UNITED HEALTHCARE ETHICS AND COMPLIANCE LATEST EXAM
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
In terms of events, which of the following is true? - CORRECT
ANSWER WRONG - Agents must report formal marketing/sales events
only to UnitedHealthcare
When completing an enrollment application in LEAN, why is an agent
prohibited from entering their own email address in a field available for
the consumer's email address? - CORRECT ANSWER The
consumer/member would not receive plan related correspondence
intended for him/her.
Annual Election Period (AEP) is a time when: - CORRECT ANSWER
Consumers can elect to join a Medicare Advantage Plan or switch to a
different plan.
You have scheduled an appointment and obtained a Scope of
Appointment (SOA) form to discuss Medicare Advantage Plans with a
consumer. When you arrive at the appointment, a friend of the
consumer who is Medicare-eligible is present to hear your
presentation. What should you do? - CORRECT ANSWER Before you
can start the appointment with both consumers, ask the consumer's
friend to complete an SOA.
Educational events allow for which of the following to occur? -
CORRECT ANSWER Provide objective information about the Medicare
program and/or health improvement and wellness.
Agent Brenda is presenting Medicare Advantage plan options to her
consumer, Melanie. During the presentation, Brenda tells Melanie that
Medicare gives each plan a Star Rating. Which of the following is not
an appropriate response when Melanie asks what the Star Rating
means? - CORRECT ANSWER Brenda should tell Melanie that the Star
Rating is the same for every plan and it does not accurately reflect a
plan's performance in certain categories.
,When does Permission to Contact for Medicare Advantage and/or
Prescription Drug Plans expire? - CORRECT ANSWER Once contact is
made or 9 months from the date the consumer provided permission
(e.g. consumer signature date on BRC) or 90 days if on federal do not
call list, whichever comes first.
Julie, a consumer, is having difficulty understanding the information
her agent, Victor, is presenting at her in-home appointment. She
provides Victor with her cousin's telephone number and email address
and asks him to explain the plan to her cousin, who frequently assists
with her health care decisions. The next day, Victor emails Julie's
cousin. Has Victor been compliant? - CORRECT ANSWER No. Victor
violated United Healthcare permission to contact guidelines by
emailing the cousin without the cousin's permission.
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? - CORRECT ANSWER 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 his
mother.
Which of the following is not considered unsolicited contact with a
Medicare eligible consumer according to CMS regulations and
UnitedHealthcare's rules, policies, and procedures? - CORRECT
ANSWER Mailing a marketing brochure to the consumer via postal
mail.
To sign an enrollment application on behalf of a consumer, what
authority must the individual have? - CORRECT ANSWER The
individual must be legally authorized in the state in which the
consumer resides to act on behalf of the consumer (e.g. Power of
Attorney).
As an agent, you must not do which of the following when marketing
UnitedHealthcare Medicare Advantage plans to consumers? -
CORRECT ANSWER 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 only enroll a consumer in a
product: - CORRECT ANSWER That is suitable for the consumer's
needs, goals, and financial resources.
What is the purpose of the Statement of Understanding? - CORRECT
ANSWER It ensures that when consumers sign the Medicare
Advantage and/or Part D Enrollment Application, they are
acknowledging their understanding that they are actually enrolling, in
which plan they are enrolling, and standard disclosures.
What is the definition of Fraud? - CORRECT ANSWER Fraud is
intentionally misrepresenting or concealing facts to obtain something
of value.
Which of the items listed are examples of Fraud, Waste, and Abuse
(FWA)? - CORRECT ANSWER - Submitting claims for services or
supplies that were never provided
- Consulting with a number of doctors in order to obtain multiple
prescriptions for the same drug.
- Billing for brand name drugs when generics were dispensed.
Whose email address may the agent enter into the LEAN enrollment
application? - CORRECT ANSWER Only the consumer's (or leave it
blank).
Which election period occurs from October 15 to December 7? -
CORRECT ANSWER Annual Election Period (AEP)
Which of the following materials is an agent NOT permitted to display
and/or distribute at a marketing /sales event? - CORRECT ANSWER 5
dollar gift cards to an in-network pharmacy.
