UHC - UNITED HEALTHCARE - 2026 CERTIFICATIONS QUESTIONS ANSWERED CORRECTLY LATEST
UPDATE 2026
Consumer John provides his cell phone number on agent Mark's Permission to Contact (PTC)
mechanism and indicates he wants to be called as a means of contact. What does that mean? (select
all that apply) - Answers 1.Agent Mark may only call John, not text him.
2. Agent Mark may only speak to John, the person who provided the PTC.
Agent Charlie receives a Business Reply Card from consumer Rebecca. Rebecca has provided her email
address only and wants information about standalone Prescription Drug Plans. What can Charlie do? -
Answers Charlie may only email Rebecca marketing material related to Prescription Drug Plans.
From the list below, select the items that should be confirmed or obtained when conducting a
thorough needs assessment. (select all that apply) - Answers 1. Eligibility
2. Current coverage
3. Current providers
4. Current prescription medications
5. Daily living needs such as transportation, fitness, travel
6. Other wish list items such as network restrictions, premium amounts, national network needs
Match the election period to the correct definition. - Answers 1. MA-OEP: Consumers can switch or
disenroll from their MA Plan & obtain Original Medicare
2. IEP: Newly eligible consumers can enroll 3 months prior, month of, & 3 months after turning 65
3. AEP: Annual period when any Medicare consumer can enroll in or disenroll from an MA or PDP
4. SEP: Opportunity to change plans for specific scenarios such as newly dual-eligible (Medicare and
Medicaid) or new chronic condition
5. 5-star: One-time opportunity to enroll in a plan with a 5 star rating (if available)
What should you do if the consumer is interested in an MA Plan that has a 2-star rating? - Answers
You should inform the consumer that the plan has received a "below average" rating.
A member can voluntarily disenroll from an MA Plan or PDP or they can be involuntarily disenrolled
by the plan. Select the reasons below for involuntary disenrollment. (select all that apply) - Answers 1.
Member moves out of the plan's service area
2. Member loses entitlement to either Part A or Part B
Can you identify these terms associated with enrollment and disenrollment basics? Read each
statement and then drag the matching term to the statement. - Answers 1. Appeal: Action members
take if they disagree with coverage or payment decision
2. Summary of benefits: Detailed summary of plan's benefits, cost sharing and special features
3. Required involuntary disenrollment: Happens when member loses Part A or B entitlement
4. Statement of understanding: Required to be read and acknowledged by the consumer at the
enrollment
5. Star Rating: Medicare's measure of a plan's quality and performance
Jared is planning a formal marketing/sales event for October 24. While it is strongly recommended
that Jared reports his event at least 14 calendar days in advance, what is the last date the Event
Request Form can be submitted to UnitedHealthcare? - Answers October 17
Tori needs to cancel an event. To allow ample time for UnitedHealthcare to process the cancellation
in the event reporting application, when should Tori submit a Cancel Event Request Form? - Answers
At least 6 business days prior to the date of the event
Janet is conducting an informal marketing/sales event at her local soup kitchen. When speaking to the
Activities Director, Janet finds out that lunch is served daily from 11:00 AM-1:00 PM. Which of the
following is a compliant time when Janet can host her event? - Answers 9 am to 11 am
Bonnie, a D-SNP member, lost her Medicaid eligibility. She has a Special Election Period available to
enroll in a new plan. When does that begin? - Answers Upon notification or effective date of the loss,
which ever is earlier
Harold lost his Medicaid eligibility. What is he responsible for paying? (select all that apply) - Answers
1. Deductibles
2. Copayments
3. Coinsurance
What are the reasons a consumer can use the Special Election Period- Special Need/Chronic? (select
all that apply) - Answers 1. Enrolling in a C-SNP first time
2. Enrolling in a C-SNP to cover a different condition
, Mrs. Murphy has recently been diagnosed with a cardiovascular disorder and wants to enroll in a C-
SNP. Joshua asked her about a provider who can verify her condition. What is true about her
provider? - Answers The provider indicated on the form does not have to be contracted with the plan.
Mrs. Murphy's effective date is February 1. She receives a letter on March 1 from the plan telling her
the attempts to verify her qualifying chronic condition have been unsuccessful. What does this mean?
