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2021 United Healthcare - Ethics And Compliance Latest Solution Actual Quiz
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2021 United Healthcare - Ethics AndCompliance Latest Solution Actual Quiz
In terms of events, which of the following is true? Correct Answers: WRONG - Agents must report
formal marketing/sales events only to United Healthcare
When completing an enrollment application in LEAN, why is an agent prohibited from entering their
own email address in a field available for the consumer's email address? Correct Answers: The
consumer/member would not receive plan related correspondence intended for him/her.
Annual Election Period (AEP) is a time when: Correct Answers: Consumers can elect to join a
Medicare Advantage Plan or switch to a different plan.
You have scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss
Medicare Advantage Plans with a consumer. When you arrive at the appointment, a friend of the
consumer who is Medicare-eligible is present to hear your presentation. What should you do? Correct
Answers: Before you can start the appointment with both consumers, ask the consumer's friend to
complete an SOA.
Educational events allow for which of the following to occur? Correct Answers: Provide objective
information about the Medicare program and/or health improvement and wellness.
Agent Brenda is presenting Medicare Advantage plan options to her consumer, Melanie. During the
presentation, Brenda tells Melanie that Medicare gives each plan a Star Rating. Which of the
following is not an appropriate response when Melanie asks what the Star Rating means? Correct
Answers: Brenda should tell Melanie that the Star Rating is the same for every plan and it does not
accurately reflect a plan's performance in certain categories.
When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire?
Correct Answers: Once contact is made or 9 months from the date the consumer provided permission
(e.g. consumer signature date on BRC) or 90 days if on federal do not call list, whichever comes first.
Julie, a consumer, is having difficulty understanding the information her agent, Victor, is presenting at
her in-home appointment. She provides Victor with her cousin's telephone number and email address
and asks him to explain the plan to her cousin, who frequently assists with her health care decisions.
The next day, Victor emails Julie's cousin. Has Victor been compliant? Correct Answers: No. Victor
violated United Healthcare permission to contact guidelines by emailing the cousin without the
cousin's permission.
John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his
mother enrolling in a Medicare Advantage Plan? Correct Answers: John may sign the Enrollment
Application and must be able to provide documentation upon request by the Plan that indicates his
authority under state law to enroll his mother.
Which of the following is not considered unsolicited contact with a Medicare eligible consumer
according to CMS regulations and United Healthcare’s rules, policies, and procedures? Correct
Answers: Mailing a marketing brochure to the consumer via postal mail.
, To sign an enrollment application on behalf of a consumer, what authority must the individual have?
Correct Answers: 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).
As an agent, you must not do which of the following when marketing United Healthcare Medicare
Advantage plans to consumers? Correct Answers: Use providers or provider groups to distribute
printed information comparing benefits of different health plans without approval.
As an agent, you have an obligation to only enroll a consumer in a product: Correct Answers: That is
suitable for the consumer's needs, goals, and financial resources.
What is the purpose of the Statement of Understanding? Correct Answers: It ensures that when
consumers sign 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 the definition of Fraud? Correct Answers: Fraud is intentionally misrepresenting or concealing
facts to obtain something of value.
Which of the items listed are examples of Fraud, Waste, and Abuse (FWA)? Correct Answers: -
Submitting claims for services or supplies that were never provided
- Consulting with a number of doctors in order to obtain multiple prescriptions for the same drug.
- Billing for brand name drugs when generics were dispensed.
Whose email address may the agent enter into the LEAN enrollment application? Correct Answers:
Only the consumer's (or leave it blank).
Which election period occurs from October 15 to December 7? Correct Answers: Annual Election
Period (AEP)
Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing
/sales event? Correct Answers: 5 dollar gift cards to an in-network pharmacy.
Providing objective information about the Medicare program and/or health improvement and wellness
at public venues is the purpose of which of the following? Correct Answers: Educational events
Agent Bryan wants to grow his book of business. Which of the following lead generating activities is
NOT compliant? Correct Answers: At each appointment he asks the consumer for the name and
phone number of at least one acquaintance who is 65 or older and calls the referred individual.
Consumer Gary his friend's telephone number and email address to agent Bethany. What should
Bethany do? Correct Answers: Bethany may accept the information, but must observe permission to
contact and unsolicited contact guidelines, which will limit her to using postal mail to contact
Bethany's friend.
When can telephonic contact with a Medicare eligible consumer be made? Correct Answers: When
the consumer consented to be contacted for sales activities, subsequent telephonic contact has not
yet occurred, and the permission has not yet expired.
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