Anthem - 2026 CertifiCAtions exAm neWest With ComPLete
QUestions AnD CorreCt DetAiLeD AnsWers (VerifieD AnsWers)
|ALreADY GrADeD A+||CUrrent UPDAte!!
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. - CorreCt AnsWer-True
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. - CorreCt AnsWer-False
Which of the following is not a valid reason for involuntary disenrollment? - CorreCt
AnsWer-Moving to a new address in the same plan service area
Prior to making an enrollment decision, beneficiaries must review and complete the pre-
enrollment checklist. - CorreCt AnsWer-True
If a beneficiary currently has drug coverage through another carrier, you must verify their
prescriptions would be covered under our plan's formulary, too. The drugs that are actually
covered may vary from one carrier to another or one plan to another. - CorreCt AnsWer-
True
You MUST tell your PPO plan clients they will have to pay more when seeking non-emergent
eligible services outside of the network. - CorreCt AnsWer-True
, You receive a questionnaire regarding a sales misrepresentation inquiry. You must respond
within the designated time frame, addressing all concerns in the allegation and include any
pertinent notes from your sales appointment, event, etc. that may apply to the allegation. -
CorreCt AnsWer-True
You MUST EXPLAIN the Part D late enrollment penalty. - CorreCt AnsWer-True
CMS will allow Third-Party Marketing Organizations (TPMOs) to continue sharing a beneficiary's
data as long as they obtain prior express written consent through a clear and conspicuous
disclosure for each TPMO that will receive the beneficiary's data and contact them. - CorreCt
AnsWer-True
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. - CorreCt AnsWer-True
Which of the following statements is NOT true about a disenrollment? - CorreCt AnsWer-
Disenrollment requests can be taken verbally
How does a cancellation differ from a disenrollment? - CorreCt AnsWer-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
FEMA disaster SEPs can only be used if members missed a valid enrollment period. - CorreCt
AnsWer-True
QUestions AnD CorreCt DetAiLeD AnsWers (VerifieD AnsWers)
|ALreADY GrADeD A+||CUrrent UPDAte!!
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. - CorreCt AnsWer-True
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. - CorreCt AnsWer-False
Which of the following is not a valid reason for involuntary disenrollment? - CorreCt
AnsWer-Moving to a new address in the same plan service area
Prior to making an enrollment decision, beneficiaries must review and complete the pre-
enrollment checklist. - CorreCt AnsWer-True
If a beneficiary currently has drug coverage through another carrier, you must verify their
prescriptions would be covered under our plan's formulary, too. The drugs that are actually
covered may vary from one carrier to another or one plan to another. - CorreCt AnsWer-
True
You MUST tell your PPO plan clients they will have to pay more when seeking non-emergent
eligible services outside of the network. - CorreCt AnsWer-True
, You receive a questionnaire regarding a sales misrepresentation inquiry. You must respond
within the designated time frame, addressing all concerns in the allegation and include any
pertinent notes from your sales appointment, event, etc. that may apply to the allegation. -
CorreCt AnsWer-True
You MUST EXPLAIN the Part D late enrollment penalty. - CorreCt AnsWer-True
CMS will allow Third-Party Marketing Organizations (TPMOs) to continue sharing a beneficiary's
data as long as they obtain prior express written consent through a clear and conspicuous
disclosure for each TPMO that will receive the beneficiary's data and contact them. - CorreCt
AnsWer-True
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. - CorreCt AnsWer-True
Which of the following statements is NOT true about a disenrollment? - CorreCt AnsWer-
Disenrollment requests can be taken verbally
How does a cancellation differ from a disenrollment? - CorreCt AnsWer-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
FEMA disaster SEPs can only be used if members missed a valid enrollment period. - CorreCt
AnsWer-True