- Answers Her enrollment will be terminated effective March 31 if, as of March 31, the plan has not
been able to verify a qualifying chronic condition
If the enrollee has not resided in the contracted SNF for 90 days at the time of enrollment, which
documents qualify as additional proof to be submitted to the enrollment department? (select all that
apply) - Answers 1. MDS (Minimum Data Set) forms; Sections A0100 - A1100 and Section Q0300-
Q0400
2. An Optum-provided form letter signed by appropriate facility staff
3. An approved letter on facility letterhead signed by appropriate facility staff
Which election periods can be used at any time during the year to enroll an eligible consumer into an
ISNP? - Answers Open Enrollment Period for Institutionalized Individuals (OEPI)
Now that you read the Provider Activity Guidelines, which statement below is true? - Answers The
skilled nursing facility staff member cannot provide a completed BRC directly to an agent but may put
it in a drop box or folder used to collect completed BRCs.
Authorization for Disclosure of Contact Information: Signed within the previous twelve-month period
- Answers Required
Authorization for Disclosure of Contact Information: No expiration date - Answers Not Required
Authorization for Disclosure of Contact Information: Anyone from the contracted skill nursing facility
can sign - Answers Not Required
Authorization for Disclosure of Contact Information: A description of entities to which the information
is to be released - Answers Required
Authorization for Disclosure of Contact Information: Information will be given to a health care plan -
Answers Required
Authorization for Disclosure of Contact Information: Indicates someone will contact them - Answers
Required
Authorization for Disclosure of Contact Information: Individual will be enrolled in an I-SNP - Answers
Not Required
Who cannot answer the questions for the Institutional Level of Care (LOC) assessment? - Answers
Agent
What are the eligibility requirements for the UHC SCO plan? - Answers 1. Be 65 years of age or older
2. Be enrolled in MassHealth Standard or MassHealth CommonHealth
3. Reside in service area
4. Not have any other comprehensive health insurance, except Medicare
Richard wants to determine if Jon is enrolled in PACE or another SCO plan. What questions could he
ask? - Answers Correct:
1. Do you currently pay copayments for your prescription drugs?
2. May I see your current insurance card?
3. Do you attend an Adult Day Health Center (ADHC) on a regular basis?
Incorrect:
1. Do you go to fitness classes?
2. Do you see a specialist in addition to your Primary Care Provider?
3. May I see your Medicare card?
Which election periods apply to the UHC SCO? (select all that apply) - Answers 1. Medicare Initial
Enrollment Period
2. Medicare Advantage Open Enrollment Period (MA OEP)
3. SEP - Integrated Care once per month throughout the year
4. Annual Election Period (AEP)
What sales support tools are available to agents for questions about SCO related materials? - Answers
1. UHC Agent Toolkit
2. Producer Help Desk
3. JarvisWrap
UPDATE 2026
Consumer John provides his cell phone number on agent Mark's Permission to Contact (PTC)
mechanism and indicates he wants to be called as a means of contact. What does that mean? (select
all that apply) - Answers 1.Agent Mark may only call John, not text him.
2. Agent Mark may only speak to John, the person who provided the PTC.
Agent Charlie receives a Business Reply Card from consumer Rebecca. Rebecca has provided her email
address only and wants information about standalone Prescription Drug Plans. What can Charlie do? -
Answers Charlie may only email Rebecca marketing material related to Prescription Drug Plans.
From the list below, select the items that should be confirmed or obtained when conducting a
thorough needs assessment. (select all that apply) - Answers 1. Eligibility
2. Current coverage
3. Current providers
4. Current prescription medications
5. Daily living needs such as transportation, fitness, travel
6. Other wish list items such as network restrictions, premium amounts, national network needs
Match the election period to the correct definition. - Answers 1. MA-OEP: Consumers can switch or
disenroll from their MA Plan & obtain Original Medicare
2. IEP: Newly eligible consumers can enroll 3 months prior, month of, & 3 months after turning 65
3. AEP: Annual period when any Medicare consumer can enroll in or disenroll from an MA or PDP
4. SEP: Opportunity to change plans for specific scenarios such as newly dual-eligible (Medicare and
Medicaid) or new chronic condition
5. 5-star: One-time opportunity to enroll in a plan with a 5 star rating (if available)
What should you do if the consumer is interested in an MA Plan that has a 2-star rating? - Answers
You should inform the consumer that the plan has received a "below average" rating.
A member can voluntarily disenroll from an MA Plan or PDP or they can be involuntarily disenrolled
by the plan. Select the reasons below for involuntary disenrollment. (select all that apply) - Answers 1.
