UHC Ethics and Compliance Section for Certification 2024
Questions and Answers (Verified Answers)
What is a servicing agent?
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?
center for medicare and medicaid services
Who administers the medicare program and contracts with private health care
companies to offer medicaid plans?
CMS
Who holds the authority to approve or disaprove plans that can be sold, and is
the regulating agency that also monitors our progresses?
CMS
Who regulates MA's and PDP's
CMS
Enrolling a customer in a plan when you are not certified in the product is non-
compliant and considered____?
an unqualified sale
Agents who are not qualified to sell the product will not be?
compensated and may receive corrective and or disciplinary action up to an including
termination
What is the purpose of an educational event?
its designed to inform medicare consumers about original medicare, medicare
advantage, prescription drug and other medicare programs.
Where must educational events be conducted?
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?
yes
WHat is a marketing/sales event?
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?
both
What describes a formal marketing/sales event?
a full plan presentation, given in a presenter-audience format.
What is an inform marketing/sales event?
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?
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?
coffee shop, or even over the phone
because marketing appointments are not formal and informal marketing sales
events, they're not reported to who?
UHC or CMS. instead, agents must obtain a completed scope of appointment prior to
conducting the appointment.
To report events, what should agents use?
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...
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?
processed
conducting an unreported event is _____?
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?
14 days prior to the event or appointment
What are marketing materials used for?
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:
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?
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?
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?
no
What methods are considered marketing material?
newspaper, tv, internet, radio advertisements, direct mail, postcards, flyers, brochures,
magnets, pre-enrollment materials, websites and social media platforms
what are some examples of generic marketing materials?
social media sites and websites
sites used to market UHC plans must be _____ by UHC and CMS prior to use
approved
when talking about marketing materials what should the agent NOT do?
Questions and Answers (Verified Answers)
What is a servicing agent?
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?
center for medicare and medicaid services
Who administers the medicare program and contracts with private health care
companies to offer medicaid plans?
CMS
Who holds the authority to approve or disaprove plans that can be sold, and is
the regulating agency that also monitors our progresses?
CMS
Who regulates MA's and PDP's
CMS
Enrolling a customer in a plan when you are not certified in the product is non-
compliant and considered____?
an unqualified sale
Agents who are not qualified to sell the product will not be?
compensated and may receive corrective and or disciplinary action up to an including
termination
What is the purpose of an educational event?
its designed to inform medicare consumers about original medicare, medicare
advantage, prescription drug and other medicare programs.
Where must educational events be conducted?
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?
yes
WHat is a marketing/sales event?
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?
both
What describes a formal marketing/sales event?
a full plan presentation, given in a presenter-audience format.
What is an inform marketing/sales event?
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?
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?
coffee shop, or even over the phone
because marketing appointments are not formal and informal marketing sales
events, they're not reported to who?
UHC or CMS. instead, agents must obtain a completed scope of appointment prior to
conducting the appointment.
To report events, what should agents use?
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...
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?
processed
conducting an unreported event is _____?
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?
14 days prior to the event or appointment
What are marketing materials used for?
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:
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?
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?
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?
no
What methods are considered marketing material?
newspaper, tv, internet, radio advertisements, direct mail, postcards, flyers, brochures,
magnets, pre-enrollment materials, websites and social media platforms
what are some examples of generic marketing materials?
social media sites and websites
sites used to market UHC plans must be _____ by UHC and CMS prior to use
approved
when talking about marketing materials what should the agent NOT do?
