/sales event and suspects a gentleman in attendance is evaluating her conducting the event. What action should Marge take?
She should conduct the event as she normally would.
2023 UHC certifications 94 QUESTIONSWITH COMPLETE SOLUTIONSLisa turned 65 and is now eligible for Medicare. She already receives Social Security benefits. How does she enroll in Original Medicare? Correct Answer: Herenrollment in Medicare Parts A and B is generally automatic if she meets all eligibility requirements.Which statement is true about a member of a Medicare Advantage (MA) Plan who wants to enroll in a Medicare Supplement Insurance Plan? Correct Answer: When a consumer enrolls in a Medicare Supplement Insurance Plan, they are not automatically disenrolled from their MA Plan.Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months, and being any age with ESRD or ALS are each eligibility requirements for which program? Correct Answer: Original MedicareWhich of the following defines a Medicare Advantage (MA) Plan? (Select 2) Correct Answer: 1. MA Plans must provide benefits equivalent to Original Medicare, and most plans also offer additional benefits.2. MA Plans provide Medicare hospital and medical insurance and often include Medicare prescription drug coverage.Which of the following is NOT an eligibility requirement for enrollment in a Medicare Advantage Plan? Correct Answer: Does not have any pre-existing conditions such as diabetes or End Stage Renal Disease (ESRD)Which of the following statements is correct about HMO MA Plans? Correct Answer: Members must receive covered services from contracted network providers with limited exceptions.Which of the following is NOT a correct statement about in-network provider services? Correct Answer: (INCORRECT) Network-based MA plans have a provider network the member can use, and some plans also cover certain services outside the network.
What is true about Medicare supplement open enrollment? Correct Answer: (INCORRECT) A consumer who waits to enroll in Medicare Part B until age 66 or older cannot qualify for Medicare Supplement Open Enrollment.(INCORRECT) It is the only time a consumer is eligible to purchase a Medicare Supplement Insurance Plan.Jennifer is enrolling into a Medicare Advantage (MA) plan and wants to know what counts toward the Out-of-Pocket Maximum. Which of the following is accurate? Correct Answer: The Out-of-Pocket Maximum will include her costs toward any Medicare-covered Part A or B services.Which of the following statements is true about a Medicare Supplement Insurance Plan member who wants to enroll in an MA Plan? Correct Answer: Medicare Supplement Insurance cannot be used in conjunction with an MA Plan; therefore, after receiving confirmation of enrollment into the MA Plan, the member must cancel their Medicare Supplement Insurance policy according to their carrier’s rules.Which of the following best defines Medicare Part D? Correct Answer: It is a government program, offered only through a private insurance company or other private company approved by Medicare, which provides prescription drug coverage.Which of the following is a fact about Medicare Prescription Drug Plans? Correct Answer: To enroll, member must be in plans service areaWhat are two options for Medicare consumers to get Part D prescription drug coverage (assuming they meet all eligibility requirements)? (Select 2) Correct Answer: Enroll in a stand-alone Medicare Prescription Drug Plan (PDP)Enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverageWhich of the following statements does NOT correctly define prescription drug stages? Correct Answer: A deductible is the amount the member must pay for every prescription medication, regardless of what stage they are in.
Which of these statements is NOT true about the drug utilization management (UM) rules? Correct Answer: (INCORRECT) Prior authorization, quantity limit, and step therapy are some examples of UM rulesWhat is the amount added to the member’s monthly plan premium if they did NOT enroll in a Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for 63 or more continuous days? Correct Answer: Late Enrollment Penalty (LEP)Can a consumer who qualifies for Low Income Subsidy receive financial assistance for their part of Medicare Part D costs? Correct Answer: Yes, through subsidies such as lower or no monthly plan premiums and lower or no copaymentsFormulary is defined as: Correct Answer: A list of medications covered within the benefit plan, based on CMS guidelines and developed in collaboration with physicians and pharmacists.Which of the following is true about Medicare Supplement Insurance underwriting criteria in states where underwriting applies? Correct Answer: Underwriting is required if the consumer is not in their Medicare Supplement Open Enrollment period or does not meet Guaranteed Issue criteria.The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which went into effect January 1, 2020, applies to all carriers offering Medicare supplement plans. Correct Answer: TrueWhich of the following is NOT true of Medicare Supplement Insurance Plans? Correct Answer: (INCORRECT) Plan benefit amounts automatically update when Medicare changes cost sharing amounts, such as deductibles, coinsurance and copayments.Which of the following consumers are eligible for Medicare if other eligibility requirements are met? Correct Answer: Consumers age 65 or older, consumers under 65 years of age with certain disabilities for more than 24 months and consumers of all ages with ESRD or ALSWhich of the following defines a Medicare Advantage (MA) Plan? (Select 3) Correct Answer: An MA Plan is a health plan option approved by Medicare and offered by private insurance companies.
