AHIP TRAINING MODULE 4
MARKETING/ Latest Update
Medicare health plans establish provisions in marketing representative contracts to
ensure compliance with applicable laws and policies. If non-compliance occurs, CMS
can penalize a plan in which of the following ways? - CORRECT ANSWERS-CMS
requires plan sponsors to create and complete a corrective action plan and may
terminate a sponsor's contract.
QUINN is a marketing representative who markets an MA plan. He is a very good
speaker and was asked to make a presentation at a local event that was advertised as
education. He accepted the invitation and the MA plan reported the event to CMS.
CMS's secret shopper attended the event and heard Mr. Quinn's sales presentation.
Which of the following could CMS do? - CORRECT ANSWERS-Require the MA plan to
suspend marketing and enrollment for a period of time.
LYNN, an agent for ACME ins. Inc., thinks that, since state laws are preempted with
regard to the marketing of Medicare health plans, he doesn't have much to worry about.
What might you, as his colleague, advise him concerning the type of scrutiny he will be
under? - CORRECT ANSWERS-Organizations sponsoring Medicare health plans are
responsible for the behavior of their contracted representatives and will be conducting
monitoring activities to ensure compliance with all applicable Federal laws and guidance
and plan policies. Furthermore, state agent licensure laws are NOT preempted and he
must abide by their requirements.
Can marketing representatives request information from providers regarding Medicare
beneficiaries with specific health conditions for marketing purposes? - CORRECT
ANSWERS-NO, providers are legally prohibited from sharing such information.
When soliciting referrals from current members of an MA or Part D plan, what may you
do? - CORRECT ANSWERS-You may request names and mailing addresses.
Ordinarily, you obtain referrals from a third-party that initiates contact with potential
clients and usually sets up appointments for you. How would the guidelines for
marketing MA and Part D plans apply to this practice? - CORRECT ANSWERS-Third
parties may NOT make unsolicited calls, visits, or emails to Medicare beneficiaries in
order to set up such appointments, or for any other reason related to the marketing of
MA or Part D plans.
PRENTICE has many clients who are Medicare beneficiaries. He should review the
Centers for Medicare and Medicaid Services' Marketing guidelines to ensure he is
compliant for which type of products? - CORRECT ANSWERS-MA and PDP
, Another agent working for your agency claims that because you are not employed by
the MA plans that you represent, you are not subject to the same requirements as the
plans themselves. - CORRECT ANSWERS-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.
You work for a company that has marketed Medigap products for many years. The
company has added MA and Part D plans and you will begin marketing those plans this
fall. You are planning what materials to use to easily show the difference in benefits,
premiums and cost sharing for each of the products. What do you need to do with your
materials before using them for marketing purposes? - CORRECT ANSWERS-You
must submit your materials to the plan you represent, so CMS can review and approve
the materials to ensure they are accurate.
Which of the following is a correct statement about state laws as they pertain to
marketing representatives? - CORRECT ANSWERS-Medicare health plans must
comply with requests for information from state insurance departments investigating
complaints about a marketing representative.
You are seeking to represent an individual MA 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? - CORRECT ANSWERS-You will NOT be able to represent any MA or Part D
plan until you compete 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.
Your colleague works at a third party marketing organization, TMO and she said she did
not need to take the Medicare training for brokers and agents or pass a test to market
Medicare plans since her contract is with the TMO, not the plans that have the products
she sells. - CORRECT ANSWERS-You could tell her she is wrong, and that only agents
selling Employer/union group plans are permitted an exemption from testing, but some
employer/union group plans may require testing to promote agent compliance with CMS
marketing requirements.
During a sales presentation to Ms. Daley for MA plan that has a 5 star rating in
customer service and care coordination, and received an overall plan performance
rating of a 4 star, which of the following would be the correct statement to say to her? -
CORRECT ANSWERS-The MA plan received a 5 star rating in customer service and
care coordination with an overall performance rating of 4 stars.
During a sales presentation, you client ask you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. - CORRECT
ANSWERS-Tell her that the Medicare agency does not endorse or recommend any
plan.
