AHIP 2024 Module 4 Verified Solutions

AHIP 2024 Module 4 Verified Solutions Question 1: Before a Medicare Advantage-Part D plan enrollment form is completed, what information must be provided to the client? Answer: You must provide information about I, II, and III (presumably referring to the plan's benefits, coverage, and premium). Question 2: What should you do when a client calls to change their Medicare Advantage plan during the annual election period? Answer: Complete a scope of appointment (SOA) during the call and indicate that you will meet to discuss Medicare Advantage plans during an appointment the following day. Question 3: What is ABC's obligation regarding marketing non-health related products to its Medicare Advantage enrollees? Answer: It must obtain a HIPAA-compliant authorization from an enrollee indicating that the plan or plan sponsor may use their information for marketing purposes. Question 4: As an independent agent, what steps are required? Answer: During the first minute of a sales call, you must use a disclaimer stating that you do not represent every plan available in the area and only represent three organizations offering ten plans in that area. You must direct beneficiaries to contact M, 1-800-MEDICARE, or their local State Health Insurance Program to get information on all their options. Question 5: Can you present a program about Medicare Advantage-PD plans to residents at an assisted living facility? Answer: No, you cannot present a program about MA-PD plans without permission from the residents or the facility. You should advise your friend to explore this further. Question 6: What should Agent Daniel Webber do when Edward Young arrives with his elderly neighbor Clara Burton at an agreed-upon appointment time? Answer: After executing a scope of appointment (SOA) with Clara Burton, meet with Edward Young and Clara Burton to discuss their Medicare Advantage options. Question 7: What type of meal is prohibited when marketing Medicare Advantage and Part D plans? Answer: A Thanksgiving-style meal would be prohibited, regardless of who provides or pays for the meal. Question 8: How is Agent Chan compensated under CMS rules? Answer: FeelBetter will pay Agent Chan initial-year compensation for months July through December. Renewal amounts will be paid starting in January if Ms. Park remains enrolled the following year. Question 9: What should you do when putting together advertisements for an educational event? Answer: Ensure that the advertisements indicate it is an educational event, otherwise it will be considered a marketing event. Question 10: What penalty might a plan impose on an agent who has engaged in misconduct? Answer: The plan may withhold commission, require retraining, report the misconduct to a state department of insurance or terminate the contract. Question 11: Can you solicit Medicare Advantage prospects through email marketing? Answer: Yes, but an opt-out process must be provided. Question 12: What advice would you give Melissa Meadows about using social media to reach potential prospects? Answer: As soon as CMS approves Best Care's social media posts, Melissa could post a tweet stating that "Best Care offers an array of Medicare Advantage benefit packages. One might be right for you. Call me to find out more!" Question 13: How should you respond to hospital administration hesitation about allowing marketing in their facility? Answer: Marketing in healthcare facilities is an acceptable practice as long as it takes place in common areas where patients are not receiving or waiting to receive healthcare and as long as the hospital displays materials for all plans that provide them to the hospital. Miguel Sanchez is a relatively new agent who has come to you for advice as to what he can do during the Medicare Advantage Open Enrollment Period (MA-OEP). What advice should you give Miguel? ️During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. Another agent working for your agency claims that because you are not employed by the Medicare Advantage plans that you represent, you are not subject to the same marketing requirements as the plans themselves. How should you respond to such a statement? ️Your coworker is not correct. Marketing on behalf of a plan is considered marketing by the plan and requires that all contracted and employed agents comply with all Medicare marketing rules. Evan Marsh is a newly appointed agent. Evan 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. Evan asks you what is permissible at such an event. What should you say? ️Evan may provide a meal as long as its value is $15 or less per attendee and he may make available business reply cards (BRCs). Sal D'Angelo is new to the Medicare marketplace having previously been focused on life insurance and disability income protection products. He intends to conduct an educational seminar during the AEP at a local hotel and then invite those who attend to a subsequent marketing meeting to discuss the benefits of next year's plans. How would you advise Sal? ️Sal should conduct the education seminar as an early morning meeting and the marketing meeting on the following day in the late afternoon so that there are at least 12 hours between the two meetings. You are seeking to represent an individual Medicare Advantage plan and an individual Part D plan in your state. You have completed the required training for each plan, but you did not achieve a passing score on the tests that came after the training. What can you do in this situation? ️You will not be able to represent any Medicare Advantage or Part D plan until you complete the training and achieve an adequate score, although you will not have to take a test if you exclusively market employer/union group plans and the companies do not require testing.