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UHC ETHICS AND COMPLIANCE EXAM QUESTIONS AND ANSWERS 2024
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UHC ETHICS AND COMPLIANCE EXAM QUESTIONS AND ANSWERS 2024
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UHC ETHICS AND COMPLIANCE EXAMWhen a consumer ask why an MA plan has a two-star rating, the agent should tell
the consumer what? - ANSWERS-That the plan has received a below average
rating
Which of the following describes permission to contact guidelines? - ANSWERS-
Contact can only be made by the methods requested by the consumer in the
agent can only market the products indicated by the consumer
Which of the following are examples of what an agent must review with a
consumer prior to completing an enrollment application? - ANSWERS-The plans,
network characteristics and how using at a network providers may impact
coverage and cost covered benefits and limitations and plan related costs such
monthly premiums and co-payment coinsurance for services received
When completing an enrollment application in lane, why is an agent prohibited
from entering his or her own email address in a field available for the consumers
email address ? - ANSWERS-The consumer/ member would not receive plan
related correspondence and titted for him/ her.
What is the purpose of the statement of understanding? - ANSWERS-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
,Which of the following must an agent obtain from the consumer no less than 48
hours before an in person, online, or telephonic marketing appointment? -
ANSWERS-Scope of appointment
On October 20th, Aries decides to switch his PDP to a Medicare advantage plan
Aries would like this change to be effective November 1st. Which statement is
true for Aries? - ANSWERS-He may be able to use a special election. To change
plans if he qualifies for one
Which of the following statements is true about using a five-star special
enrollment.? - ANSWERS-It can be used once from December 8th through
November 30th and coverage will start the first of the month following receipt of
the enrollment application
To complete an enrollment application on behalf of a consumer, what authority
must the individual have? - ANSWERS-The individual must be legally authorized in
the state in which the consumer resides to act on behalf of the consumer.
example power of attorney
What happens on the plan effective date when a member enrolled in a Medicare
supplement insurance plan and stand alone PDP in roles in a Medicare advantage
plan that includes drug coverage? - ANSWERS-Incorrect. Answer- Automatic
disenrollment from the Medicare supplement insurance plan and stand alone
PDP.
,In which situation will a member be involuntarily disenrolled from their MA plan?
- ANSWERS-The member lost entitlement to either Medicare part A or part B
Aries is currently a member of the standalone PDP areas. Would like to have
additional medical coverage. A thorough needs. Analysis indicate a Medicare
advantage plan would be a good fit. There are plans available in his area and he is
in a valid election. What option is available to Aries? - ANSWERS-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 ? - ANSWERS-A product that is
suitable for the consumers needs, goals and financial resources.
Dino, an agent, received a phone call on September 29th from a consumer
interested in Medicare advantage plans for the new plan year. Do you know
proceeded to verify the consumer's Medicare eligibility? Just grab the cost and
benefit coverage of the plan and explain that he could not accept an enrollment
application until October 15th. What did Dino do that was not compliant? -
ANSWERS-Dino presented a plan prior to October 1st
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? -
ANSWERS-On the day he called, he can enroll in a different Medicare Advantage
plan with an effective date of March 1.
, Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has
been presenting. Which statement is correct? - ANSWERS-Mrs. Violet can access
the Star Rating for a plan on Medicare.gov or in the Enrollment Guide.
Which of the following is not considered unsolicited contact with a Medicare
eligible consumer according to CMS regulations and UnitedHealthcare's rules,
policies, and procedures? - ANSWERS-Mailing a marketing brochure to the
consumer via postal mail.
Which statement is true about discussing benefits with the consumer before an
enrollment? - ANSWERS-The agent must accurately and completely disclose any
benefits discussed.
Which statement about discussing benefits with the consumer before an
enrollment is true? - ANSWERS-The agent must explain any provider and/or
pharmacy network limitations.
While using LEAN to complete an enrollment application with a consumer, Agent
Jeff learns the consumer does not have an email address. What should Jeff do? -
ANSWERS-Leave the field requesting applicant email address blank.
What is the purpose of the Statement of Understanding? - ANSWERS-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.
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