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UHC Ethics and compliance.

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UHC Ethics and compliance.

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  • June 18, 2024
  • 3
  • 2023/2024
  • Exam (elaborations)
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topgradesdr
UHC Ethics and compliance
Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He
calls in February the month before his 65th birthday and is unhappy with his current plan. On
the date of the call, what can Gene do about his coverage? - correct answer-On the day he
called, he can enroll in a different Medicare Advantage plan with an effective date of March
1.

An agent is explaining Medicare Advantage plan options to a consumer. During the
conversation, the agent explains that Medicare gives each plan a Star Rating. Which
statement is true? - correct answer-The agent said that Medicare uses a 5-star rating system
to illustrate the plan's performance and quality.

Which of the following describes Permission to Contact guidelines? - correct answer-it allows
the agent to discuss the products identified during the marketing appointment

Which statement about discussing benefits with the consumer before an enrollment is true? -
correct answer-

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.

What is the purpose of the Statement of Understanding? - correct answer-It ensures that
when consumers complete the Medicare Advantage and/or Part D Enrollment Application,
they are acknowledging their understanding that they are actually enrolling, in which plan
they are enrolling, and standard disclosures.

What is Scope of Appointment? - correct answer-The agreement obtained from the
consumer that identifies the scope of products that can be discussed at a personal/individual
marketing appointment (in-person or telephonic)

To complete an Enrollment Application on behalf of a consumer, what authority must the
individual have? - correct answer-The individual must be legally authorized in the state in
which the consumer resides to act on behalf of the consumer (e.g., Power of Attorney).

melanie is currently enrolled in an HMO MAPD, and she is talking to sales agent Brenda
about enrolling in a Medicare Supplement Insurance Plan. What should Brenda tell Melanie?
- correct answer-Brenda should tell her that she is automatically disenrolled from her MA
Plan if she enrolls in a Medicare Supplement Insurance Plan

In which situation must the Medicare Advantage (MA) organization disenroll a member from
an MA plan? - correct answer-The member loses entitlement to either Medicare Part A or
Part B

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