ETHICS AND COMPLIANCE
ASSESSMENT UHC EXAM QUESTIONS
AND ANSWERS GRADED A+ 2025/2026
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 Advantage
or Prescription Drug plan? - ANS April 1 through October 31
Which of the following statements is true about using a five star special enrollment period
(SEP)? - ANS It can be used once from December 8 through November 30 and coverage will
start the first of the month following recipient of the enrollment application
Which statement regarding star ratings is true - ANS Medicare uses a five star rating system
to illustrate the plans performance and quality
In which of the following situations can a telephonic contract be made with a Medicare eligible
consumer? - ANS When the consumer consented to be contracted for sales activities, and the
permission has not yet expired
What information should be obtained from the consumer when conducting a thorough needs
assessment? (Select 2) - ANS • their current health care coverage, including what they like
about it, and what they don't
• the providers they see in medication they take to determine network and formulary status
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Will using LEAN to complete an enrollment application with the consumer agent Jeff learns the
consumer does not have an email address. What should Jeff do? - ANS The
consumer/member would not receive plan related, corresponds, intent for him/her
What is the purpose of the statement of understanding? - ANS 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? - ANS The agreement obtained from the consumer to that
identifies the scope of products that can be discussed at a personal/individual marketing
appointment
Which statement is accurate when a consumer has a power of authority (POA) - ANS If the
POA signed the enrollment application, they must be able to provide documentation upon
request for the plan that indicates authority under state law to enroll the consumer
What happens on the plan effective date when a member enrolled in a Medicare supplement
insurance plan and standalone PDP enroll in a Medicare vantage plan that includes drug
coverage - ANS Automatic disenrollment from the standalone PDP
In which situation, MAY the Medicare advantage (MA) organization decide to disenroll a
member from an MA plan? - ANS Premiums are not paid on a timely basis
Dennis a consumer is currently enrolled in the original Medicare, plus a Medicare supplement
plan. His current plan is suitable for his Medicare needs, but he would like to add prescription
drug coverage only since Dennis wants to keep his current coverage which option is available to
Dennis (assuming he is in a valid election period)? - ANS Dennis should stay enrolled in
original Medicare and his Medicare supplement plan and enroll in a standalone PDP
In what product should agents and roll consumers? - ANS A product that is suitable for the
consumers needs, goals and financial resources
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ASSESSMENT UHC EXAM QUESTIONS
AND ANSWERS GRADED A+ 2025/2026
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 Advantage
or Prescription Drug plan? - ANS April 1 through October 31
Which of the following statements is true about using a five star special enrollment period
(SEP)? - ANS It can be used once from December 8 through November 30 and coverage will
start the first of the month following recipient of the enrollment application
Which statement regarding star ratings is true - ANS Medicare uses a five star rating system
to illustrate the plans performance and quality
In which of the following situations can a telephonic contract be made with a Medicare eligible
consumer? - ANS When the consumer consented to be contracted for sales activities, and the
permission has not yet expired
What information should be obtained from the consumer when conducting a thorough needs
assessment? (Select 2) - ANS • their current health care coverage, including what they like
about it, and what they don't
• the providers they see in medication they take to determine network and formulary status
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Will using LEAN to complete an enrollment application with the consumer agent Jeff learns the
consumer does not have an email address. What should Jeff do? - ANS The
consumer/member would not receive plan related, corresponds, intent for him/her
What is the purpose of the statement of understanding? - ANS 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? - ANS The agreement obtained from the consumer to that
identifies the scope of products that can be discussed at a personal/individual marketing
appointment
Which statement is accurate when a consumer has a power of authority (POA) - ANS If the
POA signed the enrollment application, they must be able to provide documentation upon
request for the plan that indicates authority under state law to enroll the consumer
What happens on the plan effective date when a member enrolled in a Medicare supplement
insurance plan and standalone PDP enroll in a Medicare vantage plan that includes drug
coverage - ANS Automatic disenrollment from the standalone PDP
In which situation, MAY the Medicare advantage (MA) organization decide to disenroll a
member from an MA plan? - ANS Premiums are not paid on a timely basis
Dennis a consumer is currently enrolled in the original Medicare, plus a Medicare supplement
plan. His current plan is suitable for his Medicare needs, but he would like to add prescription
drug coverage only since Dennis wants to keep his current coverage which option is available to
Dennis (assuming he is in a valid election period)? - ANS Dennis should stay enrolled in
original Medicare and his Medicare supplement plan and enroll in a standalone PDP
In what product should agents and roll consumers? - ANS A product that is suitable for the
consumers needs, goals and financial resources
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
