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Ethics and Compliance Assessment UHC Questions and Answers., Exams of Medical ethics

University of OxfordMedical ethics

Ethics and Compliance Assessment UHC Questions and Answers.Ethics and Compliance Assessment UHC Questions and Answers.

Typology: Exams

2024/2025

Available from 07/14/2025

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Ethics and Compliance Assessment UHC
Questions and Answers.
Cynthia is turning 65 on July 5. Her Medicare Part A and Part B
will be effective on July 1. Using her Initial Election Period (IEP),
when can she submit an application for a Medicare Advantage or
Prescription Drug plan? - Correct answer April 1 through October
31
Which of the following statements is true about using a five star
special enrollment period (SEP)? - Correct answer It can be used
once from December 8 through November 30 and coverage will
start the first of the month following recipient of the enrollment
application
Which statement regarding star ratings is true - Correct answer
Medicare uses a five star rating system to illustrate the plans
performance and quality
In which of the following situations can a telephonic contract be
made with a Medicare eligible consumer? - Correct answer When
the consumer consented to be contracted for sales activities, and
the permission has not yet expired
What information should be obtained from the consumer when
conducting a thorough needs assessment? (Select 2) - Correct
answer • their current health care coverage, including what they
like about it, and what they don't
• the providers they see in medication they take to determine
network and formulary status
Will using LEAN to complete an enrollment application with the
consumer agent Jeff learns the consumer does not have an email
address. What should Jeff do? - Correct answer The
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Ethics and Compliance Assessment UHC

Questions and Answers.

Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or Prescription Drug plan? - Correct answer April 1 through October 31 Which of the following statements is true about using a five star special enrollment period (SEP)? - Correct answer It can be used once from December 8 through November 30 and coverage will start the first of the month following recipient of the enrollment application Which statement regarding star ratings is true - Correct answer Medicare uses a five star rating system to illustrate the plans performance and quality In which of the following situations can a telephonic contract be made with a Medicare eligible consumer? - Correct answer When the consumer consented to be contracted for sales activities, and the permission has not yet expired What information should be obtained from the consumer when conducting a thorough needs assessment? (Select 2) - Correct answer • their current health care coverage, including what they like about it, and what they don't

  • the providers they see in medication they take to determine network and formulary status Will using LEAN to complete an enrollment application with the consumer agent Jeff learns the consumer does not have an email address. What should Jeff do? - Correct answer The

consumer/member would not receive plan related, corresponds, intent for him/her What is the purpose of the statement of understanding? - Correct answer It ensures that when consumers complete the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures. What is scope of appointment? - Correct answer The agreement obtained from the consumer to that identifies the scope of products that can be discussed at a personal/individual marketing appointment Which statement is accurate when a consumer has a power of authority (POA) - Correct answer If the POA signed the enrollment application, they must be able to provide documentation upon request for 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 standalone PDP enroll in a Medicare vantage plan that includes drug coverage - Correct answer Automatic disenrollment from the standalone PDP In which situation, MAY the Medicare advantage (MA) organization decide to disenroll a member from an MA plan? - Correct answer Premiums are not paid on a timely basis Dennis a consumer is currently enrolled in the original Medicare, plus a Medicare supplement plan. His current plan is suitable for his Medicare needs, but he would like to add prescription drug coverage only since Dennis wants to keep his current coverage which option is available to Dennis (assuming he is in a valid

assessment to make sure I gather information about the situation and preferences What is the purpose of a needs assessment? - Correct answer To gather as much information about the consumer as possible to ensure I am recommending the plan that is the best fit for the consumer Which of the following are components that at minimum should be included in a thorough needs assessment - Correct answer • identifying their current providers, including primary care, specialist hospitals in pharmacies and the medication they take

  • identifying the last time the consumer visited a doctor or hospital
  • Deterring consumer eligibility Which of the following statements are true when selling Medicare plans over the phone? (Select 2) - Correct answer I must rely on what I hear, which includes the tone of the consumers voice, the questions they ask her even there pauses in the conversation I don't have the benefit of seen the consumers facial expressions or body language in order to assess their comprehension Inez a consumer call the number on a piece of mail she received during the annual election period when you answer you can hear a lot of background noise. What action should you take to help ensure Inez will understand the information you share with her - Correct answer Speak clearly in an appropriate volume in a modern piece Ask if someone assist her with making enrollment decisions and make sure that person is presented to participate in the call Ask her to either move into another room, or turn off the TV to help her, hear me clearly in without distraction When should you assess consumer comprehension during a call?
  • Correct answer At all stages of the call

Consumer Lily tells you she is enrolled in a Medicare vantage plan where she is required to see in network providers to receive coverage except in emergencies. She is interested in a plan that offers more net work flexibility provided she can see her current primary care provider. PCP which of the following best describes steps you must take in your sales and enrollment process. - Correct answer I must ensure the consumer understands what they are gaining and what they may be given up by enrolling in the new plan I must complete a thorough needs assessment I must compare with the consumer any plan I recommend to their current MA plan, including benefits, cost network and drug coverage Which of the following are examples of phrases that must not be spoken by an agent when it consumer is contemplating a plan change (Select 2) - Correct answer • everything will be the same

  • nothing will change Simon is currently enrolled in a Medicare advantage. Plan he calls saying he saw an ad on TV that says he can get a plan with dental coverage of 3500 per year what guidelines supposed to follow before recommended a new plan to Simon? - Correct answer • conduct a thorough needs assessment together, comprehensive information related to the consumer situation and needs

Which of the following best describes why is important to compare plan options to the consumers current coverage? - Correct answer I want to make sure the consumer understands what they give up and what they gain by changing plans

Which statement about discussing benefits with a consumer before an enrollment is true - Correct answer The agent must explain any prior and/or pharmacy network limitation Rosanna is enroll in a Medicare advantage only MA only private fee for service plan - Correct answer Which statement regarding star rating is true - Correct answer Medicaid, as if I start reason to illustrate plans, performance, and quality Which of the following options will enable a consumer to obtain prescription drug coverage select 2 - Correct answer Is currently a member of a standalone PDP it was would like to have an additional Medicare coverage throwing his nose is indicates a Medicare. Advantage plan would be a good fit. There are plans available in his area and he is in a valid election. Which option is available to Aries - Correct answer Aries can enroll in a Medicare advantage plan with prescription drug coverage which will disenroll him from his PDP Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage? - Correct answer On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1. Which of the following statements is true about election periods? - Correct answer MA open enrollment period. Can only be used by consumer already enrolled in an MA plan.

When a customer asked why an MA plan has a two star rating the agent should tell the consumer one - Correct answer That the plan has received a Below Average rating Whose email address may the agent enter into the applicant information section of LEAN enrollment application? - Correct answer Only the consumer email or leave it blank