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United Ethics and Compliance Assessment
Questions and Answers 2025'
Can consumer Gene, who enrolled in a Medicare Advantage (MA) Plan with a January 1 effective date, complete an enrollment application on February 15 for a different MA Plan? - Correct answer Yes, he is still eligible to make a one-time change using the MA OEP election, and his new plan will be effective March 1. Which of the following statements is true about election periods? - Correct answer MA Open Enrollment Period can only be used by a consumer already enrolled in an MA Plan Which statement regarding Star Ratings is true? - Correct answer Medicare uses a 5-star rating system to illustrate a plan's performance and quality. Which of the following is not considered prohibited 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. Which statement about discussing benefits with the consumer before an enrollment is true? - Correct answer The agent must explain any provider and/or pharmacy network limitations. Whose email address may the agent enter into the applicant information section of the JarvisEnroll enrollment application? - Correct answer Only the consumer's email (or leave it blank). When completing an enrollment application in JarvisEnroll, why is an agent prohibited from entering their own email address in a field available for the consumer's email address? - Correct answer
The consumer/member would not receive plan related correspondence intended for them. The __________ ensures that when consumers provide their verbal agreement during the telephonic enrollment, they acknowledge and understand they are actually enrolling, in which plan they are enrolling, as well as the standard disclosures. - Correct answer Statement of Understanding When must the Scope of Appointment be obtained from the consumer for an in-person or telephonic sales presentation (unless an exception applies)? - Correct answer No less than 48 hours before the marketing appointment Which statement is accurate when a consumer has a Power of Attorney (POA)? - Correct answer If the POA signs the Enrollment Application, they must be able to provide documentation upon request by the Plan that indicates authority under applicable state law to enroll the consumer. Select the option that describes the coverage combinations a member can use at the same time. - Correct answer MA-Only PFFS plan and a stand-alone PDP What might happen if you rely on a benefit or plan feature a consumer mentions they saw or heard in an ad? - Correct answer I might be tempted to skip doing a thorough needs assessment and/or be biased only toward plans with that benefit. Dennis, a consumer, is currently enrolled in Original Medicare plus a Medicare Supplement Plan. His current plan is suitable for his medical 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 election period)? - Correct answer Dennis should stay enrolled in
when can she submit an application for a Medicare Advantage or Prescription Drug plan? - Correct answer April 1 through October 31 Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been presenting. Which statement is correct? - Correct answer The plan's Star Rating is available on Medicare.gov, the Plan's website, or in plan specific material, such as the Enrollment Guide. Which of the following describes Permission to Contact (PTC) guidelines? - Correct answer Contact is limited to the methods (e.g., phone, email) and products (e.g., Medicare Advantage, Part D plans) indicated by the consumer at the time PTC is obtained. Annual Election Period (AEP) is a time when... - Correct answer Consumers can enroll in, switch, or disenroll from a Medicare Advantage Plan or Prescription Drug Plan, or switch to Original Medicare with new coverage effective January 1. In which of the following situations can telephonic contact be made with a Medicare eligible consumer? - Correct answer When the consumer consented to be contacted for sales activities and the permission has not yet expired. As an agent, you have an obligation to only enroll a consumer in a product: - Correct answer That is suitable for the consumer's needs, goals and financial resources. While using JarvisEnroll to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Correct answer Leave the field requesting a consumer email address blank.
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 no less than 48 hours prior to the start of an in-person or telephonic personal/individual marketing appointment (unless an exception applies) that identifies the scope of products that can be discussed Jane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems confused and is struggling to understand the information Jane is explaining. Which option should Jane consider? - Correct answer Jane should ask Albert if someone, such as an Authorized Legal Representative, helps him make health care or insurance-related decisions and should be present. Which of the following options will enable a consumer to obtain prescription drug coverage? (Select 2) - Correct answer Enroll in a PFFS MA-Only plan and a stand-alone PDP Enroll in any MA-PD plan Aries is currently a member of a stand-alone PDP. Aries would like to have additional medical coverage. A thorough needs analysis indicates a Medicare Advantage Plan would be a good fit, there are plans available in his area, and he is in a valid election period. Which option is available to Aries? - Correct answer Aries can enroll into a Medicare Advantage plan with prescription drug coverage, which will disenroll him from his PDP. When should you proceed with an enrollment? (Select 3) - Correct answer If I am certain the consumer understands what they are
What should an agent tell a consumer who asks what a 2-star rating means? - Correct answer That the plan has received a "Below Average" rating. By agreeing to the Statement of Understanding, the consumer: - Correct answer Acknowledges that they clearly understand they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling. What happens on the plan effective date when a member enrolled in a Medicare Supplement Insurance Plan and stand-alone Prescription Drug Plan (PDP) enrolls in a Medicare Advantage plan that includes drug coverage? - Correct answer Automatic disenrollment from the stand-alone PDP. Jane, a consumer, calls and asks to be enrolled in the plan that will put money back into her Social Security every month. What guidelines do you keep in mind when you hear the consumer mention a specific plan benefit from an ad? (Select 3) - Correct answer While I take note of what might be important to the consumer, I do not want to rely on one benefit and become biased as to what type of plan to recommend. I remember that a thorough needs assessment is required for each enrollment. Consumers may have misunderstood or been confused by something they heard or read in an ad. Rosanna is enrolled in a Medicare Advantage Only (MA-Only) Private Fee-for-Service (PFFS) Plan. The plan is suitable for her needs and service area. She has decided she wants to add prescription drug coverage. Which option is available to Rosanna (assuming she is in a valid election period)? - Correct answer Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone PDP.
Which of the following are examples of what an agent must review with a consumer prior to completing an enrollment application? - Correct answer The plan's network characteristics and how using out-of-network providers may impact coverage and costs, covered benefits and limitations, and plan related costs such as monthly premium and copayments/coinsurance for services received. A thorough needs assessment will include which of the following components? (Select 3) - Correct answer Identifying what healthcare coverage attributes are most important to the consumer and what tradeoffs they might be willing to make. Learning about their current coverage, lifestyle and financial characteristics. Identifying the consumer's current providers (including primary care, specialists, hospitals, and pharmacies) and the medications they take. On October 20, Aries decides talks with an agent to switch his PDP that he has had since January 1 to a Medicare Advantage plan. What election period will Aries need to use (if eligible) to get a November 1 effective date? - Correct answer He can use a Special Election Period (SEP) if he qualifies for one.
