2025 WellCare ACT Mastery Exam ACTUAL FINAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS - VERIFIED ANSWERS ALREADY
GRADED A+ NEW GUARANTEED
Enrollment applications must be received by Wellcare no later than ___ calendar day(s)
following receipt from the beneficiary. - CORRECT ANSWER 1
Which elements are available as part of Wellcare's Sales Support model? - CORRECT
ANSWER All of these
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D
plan premiums - CORRECT ANSWER False
Prior to completing the enrollment form, broker/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists - CORRECT ANSWER
True
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing
score of 85% or higher to successfully complete this course - CORRECT ANSWER
True
Brokers/Agents may be investigated after being suspected of noncompliant activity
reported through a - CORRECT ANSWER Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
A broker/agent who has never had any verbal warnings cannot be issued a Corrective
Action Plan. - CORRECT ANSWER False
Wellcare does not need to be informed of all marketing/sales events at which plans or
materials will be presented or distributed (formaland informal). - CORRECT ANSWER
False
Marketing benefits in a service area where those benefits are not available is
prohibited and considered misleading unless that is unavoidable because of
local/regional or media use. - CORRECT ANSWER True
CustomPoint sales material order dates will be posted on Wellcare.com - CORRECT
ANSWER False
The online Centene Workbench self-service portal enables you to - CORRECT
ANSWER All of these
,The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more
than one MA plan provider. The disclaimer must be: - CORRECT ANSWER Included in
any marketing materials, including print materials and television advertisements
developed, used, or distributed by the TPMO.
Verbally conveyed within the first minute of a sales call.
Prominently displayed on TPMO websites (regardless of content).
Electronically conveyed when communicating with a beneficiary through email, online
chat, or other electronic means of communication (regardless of content).
Brokers/Agents can access the following resources under the Shared Resources
section in Centene Workbench. - CORRECT ANSWER All of these
Which of the following is not an example of Protected Health Information (PHI)? -
CORRECT ANSWER Library Card
When a paper SOA form is used, it must be completed __________ hosting the sales
presentation. - CORRECT ANSWER 48 Hours prior to
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted
electronic enrollments. - CORRECT ANSWER True
When explaining the provider network for D-SNPs and C-SNPs: - CORRECT ANSWER
Avoid submitting applications with no primary care provider (PCP) to assist these
higher-risk members.
If a member is not connected to a primary care provider (PCP), we should always
encourage and assist with connecting them with an in-network doctor
If a requested effective date is available for the special election period being selected,
ensure you are requesting a date within the correct time frame for the member based
on their eligibility date or change date needed. - CORRECT ANSWER True
Wellcare's _____ plan is designed for Low-Income Subsidy members. - CORRECT
ANSWER Classic
Which LIS category is assigned to members whose costs are fully subsidized and who
receive the most assistance? - CORRECT ANSWER Three
The _________ plan is expected to have one of the lowest premiums in the country! -
CORRECT ANSWER Value Script
,The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery
chains in 2024. - CORRECT ANSWER True
Wellcare continues to expand its reach by offering more products in a wider
geography. ____ new Wellcare plans are going to market. - CORRECT ANSWER
Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - CORRECT
ANSWER Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - CORRECT ANSWER Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic
drugs for the remainder of the year once their total out of pocket costs reach $8,000. -
CORRECT ANSWER Zero
Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - CORRECT ANSWER True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - CORRECT ANSWER True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at
preferred pharmacies. - CORRECT ANSWER True
____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - CORRECT ANSWER Three
Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - CORRECT ANSWER True
When verifying a D-SNP beneficiary's Medicaid eligibility through the Ascend Medicaid
search tool, you should confirm their current Medicaid status qualifies for the selected
D-SNP being enrolled in and explain that changes in Medicaid eligibility may affect
enrollment and/or cost sharing. - CORRECT ANSWER True
Which of the following statements about Scope of Appointment (SOA) is FALSE? -
CORRECT ANSWER An electronic SOA submitted in Ascend must be in a Pending
status prior to beginning the appointment.
, Key areas you as a broker/agent have control over and impact upon regarding Star
Ratings for quality are: - CORRECT ANSWER All of these
Beneficiary-facing marketing materials for multiple MA organizations or plans must be
submitted to the HPMS Marketing Module by the third-party marketing organization
(TPMO) no later than 30 days of use. - CORRECT ANSWER False
When completing an enrollment, be sure to use the correct enrollment application for
the desired plan year. - CORRECT ANSWER True
Providers may create co-branded marketing pieces using the Wellcare name and logo,
as long as they are using the current, approved logo. - CORRECT ANSWER False
Although options for capturing and submitting SOAs vary by health plan, Wellcare
accepts SOAs in which of the following methods? - CORRECT ANSWER All of these
Failure to inform a beneficiary that a trusted provider is out-of-network or is not
available in the newly selected plan can cause a sales allegation. - CORRECT ANSWER
True
Which of the following is not considered a grievance? - CORRECT ANSWER A dispute
of the appeal of an organization determination, coverage determination, or a Late
Enrollment Penalty (LEP) determination.
Brokers/Agents can access and download enrollment materials through CustomPoint.
