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Wellcare ACT Mastery Exam - Broker / Employee with A+ Answers, Exams of Nursing

Welder Training and Testing InstituteNursing

A series of multiple-choice questions and answers related to the wellcare act mastery exam, designed for brokers and employees. It covers various aspects of wellcare's plans, benefits, compliance procedures, and marketing strategies. Insights into the key features of wellcare's products and services, as well as the requirements and guidelines for brokers and employees involved in sales and enrollment processes.

Typology: Exams

2024/2025

Available from 11/16/2024

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2025 Well care ACT Mastery Exam -
Broker / Employee with A+ Answers.
1. Which Prescription Drug Plan (PDP) has the richest formulary with
the most adherence generics on Tier 1? - Correct Ans: ✔✔Value
Plus
2. Final 2025 plan and benefit information may be discussed with
beneficiaries on or before September 30, 2024. - Correct Ans:
✔✔False
3. Which will be Wellcare's Preferred Mail Order pharmacy? -
Correct Ans: ✔✔Express Scripts® Pharmacy
4. Wellcare launched new tiered provider plans in ______ and
_____. (Select two options.) - Correct Ans: ✔✔Montana
Arizona
5. Effective 2025, key provisions of the Inflation Reduction Act
include a lower annual threshold of $_____ for out-of-pocket
(OOP) prescription drug costs in Medicare. - Correct Ans:
✔✔$2.000
6. New for PY2025, the Wellcare Spendables™ Card will include
Home Improvement and Safety Items on select Dual Eligible
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Download Wellcare ACT Mastery Exam - Broker / Employee with A+ Answers and more Exams Nursing in PDF only on Docsity!

2025 Well care ACT Mastery Exam -

Broker / Employee with A+ Answers.

  1. Which Prescription Drug Plan (PDP) has the richest formulary with the most adherence generics on Tier 1? - Correct Ans: ✔✔Value Plus
  2. Final 2025 plan and benefit information may be discussed with beneficiaries on or before September 30, 2024. - Correct Ans: ✔✔False
  3. Which will be Wellcare's Preferred Mail Order pharmacy? - Correct Ans: ✔✔Express Scripts® Pharmacy
  4. Wellcare launched new tiered provider plans in ______ and _____. (Select two options.) - Correct Ans: ✔✔Montana Arizona
  5. Effective 2025, key provisions of the Inflation Reduction Act include a lower annual threshold of $_____ for out-of-pocket (OOP) prescription drug costs in Medicare. - Correct Ans: ✔✔$2.
  6. New for PY2025, the Wellcare Spendables™ Card will include Home Improvement and Safety Items on select Dual Eligible

Special Needs Plans (D-SNPs) (amount varies by plan). - Correct Ans: ✔✔True

  1. Disciplinary actions stemming from the result of a compliance allegation are always progressive. - Correct Ans: ✔✔False
  2. Brokers/Agents can access the following resources under the Shared Resources section in Centene Workbench: - Correct Ans: ✔✔All of these
  3. Self-reporting of a compliance issue must be made to Corporate Compliance or to a Health Plan Sales Leader and must indicate: - Correct Ans: ✔✔All of these
  4. The Single Sign-On Portal provides access to multiple applications, including CustomPoint®. - Correct Ans: ✔✔True
  5. Wellcare's Corporate Office support team can assist with which types of inquiries? - Correct Ans: ✔✔All of these
  6. From October 1 to October 14, certain activities are not permitted for 2025 sales and enrollments. These include: - Correct Ans: ✔✔All of these
  1. Failure to inform a beneficiary that a trusted provider is out- of-network or is not available in the newly selected plan can cause a sales allegation. - Correct Ans: ✔✔True
  2. Which of the following statements about the Scope of Appointment (SOA) is FALSE? - Correct Ans: ✔✔An electronic SOA submitted in Ascend in a Pending status is considered complete and compliant.
  3. Grievance procedures are separate and distinct from initial determination and appeal procedures. - Correct Ans: ✔✔True
  4. The online Member Portal is available Monday - Friday, 8:00am - 8:00pm. - Correct Ans: ✔✔False
  5. You can help prevent grievances by: (Select all that apply.) - Correct Ans: ✔✔- Always confirming availability of the beneficiary's primary and specialist providers by using the provider search tool available on the plan's website.
    • Always using plan materials to clearly explain plan benefits and cost (including medications) and check for understanding.
    • Always confirming a beneficiary's intent to enroll before accepting their enrollment application.
  1. Once the enrollment is completed, you can save a copy of the application for your reference. - Correct Ans: ✔✔False
  2. All Traditional Medicare Advantage Prescription Drug (MAPD) plans with drug coverage include a $ copay Tier 6 at all in-network pharmacy locations. - Correct Ans: ✔✔True
  3. Marketing benefits in a service area where those benefits are not available is prohibited and considered misleading unless that is unavoidable because of local/regional or media use. - Correct Ans: ✔✔True
  4. An Election Period Request for Information (RFI) must be resolved within 7 calendar days, or the application will be denied. - Correct Ans: ✔✔True
  5. A request to the plan from a member or provider for a formal review of an Action (Denial) or Adverse Plan Determination (Medicare) is a/an: - Correct Ans: ✔✔Appeal
  6. All Traditional Medicare Advantage Prescription Drug (MAPD) plans will offer $0 copay for most Part

