Exam (elaborations)
UHC ETHICS AND COMPLIANCE SECTION FOR CERTIFICATION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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UHC ETHICS AND COMPLIANCE SECTION FOR CERTIFICATION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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UHC ETHICS AND COMPLIANCESECTION FOR CERTIFICATION
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
What is a servicing agent? - ANSWER an inactive, nonemployee who has signed a servicing agreement in
order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on
or after 1-1-2014. the agent must maintain an active resident license and appointment and pass
medicare basics and ethics compliance assessments on an annual basis
What does CMS stand for? - ANSWER center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to offer
medicaid plans? - ANSWER CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the regulating agency
that also monitors our progresses? - ANSWER CMS
Who regulates MA's and PDP's - ANSWER CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant and
considered____? - ANSWER an unqualified sale
Agents who are not qualified to sell the product will not be? - ANSWER compensated and may receive
corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? - ANSWER its designed to inform medicare consumers
about original medicare, medicare advantage, prescription drug and other medicare programs.
Where must educational events be conducted? - ANSWER in a public venue
,Are the educational events unbiased so that it doesn't steer the consumer towards a specific plan or
limited number of plans? - ANSWER yes
WHat is a marketing/sales event? - ANSWER an event designed to steer or attempt to steer, consumers
toward a plan or limited set of plans. Agents may discuss plan specific information and collect
applications.
Can marketing/sales be formal or informal? - ANSWER both
What describes a formal marketing/sales event? - ANSWER a full plan presentation, given in a presenter-
audience format.
What is an inform marketing/sales event? - ANSWER they're passive in nature where the consumer
approaches the agent to engage in conversation. a booth, table, or kiosk is typically used
What are marketing appointments? - ANSWER They're commonly referred to as "in home, face to face,
or one on one appointment" and typically take place in the consumers home.
What other places can marketing appointments happen? - ANSWER coffee shop, or even over the phone
because marketing appointments are not formal and informal marketing sales events, they're not
reported to who? - ANSWER UHC or CMS. instead, agents must obtain a completed scope of
appointment prior to conducting the appointment.
To report events, what should agents use? - ANSWER an event request form
to ensure that events are in UHC's event reporting application no less than 7 calender days prior to the
event... - ANSWER submit the event request form, according to instructions on the form, NO LESS THAN
14 CALENDAR DAYS
event request forms submitted within7 calendar days will NOT be what? - ANSWER processed
conducting an unreported event is _____? - ANSWER prohibited
, to schedule a sign language interpreter for a formal marketing/sales event or a personal/individual
marketing appointment, enter the consumer's request direct;y in bconnected at least? - ANSWER 14
days prior to the event or appointment
What are marketing materials used for? - ANSWER 1) draw attention to a plan sponsor or their plan(s)
and
2) influence a consumer's decision when selecting a plan in which to enroll or a member's decision to
remain enrolled in their current plan
Marketing materials contain information about the plan or plans: - ANSWER 1) benefits or benefit
structure
2) cost sharing ( including premiums, copayments, and deductibles)
3) Measurements or ranking standards ( such as star ratings. comparisons to other plans, or statistical
studies or surveys)
Approval is required for? - ANSWER 1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affliated plans or
displays any logos
What does generic mean with marketing materials? - ANSWER materials that do not meet the marketing
materials criteria and do not carry any plan sponsor information or logos
does generic materials require prior approval? - ANSWER no
What methods are considered marketing material? - ANSWER newspaper, tv, internet, radio
advertisements, direct mail, postcards, flyers, brochures, magnets, pre-enrollment materials, websites
and social media platforms
what are some examples of generic marketing materials? - ANSWER social media sites and websites
sites used to market UHC plans must be _____ by UHC and CMS prior to use - ANSWER approved
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