UHC Ethics and Compliance (100% Verified) Latest Update 2023/2024 Question and Answers

What is a servicing agent? - CORRECT ANSWER an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commisions on medicare advantage and prescription drug plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare basics and ethics compliance assessments on an annual basis What does CMS stand for? - CORRECT ANSWER center for medicare and medicaid services Who administers the medicare program and contracts with private health care companies to offer medicaid plans? - CORRECT ANSWER CMS Who holds the authority to approve or disaprove plans that can be sold, and is the regulating agency that also monitors our progresses? - CORRECT ANSWER CMS Who regulates MA's and PDP's - CORRECT ANSWER CMS Enrolling a customer in a plan when you are not certified in the product is non-compliant and considered____? - CORRECT ANSWER an unqualified sale Agents who are not qualified to sell the product will not be? - CORRECT ANSWER compensated and may receive corrective and or disciplinary action up to an including termination What is the purpose of an educational event? - CORRECT ANSWER its designed to inform medicare consumers about original medicare, medicare advantage, prescription drug and other medicare programs. Where must educational events be conducted? - CORRECT ANSWER in a public venue Are the educational events unbiased so that it doesn't steer the consumer towards a specific plan or limited number of plans? - CORRECT ANSWER yes WHat is a marketing/sales event? - CORRECT ANSWER an event designed to steer or attempt to steer, consumers toward a plan or limited set of plans. Agents may discuss plan specific information and collect applications. Can marketing/sales be formal or informal? - CORRECT ANSWER both What describes a formal marketing/sales event? - CORRECT ANSWER a full plan presentation, given in a presenter-audience format. What is an inform marketing/sales event? - CORRECT ANSWER they're passive in nature where the consumer approaches the agent to engage in conversation. a booth, table, or kiosk is typically used What are marketing appointments? - CORRECT ANSWER They're commonly referred to as "in home, face to face, or one on one appointment" and typically take place in the consumers home. What other places can marketing appointments happen? - CORRECT ANSWER coffee shop, or even over the phone because marketing appointments are not formal and informal marketing sales events, they're not reported to who? - CORRECT ANSWER UHC or CMS. instead, agents must obtain a completed scope of appointment prior to conducting the appointment. To report events, what should agents use? - CORRECT ANSWER an event request form to ensure that events are in UHC's event reporting application no less than 7 calender days prior to the event... - CORRECT ANSWER submit the event request form, according to instructions on the form, NO LESS THAN 14 CALENDAR DAYS event request forms submitted within7 calendar days will NOT be what? - CORRECT ANSWER processed conducting an unreported event is _____? - CORRECT ANSWER prohibited to schedule a sign language interpreter for a formal marketing/sales event or a personal/individual marketing appointment, enter the consumer's request direct;y in bconnected at least? - CORRECT ANSWER 14 days prior to the event or appointment What are marketing materials used for? - CORRECT ANSWER 1) draw attention to a plan sponsor or their plan(s) and 2) influence a consumer's decision when selecting a plan in which to enroll or a member's decision to remain enrolled in their current plan Marketing materials contain information about the plan or plans: - CORRECT ANSWER 1) benefits or benefit structure 2) cost sharing ( including premiums, copayments, and deductibles) 3) Measurements or ranking standards ( such as star ratings. comparisons to other plans, or statistical studies or surveys) Approval is required for? - CORRECT ANSWER 1) ALL medicare marketing materials or 2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affliated plans or displays any logos What does generic mean with marketing materials? - CORRECT ANSWER materials that do not meet the marketing materials criteria and do not carry any plan sponsor information or logos does generic materials require prior approval? - CORRECT ANSWER no What methods are considered marketing material? - CORRECT ANSWER newspaper, tv, internet, radio advertisements, direct mail, postcards, flyers, brochures, magnets, pre-enrollment materials, websites and social media platforms what are some examples of generic marketing materials? - CORRECT ANSWER social media sites and websites sites used to market UHC plans must be _____ by UHC and CMS prior to use - CORRECT ANSWER approved when talking about marketing materials what should the agent NOT do? - CORRECT ANSWER add, enhance, delete, modify, edit or create any content in the marketing materials provided by the health plan modify approved materials in any way, no matter how minor ask health related or health screening questions on generic, agent created materials What must an agent do when talking about marketing materials? - CORRECT ANSWER use marketing materials only for products they are certified to market/sell What does PTC stand for? - CORRECT ANSWER permission to contract