2024 Ethics and Compliance
Assessment MC
On October 20, Aries decides to switch his PDP to a Medicare Advantage plan. Aries
would like this change to be effective November 1. Which statement is true for Aries? -
answersHe may be able to use a Special Election Period to change plans if he qualifies
for one.
Annual Election Period (AEP) is a time when. . - answersConsumers can elect to switch
to a different plan or join a Medicare Advantage plan or Prescription Drug Plan.
Which statement regarding Star Ratings is true? - answersMedicare uses a 5-star rating
system to illustrate a plan's performance and quality.
Which of the following is not considered unsolicited contact with a Medicare eligible
consumer according to CMS regulations and UnitedHealthcare's rules, policies, and
procedures? - answersMailing a marketing brochure to the consumer via postal mail.
What information should be obtained from the consumer when conducting a thorough
needs assessment? (Select 2) - answersTheir current health care coverage, including
what they like about it and what they don't.
The providers they see and medications they take to determine network and formulary
status.
Whose email address may the agent enter into the applicant information section of
LEAN enrollment application? - answersOnly the consumer's email (or leave it blank).
The __________ ensures that when consumers provide their verbal agreement during
the telephonic enrollment, they acknowledge and understand they are actually enrolling,
in which plan they are enrolling, as well as the standard disclosures. -
answersStatement of Understanding
Which of the following must an agent obtain from the consumer no less than 48 hours
(unless an exception applies) before an in-person, online, or telephonic marketing
appointment? - answersScope of Appointment
Which statement is accurate when a consumer has a Power of Attorney (POA)? -
answersIf the POA signs the Enrollment Application, they must be able to provide
documentation upon request by the Plan that indicates authority under state law to
enroll the consumer.
, What happens on the plan effective date when a member enrolled in a Medicare
Supplement Insurance Plan and stand-alone PDP enrolls in a Medicare Advantage plan
that includes drug coverage? - answers
When MUST an MA Plan or stand-alone PDP disenroll a member? - answersWhen
eligibility requirements are no longer met
Aries is currently a member of a stand-alone PDP. Aries would like to have additional
medical coverage. A thorough needs analysis indicates a Medicare Advantage Plan
would be a good fit, there are plans available in his area, and he is in a valid election
period. Which option is available to Aries? - answersAries can enroll into a Medicare
Advantage plan with prescription drug coverage, which will disenroll him from his PDP.
As an agent, you have an obligation to only enroll a consumer in a product: -
answersThat is suitable for the consumer's needs, goals and financial resources.
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? - answersDino presented a plan prior to October 1.
Which of the following are examples of lead generation materials that might result in an
inbound call from a Medicare-eligible consumer? - answersDirect mail, TV ads,
billboards
Jane, a consumer, calls your call center and asks to be enrolled in the plan that will put
money back into her Social Security every month. What do you keep in mind when you
hear the consumer mention a specific plan benefit from an ad? (Select 3) -
answersWhile I take note of what might be important to the consumer, I do not want to
rely on one benefit and become biased as to what type of plan to recommend
I make sure whatever plan I recommend has that stated benefit because I know it will
be the best fit plan for the consumer
I remember to not overlook the importance of a thorough needs assessment Wrong
What are you required to do prior to making a plan recommendation? - answersConduct
a thorough needs assessment to make sure I gather information about the consumer's
situation and preferences
What is the purpose of a needs assessment? - answersTo gather as much information
about the consumer as possible to ensure I am recommending the plan that is the best
fit for the consumer
A thorough needs assessment will include which of the following components? (Select
3) - answersIdentifying what healthcare coverage attributes are most important to the
consumer and what tradeoffs they might be willing to make
Assessment MC
On October 20, Aries decides to switch his PDP to a Medicare Advantage plan. Aries
would like this change to be effective November 1. Which statement is true for Aries? -
answersHe may be able to use a Special Election Period to change plans if he qualifies
for one.
Annual Election Period (AEP) is a time when. . - answersConsumers can elect to switch
to a different plan or join a Medicare Advantage plan or Prescription Drug Plan.
Which statement regarding Star Ratings is true? - answersMedicare uses a 5-star rating
system to illustrate a plan's performance and quality.
Which of the following is not considered unsolicited contact with a Medicare eligible
consumer according to CMS regulations and UnitedHealthcare's rules, policies, and
procedures? - answersMailing a marketing brochure to the consumer via postal mail.
What information should be obtained from the consumer when conducting a thorough
needs assessment? (Select 2) - answersTheir current health care coverage, including
what they like about it and what they don't.
The providers they see and medications they take to determine network and formulary
status.
Whose email address may the agent enter into the applicant information section of
LEAN enrollment application? - answersOnly the consumer's email (or leave it blank).
The __________ ensures that when consumers provide their verbal agreement during
the telephonic enrollment, they acknowledge and understand they are actually enrolling,
in which plan they are enrolling, as well as the standard disclosures. -
answersStatement of Understanding
Which of the following must an agent obtain from the consumer no less than 48 hours
(unless an exception applies) before an in-person, online, or telephonic marketing
appointment? - answersScope of Appointment
Which statement is accurate when a consumer has a Power of Attorney (POA)? -
answersIf the POA signs the Enrollment Application, they must be able to provide
documentation upon request by the Plan that indicates authority under state law to
enroll the consumer.
, What happens on the plan effective date when a member enrolled in a Medicare
Supplement Insurance Plan and stand-alone PDP enrolls in a Medicare Advantage plan
that includes drug coverage? - answers
When MUST an MA Plan or stand-alone PDP disenroll a member? - answersWhen
eligibility requirements are no longer met
Aries is currently a member of a stand-alone PDP. Aries would like to have additional
medical coverage. A thorough needs analysis indicates a Medicare Advantage Plan
would be a good fit, there are plans available in his area, and he is in a valid election
period. Which option is available to Aries? - answersAries can enroll into a Medicare
Advantage plan with prescription drug coverage, which will disenroll him from his PDP.
As an agent, you have an obligation to only enroll a consumer in a product: -
answersThat is suitable for the consumer's needs, goals and financial resources.
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? - answersDino presented a plan prior to October 1.
Which of the following are examples of lead generation materials that might result in an
inbound call from a Medicare-eligible consumer? - answersDirect mail, TV ads,
billboards
Jane, a consumer, calls your call center and asks to be enrolled in the plan that will put
money back into her Social Security every month. What do you keep in mind when you
hear the consumer mention a specific plan benefit from an ad? (Select 3) -
answersWhile I take note of what might be important to the consumer, I do not want to
rely on one benefit and become biased as to what type of plan to recommend
I make sure whatever plan I recommend has that stated benefit because I know it will
be the best fit plan for the consumer
I remember to not overlook the importance of a thorough needs assessment Wrong
What are you required to do prior to making a plan recommendation? - answersConduct
a thorough needs assessment to make sure I gather information about the consumer's
situation and preferences
What is the purpose of a needs assessment? - answersTo gather as much information
about the consumer as possible to ensure I am recommending the plan that is the best
fit for the consumer
A thorough needs assessment will include which of the following components? (Select
3) - answersIdentifying what healthcare coverage attributes are most important to the
consumer and what tradeoffs they might be willing to make