MARKETING/ Latest Update
Medicare health plans establish provisions in marketing representative contracts to
ensure compliance with applicable laws and policies. If non-compliance occurs, CMS
can penalize a plan in which of the following ways? - CORRECT ANSWERS-CMS
requires plan sponsors to create and complete a corrective action plan and may
terminate a sponsor's contract.
QUINN is a marketing representative who markets an MA plan. He is a very good
speaker and was asked to make a presentation at a local event that was advertised as
education. He accepted the invitation and the MA plan reported the event to CMS.
CMS's secret shopper attended the event and heard Mr. Quinn's sales presentation.
Which of the following could CMS do? - CORRECT ANSWERS-Require the MA plan to
suspend marketing and enrollment for a period of time.
LYNN, an agent for ACME ins. Inc., thinks that, since state laws are preempted with
regard to the marketing of Medicare health plans, he doesn't have much to worry about.
What might you, as his colleague, advise him concerning the type of scrutiny he will be
under? - CORRECT ANSWERS-Organizations sponsoring Medicare health plans are
responsible for the behavior of their contracted representatives and will be conducting
monitoring activities to ensure compliance with all applicable Federal laws and guidance
and plan policies. Furthermore, state agent licensure laws are NOT preempted and he
must abide by their requirements.
Can marketing representatives request information from providers regarding Medicare
beneficiaries with specific health conditions for marketing purposes? - CORRECT
ANSWERS-NO, providers are legally prohibited from sharing such information.
When soliciting referrals from current members of an MA or Part D plan, what may you
do? - CORRECT ANSWERS-You may request names and mailing addresses.
Ordinarily, you obtain referrals from a third-party that initiates contact with potential
clients and usually sets up appointments for you. How would the guidelines for
marketing MA and Part D plans apply to this practice? - CORRECT ANSWERS-Third
parties may NOT make unsolicited calls, visits, or emails to Medicare beneficiaries in
order to set up such appointments, or for any other reason related to the marketing of
MA or Part D plans.
PRENTICE has many clients who are Medicare beneficiaries. He should review the
Centers for Medicare and Medicaid Services' Marketing guidelines to ensure he is
compliant for which type of products? - CORRECT ANSWERS-MA and PDP
, Another agent working for your agency claims that because you are not employed by
the MA plans that you represent, you are not subject to the same requirements as the
plans themselves. - CORRECT ANSWERS-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.
You work for a company that has marketed Medigap products for many years. The
company has added MA and Part D plans and you will begin marketing those plans this
fall. You are planning what materials to use to easily show the difference in benefits,
premiums and cost sharing for each of the products. What do you need to do with your
materials before using them for marketing purposes? - CORRECT ANSWERS-You
must submit your materials to the plan you represent, so CMS can review and approve
the materials to ensure they are accurate.
Which of the following is a correct statement about state laws as they pertain to
marketing representatives? - CORRECT ANSWERS-Medicare health plans must
comply with requests for information from state insurance departments investigating
complaints about a marketing representative.
You are seeking to represent an individual MA 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? - CORRECT ANSWERS-You will NOT be able to represent any MA or Part D
plan until you compete 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.
Your colleague works at a third party marketing organization, TMO and she said she did
not need to take the Medicare training for brokers and agents or pass a test to market
Medicare plans since her contract is with the TMO, not the plans that have the products
she sells. - CORRECT ANSWERS-You could tell her she is wrong, and that only agents
selling Employer/union group plans are permitted an exemption from testing, but some
employer/union group plans may require testing to promote agent compliance with CMS
marketing requirements.
During a sales presentation to Ms. Daley for MA plan that has a 5 star rating in
customer service and care coordination, and received an overall plan performance
rating of a 4 star, which of the following would be the correct statement to say to her? -
CORRECT ANSWERS-The MA plan received a 5 star rating in customer service and
care coordination with an overall performance rating of 4 stars.
During a sales presentation, you client ask you whether the Medicare agency
recommends that she sign up for your plan or stay in Original Medicare. - CORRECT
ANSWERS-Tell her that the Medicare agency does not endorse or recommend any
plan.
