WELLCARE ACT MASTERY EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
Medicare Advantage and Prescription Drug Plan Fundamentals
Centene and Wellcare Compliance and Ethics
CMS Marketing and Enrollment Regulations
Sales Event and Scope of Appointment Protocols
Grievances, Appeals, and Beneficiary Protections
Special Needs Plans and Dual-Eligible Populations
Pharmacy Benefit and Formulary Management
Star Ratings and Quality Performance Measures
Introduction
The Wellcare ACT Mastery Exam evaluates the comprehensive knowledge and
applied decision-making skills of licensed insurance agents and brokers. The
assessment focuses on Centene and Wellcare-specific product offerings, CMS
regulatory requirements, and ethical sales practices. Questions include multiple-
choice and scenario-based formats to simulate real-world enrollment situations,
emphasizing critical thinking, compliance adherence, and beneficiary-focused
service. Mastery of these domains ensures agents can effectively guide Medicare-
eligible individuals through plan selection while maintaining the highest
standards of integrity and regulatory compliance.
,Section One: Questions 1–50
Question 1
Centene requires all contracted brokers and agents to read, understand, and
agree to Centene's Business Ethics and Code of Conduct Policy.
A. True
B. False
C. Only if they are new to the company
D. Only if they sell D-SNP products
🟢 Correct Answer: A. True
🔴 Explanation: Centene mandates that all contracted brokers and agents
review and agree to its Business Ethics and Code of Conduct Policy as a
condition of their contracting relationship.
Question 2
The Third-Party Marketing Organization (TPMO) disclaimer must be used by
any TPMO that sells plans on behalf of more than one MA plan provider. The
disclaimer must be: (Select all that apply.)
A. Included in any marketing materials
B. Verbally conveyed within the first minute of a sales call
C. Prominently displayed on TPMO websites
D. Electronically conveyed in communications
🟢 Correct Answer: A, B, C, D
,🔴 Explanation: The TPMO disclaimer is required in all marketing materials,
must be conveyed verbally within the first minute of a sales call, displayed
prominently on websites, and included in electronic communications.
Question 3
When a paper Scope of Appointment (SOA) form is used, it must be completed
how many hours prior to hosting the sales presentation?
A. 24 hours
B. 48 hours
C. 72 hours
D. 12 hours
🟢 Correct Answer: B. 48 hours
🔴 Explanation: A paper SOA form must be completed 48 hours prior to
hosting the sales presentation to ensure compliance with CMS regulations.
Question 4
From October 1 to October 14, certain activities are Non-Permissible Activities.
These include:
A. Assisting with completing an application
B. Collecting a completed application
C. Advising the beneficiary to complete an application prior to October 15
D. All of these
🟢 Correct Answer: D. All of these
, 🔴 Explanation: During the pre-Annual Enrollment Period window, agents may
not assist with, collect, or advise beneficiaries to complete plan applications for
the upcoming year.
Question 5
The Pre-Enrollment Checklist (PECL) is a CMS requirement that must be
reviewed with the beneficiary at what point?
A. After enrollment is completed
B. Prior to enrollment completion
C. Only if the beneficiary requests it
D. During the first month of coverage
🟢 Correct Answer: B. Prior to enrollment completion
🔴 Explanation: The PECL is a CMS-mandated tool that agents must review
with beneficiaries before completing the enrollment to ensure they understand
key plan details.
Question 6
A grievance request, or any evidence concerning a grievance, must be filed
orally or in writing no later than how many calendar days from the date of the
event?
A. 30 days
B. 60 days
AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND
PASS | LATEST EXAM UPDATE 2026/2027
Core Domains
Medicare Advantage and Prescription Drug Plan Fundamentals
Centene and Wellcare Compliance and Ethics
CMS Marketing and Enrollment Regulations
Sales Event and Scope of Appointment Protocols
Grievances, Appeals, and Beneficiary Protections
Special Needs Plans and Dual-Eligible Populations
Pharmacy Benefit and Formulary Management
Star Ratings and Quality Performance Measures
Introduction
The Wellcare ACT Mastery Exam evaluates the comprehensive knowledge and
applied decision-making skills of licensed insurance agents and brokers. The
assessment focuses on Centene and Wellcare-specific product offerings, CMS
regulatory requirements, and ethical sales practices. Questions include multiple-
choice and scenario-based formats to simulate real-world enrollment situations,
emphasizing critical thinking, compliance adherence, and beneficiary-focused
service. Mastery of these domains ensures agents can effectively guide Medicare-
eligible individuals through plan selection while maintaining the highest
standards of integrity and regulatory compliance.
,Section One: Questions 1–50
Question 1
Centene requires all contracted brokers and agents to read, understand, and
agree to Centene's Business Ethics and Code of Conduct Policy.
A. True
B. False
C. Only if they are new to the company
D. Only if they sell D-SNP products
🟢 Correct Answer: A. True
🔴 Explanation: Centene mandates that all contracted brokers and agents
review and agree to its Business Ethics and Code of Conduct Policy as a
condition of their contracting relationship.
Question 2
The Third-Party Marketing Organization (TPMO) disclaimer must be used by
any TPMO that sells plans on behalf of more than one MA plan provider. The
disclaimer must be: (Select all that apply.)
A. Included in any marketing materials
B. Verbally conveyed within the first minute of a sales call
C. Prominently displayed on TPMO websites
D. Electronically conveyed in communications
🟢 Correct Answer: A, B, C, D
,🔴 Explanation: The TPMO disclaimer is required in all marketing materials,
must be conveyed verbally within the first minute of a sales call, displayed
prominently on websites, and included in electronic communications.
Question 3
When a paper Scope of Appointment (SOA) form is used, it must be completed
how many hours prior to hosting the sales presentation?
A. 24 hours
B. 48 hours
C. 72 hours
D. 12 hours
🟢 Correct Answer: B. 48 hours
🔴 Explanation: A paper SOA form must be completed 48 hours prior to
hosting the sales presentation to ensure compliance with CMS regulations.
Question 4
From October 1 to October 14, certain activities are Non-Permissible Activities.
These include:
A. Assisting with completing an application
B. Collecting a completed application
C. Advising the beneficiary to complete an application prior to October 15
D. All of these
🟢 Correct Answer: D. All of these
, 🔴 Explanation: During the pre-Annual Enrollment Period window, agents may
not assist with, collect, or advise beneficiaries to complete plan applications for
the upcoming year.
Question 5
The Pre-Enrollment Checklist (PECL) is a CMS requirement that must be
reviewed with the beneficiary at what point?
A. After enrollment is completed
B. Prior to enrollment completion
C. Only if the beneficiary requests it
D. During the first month of coverage
🟢 Correct Answer: B. Prior to enrollment completion
🔴 Explanation: The PECL is a CMS-mandated tool that agents must review
with beneficiaries before completing the enrollment to ensure they understand
key plan details.
Question 6
A grievance request, or any evidence concerning a grievance, must be filed
orally or in writing no later than how many calendar days from the date of the
event?
A. 30 days
B. 60 days