brokers/agents to review and agree to its Business Ethics and Code of Conduct Policy. - Correct Ans: ✔✔True

  1. Which of the following actions are you required to do when contacted regarding an allegation of noncompliant activity? - Correct Ans: ✔✔All of these
  2. Which of the following statements about CustomPoint® features is FALSE? - Correct Ans: ✔✔Access through Wellcare.com
  3. Materials that include plan comparisons or cost sharing do not require Centers for Medicare & Medicaid Services (CMS) submission. - Correct Ans: ✔✔False
  4. The Third-Party Marketing Organization (TPMO) disclaimer must be used by any TPMO that sells plans on behalf of more than one Medicare Advantage (MA) plan provider. The disclaimer must be: (Select all that apply.) - Correct Ans: ✔✔
      • Included in any marketing materials, including print materials and television
    • advertisements developed, used, or distributed by the TPMO.
      • Verbally conveyed within the first minute of a sales call.
      • Prominently displayed on TPMO websites (regardless of content).
  • Electronically conveyed when communicating with a beneficiary through email, online chat, or other electronic means of communication (regardless of content). Beneficiary-facing marketing materials developed by a Third-Party Marketing Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can be reviewed by just one MA organization, submitted to the Centers for Medicare & Medicaid Services (CMS) in the Health Plan
  1. Management System (HPMS), and opted in by the health plan after distribution. - Correct Ans: ✔✔False
  2. Ascend is the fast, easy, and compliant way for brokers/agents to submit agent-assisted electronic enrollments. - Correct Ans: ✔✔True
  3. If a requested effective date is available for the Special Election Period (SEP) being selected, ensure you are requesting a date within the correct timeframe for the member based on their eligibility date or change date needed. - Correct Ans: ✔✔True
  4. Prior to the beginning of the enrollment process, a broker/agent is required to cover certain
  1. A Health Risk Assessment (HRA) provides an overview of a member's health status, gives us the opportunity to improve member care, and prevent further health challenges. - Correct Ans: ✔✔True
  2. Which Prescription Drug Plan (PDP) is best for a dual-eligible chooser? - Correct Ans: ✔✔Classic
  3. For 2025, Wellcare has 43 new plans going to market - Correct Ans: ✔✔TRUE
  4. Members are no longer required to pay a partial deductible due to the Inflation Reduction Act. - Correct Ans: ✔✔True
  5. Names and/or logos of provider co-branding partners can be displayed on marketing materials, as long as the current and approved logos are used. - Correct Ans: ✔✔False
  6. CustomPoint® sales material order dates will be posted on Wellcare.com. - Correct Ans: ✔✔False
  7. Enrollments through Ascend offer the following unique benefits: (Select all that apply.) - Correct Ans: ✔✔Validation of important data to help prevent incorrect or missing information

Search capabilities for providers and formularies to validate physician and prescription availability

  1. A Low-Income Subsidy (LIS) member could be assigned one of ____ copay categories depending on the level of need. - Correct Ans: ✔✔Four
  2. Effective 2025, key provisions of the Inflation Reduction Act include a newly designed standard Part D benefit design consisting of three phases. Which phase is not included? - Correct Ans: ✔✔Coverage Gap