UHC ethics and compliance section for certification
What is a servicing agent? Correct Answer: an inactive, nonemployee who has signed a
servicing agreement in order to receive renewal commisions 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? Correct Answer: center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to offer
medicaid plans? Correct Answer: CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the regulating
agency that also monitors our progresses? Correct Answer: CMS
Who regulates MA's and PDP's Correct Answer: CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant and
considered____? Correct Answer: an unqualified sale
Agents who are not qualified to sell the product will not be? Correct Answer: compensated and
may receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? Correct Answer: its designed to inform medicare
consumers about original medicare, medicare advantage, prescription drug and other medicare
programs.
Where must educational events be conducted? Correct 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? Correct Answer: yes
WHat is a marketing/sales event? Correct 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? Correct Answer: both
What describes a formal marketing/sales event? Correct Answer: a full plan presentation, given
in a presenter-audience format.
What is an inform marketing/sales event? Correct 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? Correct 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? Correct 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? Correct 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? Correct Answer: an event request form
to ensure that events are in UHC's event reporting application no less than 7 calender days prior
to the event... Correct 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? Correct Answer:
processed
conducting an unreported event is _____? Correct 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 direct;y in bconnected
at least? Correct Answer: 14 days prior to the event or appointment
What are marketing materials used for? Correct 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: Correct 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? Correct Answer: 1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affliated
plans or displays any logos
What does generic mean with marketing materials? Correct Answer: materials that do not meet
the marketing materials criteria and do not carry any plan sponsor information or logos
does generic materials require prior approval? Correct Answer: no
What is a servicing agent? Correct Answer: an inactive, nonemployee who has signed a
servicing agreement in order to receive renewal commisions 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? Correct Answer: center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to offer
medicaid plans? Correct Answer: CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the regulating
agency that also monitors our progresses? Correct Answer: CMS
Who regulates MA's and PDP's Correct Answer: CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant and
considered____? Correct Answer: an unqualified sale
Agents who are not qualified to sell the product will not be? Correct Answer: compensated and
may receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? Correct Answer: its designed to inform medicare
consumers about original medicare, medicare advantage, prescription drug and other medicare
programs.
Where must educational events be conducted? Correct 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? Correct Answer: yes
WHat is a marketing/sales event? Correct 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? Correct Answer: both
What describes a formal marketing/sales event? Correct Answer: a full plan presentation, given
in a presenter-audience format.
What is an inform marketing/sales event? Correct 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? Correct 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? Correct 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? Correct 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? Correct Answer: an event request form
to ensure that events are in UHC's event reporting application no less than 7 calender days prior
to the event... Correct 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? Correct Answer:
processed
conducting an unreported event is _____? Correct 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 direct;y in bconnected
at least? Correct Answer: 14 days prior to the event or appointment
What are marketing materials used for? Correct 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: Correct 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? Correct Answer: 1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affliated
plans or displays any logos
What does generic mean with marketing materials? Correct Answer: materials that do not meet
the marketing materials criteria and do not carry any plan sponsor information or logos
does generic materials require prior approval? Correct Answer: no
