UHC ethics and compliance section for
certification
What is a servicing agent? - ANSWER an inactive, nonemployee who has signed a
servicing agreement in order to receive renewal commissions on Medicare advantage
and prescription 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 disapprove plans that can be sold, and is the
regulating 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 medicare programs.
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
information 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 typically 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 market 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
completed scope of appointment prior to conducting the appointment.
To report events, what should agents use? - ANSWER an event request form
to ensure that events are in UHC's event reporting application no less than 7 calendar
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
processed
conducting an unreported event is _____? - ANSWER prohibited
to schedule a sign language interpreter for a formal marketing/sales event or a
personal/individual marketing appointment, enter the consumer's request directly in
biconnected 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
affiliated plans or displays any logos
certification
What is a servicing agent? - ANSWER an inactive, nonemployee who has signed a
servicing agreement in order to receive renewal commissions on Medicare advantage
and prescription 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 disapprove plans that can be sold, and is the
regulating 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 medicare programs.
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
information 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 typically 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 market 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
completed scope of appointment prior to conducting the appointment.
To report events, what should agents use? - ANSWER an event request form
to ensure that events are in UHC's event reporting application no less than 7 calendar
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
processed
conducting an unreported event is _____? - ANSWER prohibited
to schedule a sign language interpreter for a formal marketing/sales event or a
personal/individual marketing appointment, enter the consumer's request directly in
biconnected 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
affiliated plans or displays any logos
