UHC ETHICS AND COMPLIANCE EXAM ACTUAL EXAM VERSION A, B AND C ALL COMPLETE 350 QUESTIONS AND CORRECT DETAILED ANSWERS ALREADY GRADED A+

Page 1 of 48 1 UHC ETHICS AND COMPLIANCE EXAM ACTUAL EXAM VERSION A, B AND C ALL COMPLETE 350 QUESTIONS AND CORRECT DETAILED ANSWERS ALREADY GRADED A+ UHC ETHICS AND COMPLIANCE EXAM A John has Power of Attorney to act on behalf of his mother. What does that mean when it comes to his mother enrolling in a Medicare Advantage Plan? A) John may sign the Enrollment Application and must be able to provide documentation upon request by the plan t hat indicates his authority under state law to enroll his mother B) John may sign the Enrollment Application, but does not need to provide documentation to support his claim of authority upon request by the plan C) John may sign the Enrollment Application and must submit documentation that indicates his authority under state law to enroll his mother with the application D) John may attend a personal.individual marketing appointment with his mother, but has no authority to sign the Enrollment Application - ANSWER -A) John may sign the Enrollment Application and must be able to provide documentation upon request by the plan that indicates his authority under state law to enroll hi mother When can telephonic contact with a Medicare eligible consumer be made? A) When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. B) When confirming receipt of mailed information Page 2 of 48 2 C) When a member has voluntary disenrolled from a plan - ANSWER -A) When the consumer consented to be contacted for sales Who has the authority to sign an Enrollment Application? A) The consumer or the consumer's authorized legal rep (e.g. Power of Attorney) B) The consumer or any individual authorized by the consumer C) The consumer, the consumer's spouse, or the consumer's adult child D) The consumer only - ANSWER -A) The consumer or the consumer's authorized legal rep (e.g. Power of Attorney As an agent, you MUST NOT do which of the following when mar keting UHC Medicare Advantage plans to consumers? A) Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval B) Review and complete the Enrollment Application with consumers C) Provid e current marketing materials that have been approved by CMS and UHC D) Review out -of-pocket maximum with consumers and explain any exceptions - ANSWER -A) Use providers or provider groups to distribute printed information comparing benefits of different health plans without approval As an agent, you have an obligation to o nly enroll a consumer in a product: Page 3 of 48 3 A) That meets the interest you have in the transaction, for example commissions received for the sale B) That is suitable for the consumer's needs, goals and financial resources C) That meets the sales goal of the Center s for Medicare and Medicaid Services, UHC and the SSA D) That provides a financial advantage to a network of providers - ANSWER -B) That is suitable for the consumer's needs, goals and financial resources By signing the Statement of Understanding the consu mer: A) Acknowledges that the agent may discuss Medicare Advantage and Prescription Drug Plans with the consumer B) Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrol ling C) Acknowledges their understanding of standard enrollment and disenrollment procedures - ANSWER -B) Acknowledges that they clearly understand that they are enrolling in a plan, combined with knowing the specific plan in which they are enrolling What is the definition of Abuse? A) Abuse includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources B) Abuse includes any practice that results in the provi sion of services that are not medically necessary Page 4 of 48 4 C) Abuse is intentionally misrepresenting or concealing facts to obtain something of value - ANSWER -B) Abuse includes any practice that results in the provision of services that are not medically necessary Which of the issues below are examples of Fraud, Waste and/or Abuse? (Select 3) A) The pharmacy splits the original prescription to receive additional dispensing fees B) Using another person's medical insurance information to obtain prescriptions C) Billi ng for medical services or procedures that were actually provided or performed D) Falsifying signatures or medical records - ANSWER -A,B & D In terms of events, which of the following is true? A) Agents must report formal marketing/sales events only to UHC B) Agents must report informal marketing/sales events only to UHC C) Agents must report all marketing/sales and educational events to UHC D) Agents must report formal and informal marketing/sales events only to UHC - ANSWER -Not A Whose email address may the agent enter into the LEAN enrollment application? A) The consumer's or another individual's provided by the consumer, such as a friend's or relative's B) Only the consumer's (or leave it blank)