ing agreement in order to receive renewal commisions on medicare advantage and prescrip-
tion drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident
license and appointment and pass medicare basics and ethics compliance assessments on an
annual basis
What does CMS stand for? - ANSWER center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to
offer medicaid plans? - ANSWER CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the regulat-
ing agency that also monitors our progresses? - ANSWER CMS
Who regulates MA's and PDP's - ANSWER CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant
and considered____? - ANSWER an unqualified sale
Agents who are not qualified to sell the product will not be? - ANSWER compensated and
may receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? - ANSWER its designed to inform medicare
consumers about original medicare, medicare advantage, prescription drug and other medi-
care programs.
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,Where must educational events be conducted? - ANSWER in a public venue
Are the educational events unbiased so that it doesn't steer the consumer towards a specific
plan or limited number of plans? - ANSWER yes
WHat is a marketing/sales event? - ANSWER an event designed to steer or attempt to
steer, consumers toward a plan or limited set of plans. Agents may discuss plan specific in-
formation and collect applications.
Can marketing/sales be formal or informal? - ANSWER both
What describes a formal marketing/sales event? - ANSWER a full plan presentation, given
in a presenter-audience format.
What is an inform marketing/sales event? - ANSWER they're passive in nature where the
consumer approaches the agent to engage in conversation. a booth, table, or kiosk is typi-
cally used
What are marketing appointments? - ANSWER They're commonly referred to as "in
home, face to face, or one on one appointment" and typically take place in the consumers
home.
What other places can marketing appointments happen? - ANSWER coffee shop, or even
over the phone
because marketing appointments are not formal and informal marketing sales events,
they're not reported to who? - ANSWER UHC or CMS. instead, agents must obtain a com-
pleted scope of appointment prior to conducting the appointment.
To report events, what should agents use? - ANSWER an event request form
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, to ensure that events are in UHC's event reporting application no less than 7 calender days
prior to the event... - ANSWER submit the event request form, according to instructions
on the form, NO LESS THAN 14 CALENDAR DAYS
event request forms submitted within7 calendar days will NOT be what? - ANSWER pro-
cessed
conducting an unreported event is _____? - ANSWER prohibited
to schedule a sign language interpreter for a formal marketing/sales event or a personal/in-
dividual marketing appointment, enter the consumer's request direct;y in bconnected at
least? - ANSWER 14 days prior to the event or appointment
What are marketing materials used for? - ANSWER 1) draw attention to a plan sponsor or
their plan(s) and
2) influence a consumer's decision when selecting a plan in which to enroll or a member's
decision to remain enrolled in their current plan
Marketing materials contain information about the plan or plans: - ANSWER 1) benefits
or benefit structure
2) cost sharing ( including premiums, copayments, and deductibles)
3) Measurements or ranking standards ( such as star ratings. comparisons to other plans, or
statistical studies or surveys)
Approval is required for? - ANSWER 1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affli-
ated plans or displays any logos
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