Page 1 of 39 1 UHC ETHICS AND COMPLIANCE EXAM LATEST 2024 -2025 COMPLETE 300 QUESTIONS AND CORRECT DETAILED ANSWERS JUST RELEASED Sandra is currently enrolled in a Medicare Advantage plan that offers a variety of benefits beyond what is covered by Original Medicare, such as transportation to appointments and an over -the-counter debit card. When comparing an alternative plan, which of the following must you not use to describe benefits of the new plan? No two plans are the same, so let's be sure you enroll in the plan that best meets your needs" Wrong Which of the following guidelines must you follow before recommending a plan change? (Select 3) Conduct a thorough needs assessment Only recommend a plan that is the best fit plan, which may be the consumer's current plan Do not rely only on and become biased by the c onsumer's stated reason for calling Next question 4 Questions remaining Select the three elements you must compare when a consumer is considering changing plans. (Select 3) The providers that the consumer sees and how access to those providers might be dif ferent by enrolling in the new plan The consumer's current coverage and costs with the coverage and costs of the new plan that I want to recommend The providers that the consumer sees and how access to those providers might be different by enrolling in the new plan Page 2 of 39 2 The consumer's current coverage and costs with the coverage and costs of the new plan that I want to recommend What should the consumer understand before they agree to proceed with enrolling in a new plan? (Select 3) If the plan is network -based, that the providers they want to use are in the new plan's network If the plan has drug coverage, that the medications they use are on the plan's formulary and, if they are, what tier they are in and any utilization management limitations That their curren t plan and the new plan that I am recommending are not the same Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantag e or Prescription Drug plan? April 1 through October 31 Which of the following statements is true about election periods? MA Open Enrollment Period can only be used by a consumer already enrolled in an MA Plan When a consumer asks why an MA Plan has a 2 -star rating, the agent should tell the consumer what? That the plan has received a "Below Average" rating. Which of the following describes Permission to Contact (PTC) guidelines? Contact can only be made by the method(s) requested by the consumer and the ag ent can only market the product(s) 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? Page 3 of 39 3 The plan's network characteristics and how using out -of-network providers may impact coverage and costs, covered benefits and li mitations, and plan related costs such monthly premium and copayments/coinsurance for services received. Whose email address may the agent enter into the applicant information section of LEAN enrollment application? Only the consumer's email (or leave it b lank). What is the purpose of the Statement of Understanding? 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 th ey are enrolling, and standard disclosures. When must the Scope of Appointment be obtained from the consumer for an in -person or telephonic sales presentation (unless an exception applies)? 48 ane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Which option should Jane consider? Jane should ask Albert if someone, such as an Authorized Legal Representative, helps him make health care or insurance -relate d decisions and should be present. Which of the following options will enable a consumer to obtain prescription drug coverage? (Select 2) Enroll in a PFFS MA -Only plan and a stand -alone PDP Enroll in any MA -PD plan In which situation will a member be invol untarily disenrolled from their MA plan? Page 4 of 39 4 The member did not pay plan premiums on a timely basis. Wrong Rosanna is enrolled in a Medicare Advantage Only (MA -Only) Private Fee -for-Service (PFFS) Plan. The plan is suitable for her needs and service area. She has decided she wants to add prescription drug coverage. Which option is available to Rosanna (assuming she is in a valid election period)? Rosanna could stay enrolled in her MA -Only PFFS plan and enroll in a stand -alone PDP. In what product should agents enroll consumers? A product that is suitable for the consumer's needs, goals and financial resources. Dino, an agent, received a phone call on September 29 from a consumer interested in Medicare Advantage plans for the new plan year. Dino proceeded to veri fy the consumer's Medicare eligibility, describe the costs and benefit coverage of the plan, and explained that he could not accept an enrollment application until October 15. What did Dino do that was NOT compliant? Dino presented a plan prior to October 1. What information must you provide to the consumer (at minimum) when you conduct your call greeting? My name, my title that indicates I am a licensed insurance agent, and the name of the agency I represent Jane, a consumer, calls your call center and ask s to be enrolled in the plan that will put money back into her Social Security every month. What do you keep in mind when you hear the consumer mention a specific plan benefit from an ad? (Select 3) I remember to not overlook the importance of a thorough n eeds assessment I make sure whatever plan I recommend has that stated benefit because I know it will be the
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