An MA Plan provides Medicare hospital and medical insurance (Medicare Part A and Part B) and often includes Medicare prescription drug coverage (Part D).An MA Plan is part of Medicare and is also called Part C.Janice wants to enroll in a Medicare Advantage plan. Which of the following is NOT an eligibility requirement? Correct Answer: Does not have any pre-existing conditions, such as diabetes or End Stage Renal Disease (ESRD)Which of the following are MA Plans that focus on using network providers to maximize the benefits and reduce out-of-network expenses? Correct Answer: HMO, POS, PPOMargaret currently has an MAPD Plan. What would happen if you enrolled her into a stand-alone PDP? Correct Answer: She would be disenrolled automatically from her MAPD Plan.What is Medicare Part D? Correct Answer: A voluntary program, offered by private insurance companies that are contracted with the federal government, that provides prescription drug coverage for an additional monthly plan premiumWhich of the following statements is true about eligibility requirements for stand-alone Medicare Prescription Drug Plans? Correct Answer: A consumer must be entitled to Medicare Part A and/or enrolled in Medicare Part BAside from a Medicare Advantage Plan or other health plan that includes prescription drug coverage, how else could a Medicare-eligible consumer get Part D prescription drug coverage? Correct Answer: They could enroll in a stand-alone Medicare Prescription Drug Plan (PDP).In what order do the four prescription drug coverage stages occur? Correct Answer: Deductible, Initial Coverage, Coverage Gap, Catastrophic CoverageStep Therapy, Prior Authorization, Quantity Limit, 7-day limit, Dispensing Limit and Limited Access are all examples of what? Correct Answer: Utilization Management RulesA consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a Medicare Advantage plan with Part D benefits or stand-alone
prescription drug plan when they were first eligible for Medicare Parts A and/or B or went without creditable prescription drug coverage for __. Correct Answer: 63 or more continuous daysThrough which means is financial assistance offered to a consumer who qualifies for Low Income Subsidy for their part of Medicare Part D costs? Correct Answer: Through subsidies such as lower or no monthly plan premiums and lower or no copaymentsWhich of the following lists drug tiers from least expensive cost share to most expensive cost share? Correct Answer: Preferred Generics, Generics, Preferred Brand (and some higher-cost generics), Non-Preferred Drug (and some higher-cost generics), SpecialtyWhich of the following is NOT true about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) impact to Plans C and F? Correct Answer: Consumers already enrolled in Plans C or F are required to change plans.Which statement is true about medicare supplements? Correct Answer: Insured members have the freedom to choose any doctor who accepts Medicare patients.Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? Correct Answer: April 1 through October 31Annual Election Period (AEP) is a time when. . . Correct Answer: Consumers can elect to switch to a different plan or join a Medicare Advantage plan or PrescriptionDrug Plan.Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? Correct Answer: Mrs. Violet can access the Star Rating for a plan on Medicare.gov or in the Enrollment Guide.In which of the following situations can telephonic contact be made with a Medicare eligible consumer? Correct Answer: When the consumer consented to becontacted for sales activities and the permission has not yet expired.
Which statement is true about discussing benefits with the consumer before an enrollment? Correct Answer: The agent must accurately and completely disclose any benefits discussed.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? Correct Answer: The consumer/member would not receive plan related correspondence intended for him/her.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. Correct Answer: Statement of UnderstandingWhat is Scope of Appointment? Correct Answer: The agreement obtained from theconsumer to that identifies the scope of products that can be discussed at a personal/individual marketing appointmentJane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Whichoption should Jane consider? Correct Answer: 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.Melanie is currently enrolled in a Medicare Supplement Insurance Plan and a PDP. Assuming she has a valid election period, what would happen if she enrolled in an HMO MAPD plan? Correct Answer: (INCORRECT) She would be automatically disenrolled from the Medicare Supplement Insurance Plan and the PDP.Medicare Advantage (MA) organization must disenroll a member from an MA planin which situation? Correct Answer: The member loses entitlement to either Medicare Part A or Part B.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? Correct Answer: Aries can enroll into a Medicare Advantage plan with prescription drug coverage, which will disenroll him from his PDP.
