UHC ETHICS AND COMPLIANCE
COMPREHENSIVE EXAM
QUESTIONS CORRECT ANSWERS
◉ Define compensation according to CMS? Answer: monetary or
non-monetary remuneration of any kind relating to the sale or
renewal of a policy including, but not limited to, commission,
bonuses, gifts, prizes, awards, and referral/finder's fees.
◉ What does compensation not involve? Answer: payment of fees to
comply with stat appointment laws.: costs related to training,
certification, and testing requirements; reimbursement for mileage
to and from educational and marketing/sales events or marketing
appointments with consumers
◉ What does ISR stand for? Answer: internal sales representitives
◉ What is a sales incentive plan? Answer: Employed agents are paid
an incentive when specific goals have been met.
◉ referral/finder's fees? Answer: UHC does not sponsor a lead
referral program; therefore, no payment is made in exchange for a
referral or as a result of referred consumer's enrollment
,◉ Marketing fees? Answer: Agents are prohibited from charging a
consimer or member any type of fee for the marketing of a Medicare
insurance product, including but not limited to : entrance fees to
attend educational or marketing/sales events, fees to conduct a
personal/individual meeting appointment, or to cover the cost of
materials
◉ What is another name for compensation recovery? Answer:
charge backs
◉ What is compensation recovery? Answer: Incentive amounts are
deducted from a SIP participant's incentive payment for previously
paid advances on sales that aren't earned. generally the result of a
member's rapid disenrollment from their plan, but can occur for
other reasons.
◉ When does rapid dis-enrollment occur? Answer: it occurs when a
member voluntarily dis-enrolls or moves from one UHC plan to
another prior to the member's FOURTH month effective date
following the original effective date.
◉ What does EDC stand for? Answer: external distribution channel
◉ What does ICA stand for? Answer: independent career agent
, ◉ How does UHC pay non-employee agents in the EDC and ICA?
Answer: pays on commission for enrollment of a consumer into a
UHC medicare solutions MA plan, PDP, or med sup insurance policies
according to the terms of their agent agreement.
◉ How are commissions paid on sales written by a solicitor?
Answer: paid to the solicitor's up-line.
◉ for each MA, MA-PD and PDP enrollment, CMS determines if hte
enrollment qualifies for Answer: Initial or renewal compensation
◉ If a member disenrolls from one plan and enrolls in another, CMS
determines the compensation type for the ______ Answer: new
enrollment
◉ What is initial compensation? Answer: is paid at an amount at or
below the fair market value (FMV)
◉ When a member enrolls in a plan and has no prior plan history,
the plan sponsor may pay the full year initial compensation amount
or a ? Answer: pro-rated amount based on the number of months the
member is enrolled
◉ What happens when the member changes plans during the initial
year? Answer: The plan sponsor must pay the agent at a pro-rated
COMPREHENSIVE EXAM
QUESTIONS CORRECT ANSWERS
◉ Define compensation according to CMS? Answer: monetary or
non-monetary remuneration of any kind relating to the sale or
renewal of a policy including, but not limited to, commission,
bonuses, gifts, prizes, awards, and referral/finder's fees.
◉ What does compensation not involve? Answer: payment of fees to
comply with stat appointment laws.: costs related to training,
certification, and testing requirements; reimbursement for mileage
to and from educational and marketing/sales events or marketing
appointments with consumers
◉ What does ISR stand for? Answer: internal sales representitives
◉ What is a sales incentive plan? Answer: Employed agents are paid
an incentive when specific goals have been met.
◉ referral/finder's fees? Answer: UHC does not sponsor a lead
referral program; therefore, no payment is made in exchange for a
referral or as a result of referred consumer's enrollment
,◉ Marketing fees? Answer: Agents are prohibited from charging a
consimer or member any type of fee for the marketing of a Medicare
insurance product, including but not limited to : entrance fees to
attend educational or marketing/sales events, fees to conduct a
personal/individual meeting appointment, or to cover the cost of
materials
◉ What is another name for compensation recovery? Answer:
charge backs
◉ What is compensation recovery? Answer: Incentive amounts are
deducted from a SIP participant's incentive payment for previously
paid advances on sales that aren't earned. generally the result of a
member's rapid disenrollment from their plan, but can occur for
other reasons.
◉ When does rapid dis-enrollment occur? Answer: it occurs when a
member voluntarily dis-enrolls or moves from one UHC plan to
another prior to the member's FOURTH month effective date
following the original effective date.
◉ What does EDC stand for? Answer: external distribution channel
◉ What does ICA stand for? Answer: independent career agent
, ◉ How does UHC pay non-employee agents in the EDC and ICA?
Answer: pays on commission for enrollment of a consumer into a
UHC medicare solutions MA plan, PDP, or med sup insurance policies
according to the terms of their agent agreement.
◉ How are commissions paid on sales written by a solicitor?
Answer: paid to the solicitor's up-line.
◉ for each MA, MA-PD and PDP enrollment, CMS determines if hte
enrollment qualifies for Answer: Initial or renewal compensation
◉ If a member disenrolls from one plan and enrolls in another, CMS
determines the compensation type for the ______ Answer: new
enrollment
◉ What is initial compensation? Answer: is paid at an amount at or
below the fair market value (FMV)
◉ When a member enrolls in a plan and has no prior plan history,
the plan sponsor may pay the full year initial compensation amount
or a ? Answer: pro-rated amount based on the number of months the
member is enrolled
◉ What happens when the member changes plans during the initial
year? Answer: The plan sponsor must pay the agent at a pro-rated
