AHIP MODULE 4 2026 QUESTIONS
AND CORRECT ANSWERS| VERIFIED
Steban Marsh is a newly appointed agent. Steban intends to conduct an
educational session on Medicare at a senior citizens center near his
home. He has advertised the session as an educational event. Steban
asks you what is permissible at such an event. What should you say? -
CORRECT ANSWER- Steban may provide a meal as long as its value
is $15 or less per attendee and he may make available business reply
cards (BRCs).
Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage
plan during the Annual Open Enrollment Period. Ralph's effective
enrollment date is January 1st. Ralph disenrolls on February 12th
because he discovers that the plan does not cover services furnished by
several of his longtime providers. Which of the following statements best
describes the impact of Ralph's action upon Agent Lopez's
compensation? - CORRECT ANSWER- Agent Lopez's entire
compensation must be recouped because Ralph disenrolled within 3
months of enrollment.
BestCare Health Plan has received a request from a state insurance
department in connection with the investigation of several marketing
representatives licensed by the state who sell Medicare Advantage
plans. What action(s) should BestCare take in response? - CORRECT
ANSWER- Cooperate with the state and supply requested information.
You are working with several plans and community organizations to
sponsor an educational event. When putting together advertisements for
this event, what should you do? - CORRECT ANSWER- You must
ensure that the advertisements indicate it is an educational event,
otherwise it will be considered a marketing event.
, You have approached a hospital administrator about marketing in her
facility. The administrator is uncomfortable with the suggestion. How
could you address her concerns? - CORRECT ANSWER- Tell her
that Medicare guidelines allow you to conduct marketing activities in
common areas of a provider's facility.
Alice is a marketing representative employed by a health plan. Betty is a
captive agent of a health plan who markets for multiple plans and
sponsors. Carl is a captive agent who markets for only one plan/sponsor.
Denise is an independent agent who markets to different types of
groups. Edward is an independent agent who markets only to employer
and union groups. CMS marketing representative compensation rules
generally apply to: - CORRECT ANSWER- Betty and Denise, but not
Alice (the employee) or Carl or Edward (to whom exceptions apply).
Stephanie King becomes eligible for Medicare for the first time in July.
With the help of Agent James Chan, she enrolls in FeelBetter Medicare
Advantage plan with an effective date of July 1st. Which statement best
describes how Agent Chan may be compensated under CMS rules? -
CORRECT ANSWER- FeelBetter will pay Agent Chan initial year
compensation for July through December. The renewal amounts will be
paid starting in January if Ms. King remains enrolled the following year.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its
enrollees' information to market non-health related products such as life
insurance and annuities. Which statement best describes ABC's
obligation to its enrollees regarding marketing such products? -
CORRECT ANSWER- It must obtain a HIPAA compliant authorization
from an enrollee that indicates the plan or plan sponsor may use their
information for marketing purposes.
Mrs. Lewis is turning 65 in November and called to ask for your help
deciding on a Medicare Advantage plan. She agreed to sign a scope of
appointment form and meet with you on October 15. During the
appointment, what are you permitted to do? - CORRECT ANSWER-
You may provide her with the required enrollment materials and take her
completed enrollment application.
AND CORRECT ANSWERS| VERIFIED
Steban Marsh is a newly appointed agent. Steban intends to conduct an
educational session on Medicare at a senior citizens center near his
home. He has advertised the session as an educational event. Steban
asks you what is permissible at such an event. What should you say? -
CORRECT ANSWER- Steban may provide a meal as long as its value
is $15 or less per attendee and he may make available business reply
cards (BRCs).
Agent Lopez helps Ralph to enroll in Top Choice Medicare Advantage
plan during the Annual Open Enrollment Period. Ralph's effective
enrollment date is January 1st. Ralph disenrolls on February 12th
because he discovers that the plan does not cover services furnished by
several of his longtime providers. Which of the following statements best
describes the impact of Ralph's action upon Agent Lopez's
compensation? - CORRECT ANSWER- Agent Lopez's entire
compensation must be recouped because Ralph disenrolled within 3
months of enrollment.
BestCare Health Plan has received a request from a state insurance
department in connection with the investigation of several marketing
representatives licensed by the state who sell Medicare Advantage
plans. What action(s) should BestCare take in response? - CORRECT
ANSWER- Cooperate with the state and supply requested information.
You are working with several plans and community organizations to
sponsor an educational event. When putting together advertisements for
this event, what should you do? - CORRECT ANSWER- You must
ensure that the advertisements indicate it is an educational event,
otherwise it will be considered a marketing event.
, You have approached a hospital administrator about marketing in her
facility. The administrator is uncomfortable with the suggestion. How
could you address her concerns? - CORRECT ANSWER- Tell her
that Medicare guidelines allow you to conduct marketing activities in
common areas of a provider's facility.
Alice is a marketing representative employed by a health plan. Betty is a
captive agent of a health plan who markets for multiple plans and
sponsors. Carl is a captive agent who markets for only one plan/sponsor.
Denise is an independent agent who markets to different types of
groups. Edward is an independent agent who markets only to employer
and union groups. CMS marketing representative compensation rules
generally apply to: - CORRECT ANSWER- Betty and Denise, but not
Alice (the employee) or Carl or Edward (to whom exceptions apply).
Stephanie King becomes eligible for Medicare for the first time in July.
With the help of Agent James Chan, she enrolls in FeelBetter Medicare
Advantage plan with an effective date of July 1st. Which statement best
describes how Agent Chan may be compensated under CMS rules? -
CORRECT ANSWER- FeelBetter will pay Agent Chan initial year
compensation for July through December. The renewal amounts will be
paid starting in January if Ms. King remains enrolled the following year.
ABC is a Medicare Advantage (MA) plan sponsor. It would like to use its
enrollees' information to market non-health related products such as life
insurance and annuities. Which statement best describes ABC's
obligation to its enrollees regarding marketing such products? -
CORRECT ANSWER- It must obtain a HIPAA compliant authorization
from an enrollee that indicates the plan or plan sponsor may use their
information for marketing purposes.
Mrs. Lewis is turning 65 in November and called to ask for your help
deciding on a Medicare Advantage plan. She agreed to sign a scope of
appointment form and meet with you on October 15. During the
appointment, what are you permitted to do? - CORRECT ANSWER-
You may provide her with the required enrollment materials and take her
completed enrollment application.