In what product should agents enroll consumers? Correct Answer: A product that is suitable for the consumer’s needs, goals and financial resources.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? Correct Answer: Presented a plan before October 1Which of the following is NOT true about UnitedHealthcare Medicare plans carrying the AARP name? Correct Answer: AARP endorses UnitedHealthcare MA, PDP and Medicare Supplement plans.AARP expects agents offering AARP-branded products to demonstrate five key behaviors when interacting with customers. AARP wants customers we work with to feel their relationship with AARP is ____. Correct Answer: Effortless and inspiringWhich of the following are part of being straightforward when servicing a customer? (Select 3) Correct Answer: Being upfront about what information means.Communicating clearly to alleviate any confusion.Providing the right information.Do consumers have to be an AARP member to enroll in an AARP-branded plan with UnitedHealthcare? Correct Answer: Yes, if the consumer is enrolling in a Medicare Supplement Plan.How many status levels are in the Authorized to Offer Program? Correct Answer: 2According to AARP, there are how many individual AARP members? Correct Answer: Nearly 37 millionWhich of the following statements about AARP are TRUE? (Select 2) Correct Answer: The AARP motto is to serve, not be served.
AARP advocates for the 50+ population in congress for legislation to lower medical costs.Which of the following is TRUE about the production requirement for the Authorized to Offer Elite status? Correct Answer: Each calendar year, agents need to have at least 30 commission-eligible, accepted, and paid AARP Medicare Supplement Plan and/or Medicare Select Plan sales or retain a book of business of 150 or more active members.The value proposition for the AARP brand is seen in what kinds of benefits for the members? (Select 3) Correct Answer: Which AARP-branded Medicare products does UnitedHealthcare offer? (Select 3) Correct Answer: MA, PDP, SupplementsDual Special Needs Plans (D-SNP) are defined as which of the following: Correct Answer: Medicare Advantage Plans uniquely designed for consumers enrolled in both Medicare and Medicaid.When does the Special Election Period for Dual/LIS Change in Status begin for D-SNP members that lose Medicaid eligibility? Correct Answer: Upon notification or effective date of the loss, whichever is earlierWhich consumer might benefit the most by enrolling in a D-SNP? Correct Answer:Joe, who receives Qualified Medicaid Beneficiary benefits (QMB+)Which statement best describes a care management program that varies depending upon the level of the member’s health risk? Correct Answer: Support provided to C-SNP and D-SNP members that may have unique health care needsSelect the statement that best describes a feature of D-SNPs. Correct Answer: D-SNPs are network-basedWhen selling D-SNPs, agents must: Correct Answer: Confirm the consumer’s Medicaid level and that the consumer is entitled to Medicare Part A and enrolled inPart BWhich consumer may be a good candidate for a D-SNP? Correct Answer: Anne, who does not pay a percentage of charges when she receives medical care
The following is a characteristic of consumers for whom a C-SNP may be most appropriate: Correct Answer: Consumers who have a qualifying chronic condition,are focused on their health issues and may have concerns with having to manage their illness or dealing with multiple providersOn July 19, each of the following consumers met with an agent. Based on the information provided, which consumer must wait until the Annual Election Period (AEP) or Open Enrollment Period (OEP) to enroll? Correct Answer: Joy has a cardiovascular disorder, is enrolled in a C-SNP that covers the condition, and wantsto enroll in another CSNP offered by the plan that covers the same condition.Which service will a C-SNP or D-SNP member in the high risk care management category receive? Correct Answer: Case Management (telephonic, digital and/or face-to-face) according to individual needsWhich statement is true about provider information on the Chronic Condition Verification Form? Correct Answer: The provider indicated on the form does not have to be contracted with the plan.Which statement is true about the Medicaid program? Correct Answer: Benefits vary from state to state.Which statement is true of D-SNP members? Correct Answer: Members who are QMB+ or are Full Dual-Eligible are not required to pay copayments for Medicare-covered services obtained from a D-SNP in-network provider. Their provider should bill the state Medicaid program, as appropriate, for these costs.How long do plans using the C-SNP pre-enrollment verification process have to verify the qualifying chronic condition until they must deny the enrollment request? Correct Answer: Within 21 days of the request for additional information or the end of the month in which the enrollment request is made (whichever is longer).Lucille is no longer eligible for her state Medicaid program and has lost her eligibility for the D-SNP in which she is enrolled. What is her responsibility for cost sharing? Correct Answer: All, such as premiums, deductibles, copayments, and coinsurance
