HUMANA PRACTICE Questions with 100% Correct Answers

When would an agent need to check for an SEP? - Correct answer-When medicare A and B have different dates and the enrollment is after the Part B effective date. Correct Which of the following guidelines are you to follow-when avoiding member complaints on enrollment issues? - Correct answer-Only enroll beneficiaries when express consent is given. Correct When a member is dual eligible when can plan changes be made using the SEP? - Correct answer-With this SEP a change can only be made once per calendar quarterfor the first 3 quarters and then during AEP. Correct Which of the following are NOT proper guidelines when responding to agent complaints? - Correct answer-Contact the member first before responding to the complaint. Correct Which statement best describes Humana's Care Highlight program? - Correct answerHumana's Care Highlight Program recognizes physician practices that meet quality and cost-efficiency guidelines. Correct Which of the following are you permitted to do-as it relates to marketing or discussing Value Added items and Services (such as Weight Watchers discount)? - Correct answer-Yes, can mention plan benefits -but NOT permitted to mention VAIS to help the member decide on which healthcare coverage. Correct An agent is speaking with a member on February 6, 2020-after having second thoughts on the plan chosen during AEP. The member does NOT have a SEP. Can she enroll? - Correct answer-Yes, she can enroll using OEP. Correct Tamara is aging into Medicare and is in her 7 months initial enrollment period. She tells you she would like to enroll in a MA-only ( no Rx) . Which enrollment period should you select for Tamara's application? - Correct answer-Initial Coverage Enrollment Period (ICEP) Correct When presenting an HMO plan the member has indicated being familiar with the benefits and will not need to review the out-of-network implications. What do you do? - Correct answer-Advise the member that you are required to present the entire summary of benefits so that the member can make a fully informed decision about enrolling in the plan. Correct Which one of the following statements is true- as it pertains to agent licensing? - Correct answer-Agents must hold an active license in the state where the beneficiary resides prior to selling Humana plans. Correct In which of the following scenarios would someone qualify for a plan change during OEP? - Correct answer-MA member wants to enroll in a different MA plan with prescription drug coverage. Correct Which of the following are examples of how to provide a full and compliant presentation? - Correct answer-Present full disclosure of all plan benefits, limitations, and cost sharing-for the plan year being presented. Correct Who is responsible for ensuring the agent licensing is current? - Correct answer-Agent - Correct How often can members be enrolled in Dual Eligible Special Needs Plans (D-SNP's) which plans? - Correct answer-Once per calendar quarter from January to September. Correct What is the determining factor of how an OSB premium is paid? - Correct answer-The payment method selected on the base MA/MAPD plan is the same payment method that will be used to the OSB. Correct Which of the following is NOT a benefit to automated premium payments? - Correct answer-Additional commission to set up automatic payments. Correct During a presentation a member indicates being well-versed in the different plans and asks you to point out what's most important. What do you do? - Correct answer-Indicate you are required to present all plan benefits, limitations, and cost sharing-for the plan year being presented. Correct Which of the following is considered an acceptable change to make during OEP? - Correct answer-Individuals enrolled in an MAPD plan switching to a different MAPD plan. Which of the following is an application of inadvertently dis-enrolling an existing Group Medicare member? - Correct answerWhich of the following is NOT part of your presentation when discussing the Late Enrollment Penalty for prescription drug plans? - Correct answer-Advise the penalty does not have to be paid when moving to another plan. Correct Chris is dual eligible and therefore qualifies for the SEP for duals. Which of the following dates can he make plan changes? - Correct answer-02/15/20, 06/19/20, and 8/17/20. Correct In which of the following scenarios would an agent use ICEP? - Correct answer-When Part A and Part B dates are the same and the person is enrolling in a MA only plan. Correc