Member moves out of the plan's service area
2. Member loses entitlement to either Part A or Part B
Can you identify these terms associated with enrollment and disenrollment basics? Read each
statement and then drag the matching term to the statement. - Answers 1. Appeal: Action members
take if they disagree with coverage or payment decision
2. Summary of benefits: Detailed summary of plan's benefits, cost sharing and special features
3. Required involuntary disenrollment: Happens when member loses Part A or B entitlement
4. Statement of understanding: Required to be read and acknowledged by the consumer at the
enrollment
5. Star Rating: Medicare's measure of a plan's quality and performance
Jared is planning a formal marketing/sales event for October 24. While it is strongly recommended
that Jared reports his event at least 14 calendar days in advance, what is the last date the Event
Request Form can be submitted to UnitedHealthcare? - Answers October 17
Tori needs to cancel an event. To allow ample time for UnitedHealthcare to process the cancellation
in the event reporting application, when should Tori submit a Cancel Event Request Form? - Answers
At least 6 business days prior to the date of the event
Janet is conducting an informal marketing/sales event at her local soup kitchen. When speaking to the
Activities Director, Janet finds out that lunch is served daily from 11:00 AM-1:00 PM. Which of the
following is a compliant time when Janet can host her event? - Answers 9 am to 11 am
Bonnie, a D-SNP member, lost her Medicaid eligibility. She has a Special Election Period available to
enroll in a new plan. When does that begin? - Answers Upon notification or effective date of the loss,
which ever is earlier
Harold lost his Medicaid eligibility. What is he responsible for paying? (select all that apply) - Answers
1. Deductibles
2. Copayments
3. Coinsurance
What are the reasons a consumer can use the Special Election Period- Special Need/Chronic? (select
all that apply) - Answers 1. Enrolling in a C-SNP first time
2. Enrolling in a C-SNP to cover a different condition
, Mrs. Murphy has recently been diagnosed with a cardiovascular disorder and wants to enroll in a C-
SNP. Joshua asked her about a provider who can verify her condition. What is true about her
provider? - Answers The provider indicated on the form does not have to be contracted with the plan.
Mrs. Murphy's effective date is February 1. She receives a letter on March 1 from the plan telling her
the attempts to verify her qualifying chronic condition have been unsuccessful. What does this mean?
- Answers Her enrollment will be terminated effective March 31 if, as of March 31, the plan has not
been able to verify a qualifying chronic condition
If the enrollee has not resided in the contracted SNF for 90 days at the time of enrollment, which
documents qualify as additional proof to be submitted to the enrollment department? (select all that
apply) - Answers 1. MDS (Minimum Data Set) forms; Sections A0100 - A1100 and Section Q0300-
Q0400
2. An Optum-provided form letter signed by appropriate facility staff
3. An approved letter on facility letterhead signed by appropriate facility staff
Which election periods can be used at any time during the year to enroll an eligible consumer into an
ISNP? - Answers Open Enrollment Period for Institutionalized Individuals (OEPI)
Now that you read the Provider Activity Guidelines, which statement below is true? - Answers The
skilled nursing facility staff member cannot provide a completed BRC directly to an agent but may put
it in a drop box or folder used to collect completed BRCs.
Authorization for Disclosure of Contact Information: Signed within the previous twelve-month period
- Answers Required
Authorization for Disclosure of Contact Information: No expiration date - Answers Not Required
Authorization for Disclosure of Contact Information: Anyone from the contracted skill nursing facility
can sign - Answers Not Required
Authorization for Disclosure of Contact Information: A description of entities to which the information
is to be released - Answers Required
Authorization for Disclosure of Contact Information: Information will be given to a health care plan -
Answers Required
Authorization for Disclosure of Contact Information: Indicates someone will contact them - Answers
Required
Authorization for Disclosure of Contact Information: Individual will be enrolled in an I-SNP - Answers
Not Required
Who cannot answer the questions for the Institutional Level of Care (LOC) assessment? - Answers
Agent
What are the eligibility requirements for the UHC SCO plan? - Answers 1. Be 65 years of age or older
2. Be enrolled in MassHealth Standard or MassHealth CommonHealth
3. Reside in service area
4. Not have any other comprehensive health insurance, except Medicare
Richard wants to determine if Jon is enrolled in PACE or another SCO plan. What questions could he
ask? - Answers Correct:
1. Do you currently pay copayments for your prescription drugs?
2. May I see your current insurance card?
3. Do you attend an Adult Day Health Center (ADHC) on a regular basis?
Incorrect:
1. Do you go to fitness classes?
2. Do you see a specialist in addition to your Primary Care Provider?
3. May I see your Medicare card?
Which election periods apply to the UHC SCO? (select all that apply) - Answers 1. Medicare Initial
Enrollment Period
2. Medicare Advantage Open Enrollment Period (MA OEP)
3. SEP - Integrated Care once per month throughout the year
4. Annual Election Period (AEP)
What sales support tools are available to agents for questions about SCO related materials? - Answers
1. UHC Agent Toolkit
2. Producer Help Desk
3. JarvisWrap
