ANTHEM - 2026 CERTIFICATIONS | 80
COMPREHENSIVE QUESTIONS & ANSWERS
| GRADE A | 100% CORRECT -THE
ULTIMATE GUIDE FOR YR. (2026/2027)
Quiz_________________?
The Special Election Period (SEP) for Dual Eligible and Other LIS Eligible
Individuals previously allowed one time per-calendar-quarter during the first
nine months of the year was replaced beginning Calendar Year 2025 with a
monthly SEP to enroll in a standalone PDP. Eligible beneficiaries can switch PDPs
or leave a MA/MAPD plan for Original Medicare plus a standalone PDP. -
Answer☑️
True
Quiz_________________?
Which of the following statements is NOT true about a disenrollment? -
Answer☑️
Disenrollment requests can be taken verbally
Quiz_________________?
How does a cancellation differ from a disenrollment? -
Answer☑️
1
, Both A and B are correct
A. A cancellation applies if a request is received prior to a member's effective
date or by the date on the Outbound Enrollment Verification (OEV) letter
B. Cancellation requests are initiated by the member and can be received either
verbally or in writing
Quiz_________________?
FEMA disaster SEPs can only be used if members missed a valid enrollment
period. -
Answer☑️
True
Quiz_________________?
A monthly integrated care SEP beginning calendar year 2025 allows full dual
eligible individuals to elect an integrated Dual Eligible Special Needs Plan (D-
SNP) (for example, Fully Integrated Dual Eligible (FIDE), Highly Integrated Dual
Eligible (HIDE), and Applicable Integrated Plan (AIP)). This SEP is allowed only
when the individual receives Medicaid through an affiliated managed care plan.
-
Answer☑️
True
Quiz_________________?
A member can add or drop prescription drug coverage during the Annual
Election Period (AEP). -
Answer☑️
True
2
, Quiz_________________?
If a beneficiary has agreed to an in-home appointment to discuss a PDP product,
an agent can discuss an HMO product with them during that same meeting, if
the beneficiary requests it and a new scope of appointment form is completed. -
Answer☑️
True
Quiz_________________?
The Open Election Period (OEP) is for beneficiaries who are enrolled in a MA-
only or MA-PD plan, or those who are enrolled in Original Medicare, including
those enrolled in stand-alone PDPs. -
Answer☑️
False
Quiz_________________?
Which of the following is not a valid reason for involuntary disenrollment? -
Answer☑️
Moving to a new address in the same plan service area
Quiz_________________?
Prior to making an enrollment decision, beneficiaries must review and complete
the pre-enrollment checklist. -
Answer☑️
True
3
COMPREHENSIVE QUESTIONS & ANSWERS
| GRADE A | 100% CORRECT -THE
ULTIMATE GUIDE FOR YR. (2026/2027)
Quiz_________________?
The Special Election Period (SEP) for Dual Eligible and Other LIS Eligible
Individuals previously allowed one time per-calendar-quarter during the first
nine months of the year was replaced beginning Calendar Year 2025 with a
monthly SEP to enroll in a standalone PDP. Eligible beneficiaries can switch PDPs
or leave a MA/MAPD plan for Original Medicare plus a standalone PDP. -
Answer☑️
True
Quiz_________________?
Which of the following statements is NOT true about a disenrollment? -
Answer☑️
Disenrollment requests can be taken verbally
Quiz_________________?
How does a cancellation differ from a disenrollment? -
Answer☑️
1
, Both A and B are correct
A. A cancellation applies if a request is received prior to a member's effective
date or by the date on the Outbound Enrollment Verification (OEV) letter
B. Cancellation requests are initiated by the member and can be received either
verbally or in writing
Quiz_________________?
FEMA disaster SEPs can only be used if members missed a valid enrollment
period. -
Answer☑️
True
Quiz_________________?
A monthly integrated care SEP beginning calendar year 2025 allows full dual
eligible individuals to elect an integrated Dual Eligible Special Needs Plan (D-
SNP) (for example, Fully Integrated Dual Eligible (FIDE), Highly Integrated Dual
Eligible (HIDE), and Applicable Integrated Plan (AIP)). This SEP is allowed only
when the individual receives Medicaid through an affiliated managed care plan.
-
Answer☑️
True
Quiz_________________?
A member can add or drop prescription drug coverage during the Annual
Election Period (AEP). -
Answer☑️
True
2
, Quiz_________________?
If a beneficiary has agreed to an in-home appointment to discuss a PDP product,
an agent can discuss an HMO product with them during that same meeting, if
the beneficiary requests it and a new scope of appointment form is completed. -
Answer☑️
True
Quiz_________________?
The Open Election Period (OEP) is for beneficiaries who are enrolled in a MA-
only or MA-PD plan, or those who are enrolled in Original Medicare, including
those enrolled in stand-alone PDPs. -
Answer☑️
False
Quiz_________________?
Which of the following is not a valid reason for involuntary disenrollment? -
Answer☑️
Moving to a new address in the same plan service area
Quiz_________________?
Prior to making an enrollment decision, beneficiaries must review and complete
the pre-enrollment checklist. -
Answer☑️
True
3
