Certification Exam
Actual Questions with Correct Answers
Pass with 90% or Higher
What’s Included:
• 70+ verified questions with Correct
answers with Rationales.
• Ideal for exam preparation and concept reinforcement.
,1. Tori needs to cancel an event. To allow ample time for UnitedHealthcare to process
the cancellation in the event reporting application, when should Tori submit a Cancel
Event Request Form?
A. At least 3 business days prior to the event
B. At least 6 business days prior to the date of the event
C. At least 10 business days prior to the event
D. On the day of the event
Correct Answer: B
Expert Rationale:
Event cancellations must be submitted at least 6 business days before the scheduled
event date to ensure proper processing in the event reporting system and to avoid
compliance violations related to unreported or improperly canceled events.
2. Janet is conducting an informal marketing/sales event at her local soup kitchen.
When speaking to the Activities Director, Janet finds out that lunch is served daily
from 11:00 AM–1:00 PM. Which of the following is a compliant time when Janet can
host her event?
A. 11:00 AM to 1:00 PM
B. 10:00 AM to 12:00 PM
C. 9:00 AM to 11:00 AM
D. 1:00 PM to 3:00 PM
Correct Answer: C
Expert Rationale:
Informal marketing events must not occur during meal service times at meal-providing
facilities to avoid the appearance of conditioning enrollment on food provision. Hosting the
event from 9:00 AM to 11:00 AM ensures compliance with CMS marketing guidelines and
UnitedHealthcare event standards.
3. From the list below, select the items that should be confirmed or obtained when
conducting a thorough needs assessment. (Select all that apply)
A. Eligibility
B. Current coverage
C. Current providers
, D. Current prescription medications
E. Daily living needs such as transportation, fitness, travel
F. Other wish list items such as network restrictions, premium amounts, national network
needs
Correct Answers: A, B, C, D, E, F
Expert Rationale:
A thorough needs assessment is a regulatory requirement before enrollment. It must verify
Medicare eligibility, existing coverage, provider networks, prescription drug needs, lifestyle
factors affecting healthcare access, and consumer preferences (e.g., premium tolerance,
network flexibility) to ensure the recommended product is suitable.
4. Match the election period to the correct definition.
A. MA-OEP → Consumers can switch or disenroll from their MA Plan and obtain Original
Medicare
B. IEP → Newly eligible consumers can enroll 3 months prior, month of, and 3 months after
turning 65
C. AEP → Annual period when any Medicare consumer can enroll in or disenroll from an
MA or PDP
D. SEP → Opportunity to change plans for specific scenarios such as newly dual-eligible
(Medicare and Medicaid) or new chronic condition
E. 5-Star → One-time opportunity to enroll in a plan with a 5-star rating (if available)
Correct Answer: All matches (A, B, C, D, E) as shown above
Expert Rationale:
• MA-OEP (Jan 1 – Mar 31): Allows MA enrollees to switch MA plans or return to
Original Medicare.
• IEP: The 7-month window surrounding the month of Medicare eligibility.
• AEP (Oct 15 – Dec 7): Annual enrollment period for MA and PDP changes, effective
Jan 1.
• SEP: Triggered by qualifying life events (e.g., moving, losing Medicaid, qualifying for
C-SNP).
• 5-Star SEP: CMS allows one enrollment into a 5-star rated plan between Dec 8 and
Nov 30 if available in the service area.
5. What should you do if the consumer is interested in an MA Plan that has a 2-star
rating?