What type of event must an agent conduct when they want to be able to collect consumer information, schedule future appointments, and accept enrollment applications? Correct Answer: Marketing/sales eventWhich of the following does not describe a personal/individual marketing appointment? Correct Answer: It needs to be reported to UnitedHealthcare prior toadvertising and not less than 7 calendar days prior to the date of the eventWhen conducting an event, agents should select a site that is compliant with the Americans with Disabilities Act (ADA). Which of the following is not an ADA requirement? Correct Answer: Extra-wide sidewalks that accommodate wheelchairsWhich of the following elements does not need to be entered on the NEW Event Request Form when reporting a new event? Correct Answer: The event venue manager/contact personJeff has an informal marketing/sales event scheduled this afternoon, but a consumer has requested an in-home appointment during that time. He would like tocancel or reschedule the event because he is certain to get an enrollment application at the appointment. Which of the statements below is correct about Jeff’s event? Correct Answer: Jeff is prohibited from canceling the event because itis within 1 business day and is not due to inclement weather. Jeff must hold his event or he could work with his manager to get a replacement to conduct the event.On October 1, Sam reported the formal marketing/sales event he has scheduled for 9 a.m. on November 19. Luckily, before he had flyers printed, he remembered he has an 8 a.m. dentist appointment November 19. Just to make sure he can get to hisevent on time, he advertises the event to start at 9:30 a.m. What event reporting infraction(s) might Sam incur? Correct Answer: (INCORRECT) None, Sam reported the event prior to advertising and not less than 7 calendar days prior to thedate of the eventMarcus is planning an educational event and has decided to place an advertisementin the local paper. What must the advertisement include? Correct Answer: A statement that makes it clear that the event is for educational purposes only.Which of the following food and beverage options may be provided at an educational event if the nominal retail value of the items when combined with
other giveaways does not exceed $15 per person? (Select 2) Correct Answer: Coffee, juice, fresh fruit, and pastriesBoxed lunch with assorted non-alcoholic beveragesIf you conduct an educational event and invite a provider or vendor to be a part of the event, the provider/vendor must not do which of the following? Correct Answer: Provide free health screenings such as blood pressure checks or hearing tests as a marketing activityAgent John Rogers is planning a formal marketing/sales event and has decided to place an advertisement in the local paper. What disclaimers must John include in the advertisement? Correct Answer: “For accommodation of persons with special needs at sales meetings, call 555-555-1234, TTY 711.”Janine is conducting a marketing/sales event in a senior center cafeteria. The cafeteria generally provides a dinner meal from 5pm to 6pm. Can Janine conduct her marketing/sales meeting in the cafeteria between 5pm and 6pm? Correct Answer: No, she can conduct an event that ends no later than 5pm or wait until after 6pm.Agent Rita Garcia must not do which of the following while conducting a marketing/sales event? Correct Answer: State the plan she is presenting is the best plan on the market.At a formal marketing/sales event, an agent presented information about prescription drug coverage. Which statement is not accurate? Correct Answer: Members and providers are not able to ask the plan for exceptions to any utilization management rulesAt an informal marketing/sales event, which of the following activities is not permitted? Correct Answer: Approaching consumers as they pass by your booth/kiosk/tableAgent Santana has developed a relationship with Dr. Westberry, a Primary Care Provider contracted with several Medicare Advantage Plans. Dr. Westberry is asked to attend a formal marketing/sales event conducted by Agent Santana. Whichof Dr. Westberry’s actions is non-compliant? Correct Answer: Offers blood pressure screenings as consumers wait for the event to begin
Which of the following best describes the purpose of event observation? Correct Answer: An oversight activity where an individual evaluates an event as a means to ensure the information provided by the agent was accurate and compliant.Which of the following statements describes compliant activity during a formal marketing/sales event? Correct Answer: Not one plan fits allWhich of the following statements is true about conducting a formal marketing/sales event in a conference room inside a UnitedHealthcare MedicareStore? Correct Answer: All rules relating to formal marketing/sales events apply including event reporting and providing a complete plan presentation.When must an agent inform the consumer of the availability of no-cost interpreter services? Correct Answer: Whenever the agent is presenting a Medicare Advantage or Prescription Drug Plan.