UHC 2022 Ethics And Compliance Test
Questions And Answers
Agent John is planning to conduct a series of events. Some will be strictly educational, others will be
formal presentations of specific United Healthcare plans, and others will be informal marketing events
where he can generate leads and schedule future in-home marketing appointments. Of the three
types of events John plans to conduct, which need to be reported to United Healthcare? - *******
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or
her own email address in a field available for the consumer's email address? - The
consumer/member would not receive plan related correspondence intended for him/her.
Which election period runs from October 15 to December 7 and allows consumers to elect to join a
Medicare Advantage Plan or switch to a different plan? - Annual Election Period (AEP)
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 verify 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.
Mr. and Mrs. Nelson, who are current members, unexpectedly walk into Jake's insurance agency
office and ask him to discuss Medicare Advantage Plans. Does Jake need to obtain a Scope of
Appointment (SOA) form? - Yes, he needs to obtain an SOA from both Mr. and Mrs. Nelson.
Which describes the purpose of educational events? - Educational events provide objective
information about the Medicare program and/or health improvement and wellness.
How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a
Star Rating of 2 stars? - Erin should tell Mrs. Rose that the plan has received a "Below Average"
rating.
Which of the following describes Permission to Contact guidelines? - It is method specific (e.g.,
telephone, email), short term (i.e., expires when contact is made), and event specific (i.e., limited to
the products identified).
Julie, a consumer, is having difficulty understanding the information her agent, Victor, is presenting at
her in-home appointment. She provides Victor with her cousin's telephone number and email address
and asks him to explain the plan to her cousin, who frequently assists with her health care decisions.
The next day, Victor emails Julie's cousin. Has Victor been compliant? - No. Victor violated United
Healthcare permission to contact guidelines by emailing the cousin without the cousin's permission
Which of the individuals below would not likely have the authority to enroll a consumer in a Medicare
Advantage Plan? - The consumer's spouse, who is neither a Power of Attorney nor legal guardian.
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer? - When the consumer consented to be contacted for sales activities, subsequent
telephonic contact has not yet occurred, and the permission has not yet expired.
Questions And Answers
Agent John is planning to conduct a series of events. Some will be strictly educational, others will be
formal presentations of specific United Healthcare plans, and others will be informal marketing events
where he can generate leads and schedule future in-home marketing appointments. Of the three
types of events John plans to conduct, which need to be reported to United Healthcare? - *******
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or
her own email address in a field available for the consumer's email address? - The
consumer/member would not receive plan related correspondence intended for him/her.
Which election period runs from October 15 to December 7 and allows consumers to elect to join a
Medicare Advantage Plan or switch to a different plan? - Annual Election Period (AEP)
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 verify 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.
Mr. and Mrs. Nelson, who are current members, unexpectedly walk into Jake's insurance agency
office and ask him to discuss Medicare Advantage Plans. Does Jake need to obtain a Scope of
Appointment (SOA) form? - Yes, he needs to obtain an SOA from both Mr. and Mrs. Nelson.
Which describes the purpose of educational events? - Educational events provide objective
information about the Medicare program and/or health improvement and wellness.
How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a
Star Rating of 2 stars? - Erin should tell Mrs. Rose that the plan has received a "Below Average"
rating.
Which of the following describes Permission to Contact guidelines? - It is method specific (e.g.,
telephone, email), short term (i.e., expires when contact is made), and event specific (i.e., limited to
the products identified).
Julie, a consumer, is having difficulty understanding the information her agent, Victor, is presenting at
her in-home appointment. She provides Victor with her cousin's telephone number and email address
and asks him to explain the plan to her cousin, who frequently assists with her health care decisions.
The next day, Victor emails Julie's cousin. Has Victor been compliant? - No. Victor violated United
Healthcare permission to contact guidelines by emailing the cousin without the cousin's permission
Which of the individuals below would not likely have the authority to enroll a consumer in a Medicare
Advantage Plan? - The consumer's spouse, who is neither a Power of Attorney nor legal guardian.
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer? - When the consumer consented to be contacted for sales activities, subsequent
telephonic contact has not yet occurred, and the permission has not yet expired.