Providing objective information about the Medicare program and/or
health improvement and wellness at public venues is the purpose of
which of the following? - CORRECT ANSWER Educational events
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
In terms of events, which of the following is true? - CORRECT
ANSWER WRONG - Agents must report formal marketing/sales events
only to UnitedHealthcare
When completing an enrollment application in LEAN, why is an agent
prohibited from entering their own email address in a field available for
the consumer's email address? - CORRECT ANSWER The
consumer/member would not receive plan related correspondence
intended for him/her.
Annual Election Period (AEP) is a time when: - CORRECT ANSWER
Consumers can elect to join a Medicare Advantage Plan or switch to a
different plan.
You have scheduled an appointment and obtained a Scope of
Appointment (SOA) form to discuss Medicare Advantage Plans with a
consumer. When you arrive at the appointment, a friend of the
consumer who is Medicare-eligible is present to hear your
presentation. What should you do? - CORRECT ANSWER Before you
can start the appointment with both consumers, ask the consumer's
friend to complete an SOA.
Educational events allow for which of the following to occur? -
CORRECT ANSWER Provide objective information about the Medicare
program and/or health improvement and wellness.
Agent Brenda is presenting Medicare Advantage plan options to her
consumer, Melanie. During the presentation, Brenda tells Melanie that
Medicare gives each plan a Star Rating. Which of the following is not
an appropriate response when Melanie asks what the Star Rating
means? - CORRECT ANSWER Brenda should tell Melanie that the Star
Rating is the same for every plan and it does not accurately reflect a
plan's performance in certain categories.
,When does Permission to Contact for Medicare Advantage and/or
Prescription Drug Plans expire? - CORRECT ANSWER Once contact is
made or 9 months from the date the consumer provided permission
(e.g. consumer signature date on BRC) or 90 days if on federal do not
call list, whichever comes first.
Julie, a consumer, is having difficulty understanding the information
her agent, Victor, is presenting at her in-home appointment. She
provides Victor with her cousin's telephone number and email address
and asks him to explain the plan to her cousin, who frequently assists
with her health care decisions. The next day, Victor emails Julie's
cousin. Has Victor been compliant? - CORRECT ANSWER No. Victor
violated United Healthcare permission to contact guidelines by
emailing the cousin without the cousin's permission.
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? - CORRECT ANSWER 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 his
mother.
Which of the following is not considered unsolicited contact with a
Medicare eligible consumer according to CMS regulations and
UnitedHealthcare's rules, policies, and procedures? - CORRECT
ANSWER Mailing a marketing brochure to the consumer via postal
mail.
To sign an enrollment application on behalf of a consumer, what
authority must the individual have? - CORRECT ANSWER The
individual must be legally authorized in the state in which the
consumer resides to act on behalf of the consumer (e.g. Power of
Attorney).
As an agent, you must not do which of the following when marketing
UnitedHealthcare Medicare Advantage plans to consumers? -
CORRECT ANSWER 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 only enroll a consumer in a
product: - CORRECT ANSWER That is suitable for the consumer's
needs, goals, and financial resources.
What is the purpose of the Statement of Understanding? - CORRECT
ANSWER It ensures that when consumers sign the Medicare
Advantage and/or Part D Enrollment Application, they are
acknowledging their understanding that they are actually enrolling, in
which plan they are enrolling, and standard disclosures.
What is the definition of Fraud? - CORRECT ANSWER Fraud is
intentionally misrepresenting or concealing facts to obtain something
of value.
Which of the items listed are examples of Fraud, Waste, and Abuse
(FWA)? - CORRECT ANSWER - Submitting claims for services or
supplies that were never provided
- Consulting with a number of doctors in order to obtain multiple
prescriptions for the same drug.
- Billing for brand name drugs when generics were dispensed.
Whose email address may the agent enter into the LEAN enrollment
application? - CORRECT ANSWER Only the consumer's (or leave it
blank).
Which election period occurs from October 15 to December 7? -
CORRECT ANSWER Annual Election Period (AEP)
Which of the following materials is an agent NOT permitted to display
and/or distribute at a marketing /sales event? - CORRECT ANSWER 5
dollar gift cards to an in-network pharmacy.
Providing objective information about the Medicare program and/or
health improvement and wellness at public venues is the purpose of
which of the following? - CORRECT ANSWER Educational events
