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Ethics and Compliance Test UHC Test(Questions and Answers) Ethics and Compliance Test UHC Test(Questions and Answers)
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Agent John is planning to conduct a series of events. Some will be strictly educational, others will be formal presentations of specific UnitedHealthcare plans, and others will be informal marketing events where he can generate leads and schedule future in-home marketing appointments. Of the three types of events John plans to conduct, which need to be reported to UnitedHealthcare? - Correct answer Only the marketing/sales events, both formal and informal. Whose email address may the agent enter into the LEAN enrollment application? - Correct answer Only the consumer's email (or leave it blank). Annual Election Period (AEP) is a time when: - Correct answer Consumers can elect to join a Medicare Advantage Plan or switch to a different plan. Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? - Correct answer 5-dollar gift cards to an in-network pharmacy. Rina, a consumer, has requested an appointment with Connor, an agent, to discuss DSNPs. Prior to the appointment Rina completed a Scope of Appointment (SOA) form. On the day of the appointment, Rina brings her friend Shelley, who is Medicare- eligible, to the meeting. Shelley also wants to talk about DSNPs. What should Connor do when he sees both Rina and Shelley at the appointment? - Correct answer Ask Shelley to complete an SOA before the start of the meeting.
Which describes the purpose of educational events? - Correct answer Educational events provide objective information about the Medicare program and/or health improvement and wellness. Which of the following describes Permission to Contact guidelines? - Correct answer It is method specific (e.g., telephone, email), short term (i.e., expires when contact is made), and event specific (i.e., limited to the products identified). Agent Ralph wants to market Medicare Advantage Plans in his neighborhood - an area that consists of single-family houses, an assisted living facility, a church, and public library. Which of the following methods of contact is permitted? - Correct answer Ralph sends a flyer inviting consumers to a marketing/sales event to each resident via postal mail. An individual with Power of Attorney is an example of what authority? - Correct answer Legal authority under state law to act on behalf of another individual. 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? - Correct answer Mailing a marketing brochure to the consumer via postal mail. Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal representative for her father. What must Jacob explain to Emily when completing an Enrollment Application for her father? - Correct answer (WRONG)Jacob must explain that Emily will sign the Enrollment Application and must be able to provide documentation UPON REQUEST by the Plan that indicates her legal authority to enroll her father.
Which election period runs from October 15 to December 7 and allows consumers to elect to join a Medicare Advantage Plan or switch to a different plan? - Correct answer Annual Enrollment Period (AEP) Kira has scheduled an appointment and obtained a Scope of Appointment (SOA) form to discuss Medicare Advantage Plans with a consumer. When she arrives at the appointment, a friend of the consumer who is Medicare-eligible is present to hear your presentation. What should Kira do? - Correct answer Before Kira can start the appointment with both consumers, she must ask the consumer's friend to complete an SOA. Providing objective information about the Medicare program and/or health improvement and wellness at public venues is the purpose of which of the following? - Correct answer Educational events Janine, currently enrolled in a 3-star plan, discovers there is 5-star plan available where she lives. She asks her agent, Josh, to enroll her in the 5-star plan. Josh can advise Janine of each of the following except: - Correct answer (WRONG)Josh should tell Janine that she can only use the 5-Star SEP once per calendar year. Agent Bryan wants to grow his book of business. Which of the following lead generating activities is NOT compliant? - Correct answer At each appointment he asks the consumer for the name and phone number of at least one acquaintance who is 65 or older and calls the referred individual. John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? - Correct answer John may sign the Enrollment Application and must be able to provide
documentation upon request by the Plan that indicates his authority under state law to enroll his mother. 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? - Correct answer Mailing a marketing brochure to the consumer via postal mail. To sign an Enrollment Application on behalf of a consumer, what authority must the individual have? - Correct answer The individual must be legally authorized in the state in which the consumer resides to act on behalf of the consumer (e.g., Power of Attorney). When marketing UnitedHealthcare Medicare Advantage plans to consumers, which of the following must an agent do? - Correct answer Provide current marketing materials that have been approved by CMS and UnitedHealthcare. An agent should only enroll a consumer in a product: - Correct answer That is suitable for the consumer's needs, goals and financial resources. By signing the Statement of Understanding, the consumer: - Correct answer Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling. What is the definition of Abuse? - Correct answer (WRONG) Abuse includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources. (WRONG)Abuse is intentionally misrepresenting or concealing facts to obtain something of value.
cousin, who frequently assists with her health care decisions. The next day, Victor emails Julie's cousin. Has Victor been compliant?