- CORRECT ANSWER True
______ events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug, or other Medicare programs without going into the specifics of a
particular carrier. - CORRECT ANSWER Educational
Materials that include plan comparisons or cost-sharing do not require CMS
submission. - CORRECT ANSWER False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - CORRECT ANSWER Member Payments
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024
will impact which plan(s)? - CORRECT ANSWER Both PDP & MAPD
A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories
depending on the level of need. - CORRECT ANSWER Four
AND CORRECT DETAILED ANSWERS - VERIFIED ANSWERS ALREADY
GRADED A+ NEW GUARANTEED
Enrollment applications must be received by Wellcare no later than ___ calendar day(s)
following receipt from the beneficiary. - CORRECT ANSWER 1
Which elements are available as part of Wellcare's Sales Support model? - CORRECT
ANSWER All of these
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D
plan premiums - CORRECT ANSWER False
Prior to completing the enrollment form, broker/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists - CORRECT ANSWER
True
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing
score of 85% or higher to successfully complete this course - CORRECT ANSWER
True
Brokers/Agents may be investigated after being suspected of noncompliant activity
reported through a - CORRECT ANSWER Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
A broker/agent who has never had any verbal warnings cannot be issued a Corrective
Action Plan. - CORRECT ANSWER False
Wellcare does not need to be informed of all marketing/sales events at which plans or
materials will be presented or distributed (formaland informal). - CORRECT ANSWER
False
Marketing benefits in a service area where those benefits are not available is
prohibited and considered misleading unless that is unavoidable because of
local/regional or media use. - CORRECT ANSWER True
CustomPoint sales material order dates will be posted on Wellcare.com - CORRECT
ANSWER False
The online Centene Workbench self-service portal enables you to - CORRECT
ANSWER All of these
,The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more
than one MA plan provider. The disclaimer must be: - CORRECT ANSWER Included in
any marketing materials, including print materials and television advertisements
developed, used, or distributed by the TPMO.
Verbally conveyed within the first minute of a sales call.
Prominently displayed on TPMO websites (regardless of content).
Electronically conveyed when communicating with a beneficiary through email, online
chat, or other electronic means of communication (regardless of content).
Brokers/Agents can access the following resources under the Shared Resources
section in Centene Workbench. - CORRECT ANSWER All of these
Which of the following is not an example of Protected Health Information (PHI)? -
CORRECT ANSWER Library Card
When a paper SOA form is used, it must be completed __________ hosting the sales
presentation. - CORRECT ANSWER 48 Hours prior to
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted
electronic enrollments. - CORRECT ANSWER True
When explaining the provider network for D-SNPs and C-SNPs: - CORRECT ANSWER
Avoid submitting applications with no primary care provider (PCP) to assist these
higher-risk members.
If a member is not connected to a primary care provider (PCP), we should always
encourage and assist with connecting them with an in-network doctor
If a requested effective date is available for the special election period being selected,
ensure you are requesting a date within the correct time frame for the member based
on their eligibility date or change date needed. - CORRECT ANSWER True
Wellcare's _____ plan is designed for Low-Income Subsidy members. - CORRECT
ANSWER Classic
Which LIS category is assigned to members whose costs are fully subsidized and who
receive the most assistance? - CORRECT ANSWER Three
The _________ plan is expected to have one of the lowest premiums in the country! -
CORRECT ANSWER Value Script
,The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery
chains in 2024. - CORRECT ANSWER True
Wellcare continues to expand its reach by offering more products in a wider
geography. ____ new Wellcare plans are going to market. - CORRECT ANSWER
Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - CORRECT
ANSWER Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary
structure for 2024? - CORRECT ANSWER Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic
drugs for the remainder of the year once their total out of pocket costs reach $8,000. -
CORRECT ANSWER Zero
Members are no longer required to pay a partial deductible due to the Inflation
Reduction Act. - CORRECT ANSWER True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - CORRECT ANSWER True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at
preferred pharmacies. - CORRECT ANSWER True
____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and
Washington, D.C. - CORRECT ANSWER Three
Noting the correct enrollment period on enrollment applications helps in preventing
delayed enrollment processing. - CORRECT ANSWER True
When verifying a D-SNP beneficiary's Medicaid eligibility through the Ascend Medicaid
search tool, you should confirm their current Medicaid status qualifies for the selected
D-SNP being enrolled in and explain that changes in Medicaid eligibility may affect
enrollment and/or cost sharing. - CORRECT ANSWER True
Which of the following statements about Scope of Appointment (SOA) is FALSE? -
CORRECT ANSWER An electronic SOA submitted in Ascend must be in a Pending
status prior to beginning the appointment.
, Key areas you as a broker/agent have control over and impact upon regarding Star
Ratings for quality are: - CORRECT ANSWER All of these
Beneficiary-facing marketing materials for multiple MA organizations or plans must be
submitted to the HPMS Marketing Module by the third-party marketing organization
(TPMO) no later than 30 days of use. - CORRECT ANSWER False
When completing an enrollment, be sure to use the correct enrollment application for
the desired plan year. - CORRECT ANSWER True
Providers may create co-branded marketing pieces using the Wellcare name and logo,
as long as they are using the current, approved logo. - CORRECT ANSWER False
Although options for capturing and submitting SOAs vary by health plan, Wellcare
accepts SOAs in which of the following methods? - CORRECT ANSWER All of these
Failure to inform a beneficiary that a trusted provider is out-of-network or is not
available in the newly selected plan can cause a sales allegation. - CORRECT ANSWER
True
Which of the following is not considered a grievance? - CORRECT ANSWER A dispute
of the appeal of an organization determination, coverage determination, or a Late
Enrollment Penalty (LEP) determination.
Brokers/Agents can access and download enrollment materials through CustomPoint.
- CORRECT ANSWER True
______ events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug, or other Medicare programs without going into the specifics of a
particular carrier. - CORRECT ANSWER Educational
Materials that include plan comparisons or cost-sharing do not require CMS
submission. - CORRECT ANSWER False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality
strategy. Wellcare's quality focus consists of six drivers. Which of the following is not a
Wellcare quality driver? - CORRECT ANSWER Member Payments
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024
will impact which plan(s)? - CORRECT ANSWER Both PDP & MAPD
A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories
depending on the level of need. - CORRECT ANSWER Four
