2024 AHIP MODULE 4 EXAM QUESTIONS AND ANSWERS
VERIFIED.
Another agent you know has engaged in misconduct that has been verified by the plan she
represented. What sort of penalty might the plan impose on this individual?
Question 1Select one:
a.
Plans must immediately terminate their contracts with such individuals. b.
Her name will be reported to a publicly accessible database and could be advertised in local
newspapers.
c.
The plan may withhold commission, require retraining, report the misconduct to a state department
of insurance or terminate the contract.
Correct: Plans must take corrective action in the event of verified misconduct by a marketing
representative. Such disciplinary action might include withholding or withdrawing commissions,
retraining, termination, and reporting agent termination to a state department of insurance.
d.
Plans do not impose penalties. Instead, the Medicare agency has specific authority to fine such
individuals for each violation.
Source: Module 4, Slide - Plan Oversight and Enforcement.
Question 2
Correct
You have approached a hospital administrator about marketing in her facility. The administrator is
uncomfortable with the suggestion. How could you address her concerns?
Question 2Select one:
a.
Tell her that if a plan obtains permission from CMS for a marketing event in a provider facility, the
event may go forward, regardless of where it occurs in the facility.
b.
Tell her that Medicare guidelines allow you to conduct marketing activities in common areas of
a provider’s facility.
, Correct: Marketing representatives may engage in marketing activities in common areas of health
care settings. This includes a cafeteria, community or recreational room as well as a conference
room.
c.
Tell her that Medicare guidelines only allow you to conduct marketing activities in areas of
the facility where individuals are waiting to receive health care services, but not in places
where they would be receiving health care such as an examining room.
d.
Tell her that Medicare guidelines allow you to conduct marketing activities anywhere in the facility,
so long as the affected providers agree to that event.
Source: Module 4, Slide - Marketing Activities: Marketing in a Health Care Setting.
Question 3
Correct
Another agent working for your agency claims that because you are not employed by the
Medicare Advantage plans that you represent, you are not subject to the same marketing
requirements as the plans themselves. How should you respond to such a statement?
Question 3Select one:
a.
Your coworker is correct because employed agents have to follow a stricter set of rules than
do independent agents, such as yourself.
b.
Your coworker is correct. You may use any marketing techniques that do not involve providing
misinformation to potential enrollees.
c.
Your coworker is correct. You are subject only to marketing requirements issued by your state
department of insurance.
d.
Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the
plan and requires that all contracted and employed agents comply with all Medicare marketing
rules.
Correct: Plan marketing representatives are subject to the same requirements related to
marketing and communications as the plans.
VERIFIED.
Another agent you know has engaged in misconduct that has been verified by the plan she
represented. What sort of penalty might the plan impose on this individual?
Question 1Select one:
a.
Plans must immediately terminate their contracts with such individuals. b.
Her name will be reported to a publicly accessible database and could be advertised in local
newspapers.
c.
The plan may withhold commission, require retraining, report the misconduct to a state department
of insurance or terminate the contract.
Correct: Plans must take corrective action in the event of verified misconduct by a marketing
representative. Such disciplinary action might include withholding or withdrawing commissions,
retraining, termination, and reporting agent termination to a state department of insurance.
d.
Plans do not impose penalties. Instead, the Medicare agency has specific authority to fine such
individuals for each violation.
Source: Module 4, Slide - Plan Oversight and Enforcement.
Question 2
Correct
You have approached a hospital administrator about marketing in her facility. The administrator is
uncomfortable with the suggestion. How could you address her concerns?
Question 2Select one:
a.
Tell her that if a plan obtains permission from CMS for a marketing event in a provider facility, the
event may go forward, regardless of where it occurs in the facility.
b.
Tell her that Medicare guidelines allow you to conduct marketing activities in common areas of
a provider’s facility.
, Correct: Marketing representatives may engage in marketing activities in common areas of health
care settings. This includes a cafeteria, community or recreational room as well as a conference
room.
c.
Tell her that Medicare guidelines only allow you to conduct marketing activities in areas of
the facility where individuals are waiting to receive health care services, but not in places
where they would be receiving health care such as an examining room.
d.
Tell her that Medicare guidelines allow you to conduct marketing activities anywhere in the facility,
so long as the affected providers agree to that event.
Source: Module 4, Slide - Marketing Activities: Marketing in a Health Care Setting.
Question 3
Correct
Another agent working for your agency claims that because you are not employed by the
Medicare Advantage plans that you represent, you are not subject to the same marketing
requirements as the plans themselves. How should you respond to such a statement?
Question 3Select one:
a.
Your coworker is correct because employed agents have to follow a stricter set of rules than
do independent agents, such as yourself.
b.
Your coworker is correct. You may use any marketing techniques that do not involve providing
misinformation to potential enrollees.
c.
Your coworker is correct. You are subject only to marketing requirements issued by your state
department of insurance.
d.
Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the
plan and requires that all contracted and employed agents comply with all Medicare marketing
rules.
Correct: Plan marketing representatives are subject to the same requirements related to
marketing and communications as the plans.
