Exam (elaborations)
UHC ethics and compliance section for certification
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- PHI 101 Ethics OF DATA SCIENCE
UHC ethics and compliance section for certification
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UHC ethics and compliance section forcertification
What is a servicing agent? - correct 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? - correct answer-center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to
offer medicaid plans? - correct 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? - correct answer-CMS
Who regulates MA's and PDP's - correct answer-CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant and
considered____? - correct answer-an unqualified sale
Agents who are not qualified to sell the product will not be? - correct answer-compensated
and may receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? - correct answer-its designed to inform
medicare consumers about original medicare, medicare advantage, prescription drug and
other medicare programs.
Where must educational events be conducted? - correct 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? - correct answer-yes
WHat is a marketing/sales event? - correct 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? - correct answer-both
What describes a formal marketing/sales event? - correct answer-a full plan presentation,
given in a presenter-audience format.
, What is an inform marketing/sales event? - correct 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? - correct 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? - correct 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? - correct 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? - correct 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... - correct 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? - correct
answer-processed
conducting an unreported event is _____? - correct 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? - correct answer-14 days prior to the event or appointment
What are marketing materials used for? - correct 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: - correct 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? - correct 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? - correct answer-materials that do not
meet the marketing materials criteria and do not carry any plan sponsor information or logos
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