WellCare ACT Mastery Exam VERIFIED ANSWERS
ALREADY GRADED A+ NEW GUARANTEED
When a paper SOA form is used, it must be completed __________
hosting the sales presentation. - CORRECT ANSWER Prior to
A broker/agent who has never had any verbal warnings cannot be
issued a Corrective Action Plan. - CORRECT ANSWER False
A Health Risk Assessment (HRA) can be completed for C-SNP and D-
SNP plans only, before the enrollment application process in Ascend
through the Value Based Enrollment (VBE) portal. - CORRECT
ANSWER False
Health risk assessment (HRA) - CORRECT ANSWER All of the
above
Although options for capturing and submitting SOAs vary by health
plan, Wellcare accepts SOAs in which of the following methods? -
CORRECT ANSWER All of the above
Low-Income Subsidy (LIS)/Medicaid Lookup status verification in
Ascend is:
(Select all that apply.) - CORRECT ANSWER -Available for LIS
level searches in all states
-Available for Medicaid status searches in select states.
-A way to assist brokers/agents with enrolling beneficiaries into the
right plan based on their extra help status.
,When discussing prescription drug coverage, you should:
(Select all that apply.) - CORRECT ANSWER -Explain how to use
the formulary to look up limitations and exclusions (e.g., step therapy,
quantity limits).
-Confirm coverage of the beneficiary's current and/or anticipated
prescriptions.
-Explain formulary tiers as well as drug copayment amounts.
-For drugs that are not covered by the new plan, explain the Transition
Fill program and how to request a coverage exception
Communication of PHI can be:
(Select all that apply.) - CORRECT ANSWER Written
Electronic
Verbal
Wellcare must receive notice of an event change or cancellation as
soon as possible, but no later than 30 minutes after the event start
time. - CORRECT ANSWER False
Which elements are available as part of Wellcare's sales support
model? - CORRECT ANSWER All of the above
Brokers/Agents must meet all required contracting, training, and
certification requirements to be eligible to sell Wellcare's Medicare
Products. - CORRECT ANSWER True
What are some examples of what can trigger a beneficiary complaint?
(Select all that apply.) - CORRECT ANSWER -Did not consent to
enroll in the plan.
-Received incorrect plan benefit information or were dissatisfied with
plan benefits.
,-Had enrollment/disenrollment issues (e.g., disenrollment/cancellation
requests, late enrollment penalty, loss of entitlement).
-Were misled about which providers were in-network
Noting the correct enrollment period on enrollment applications helps
in preventing delayed enrollment processing. - CORRECT ANSWER
True
Key areas you as a broker/agent have control over and impact upon
regarding Star Ratings for quality are: - CORRECT ANSWER All of
the above
Health plan fax numbers vary for health plans that offer fax
enrollment submissions. - CORRECT ANSWER True
Which of the following actions are you required to do when contacted
regarding an allegation of noncompliant activity? - CORRECT
ANSWER All of the above
Which of the following statements about Scope of Appointment (SOA)
is FALSE? - CORRECT ANSWER An electronic SOA submitted in
Ascend must be in a Pending status prior to beginning the
appointment.
The information contained within ACT will equip brokers/agents to
certify, market, and sell which health plans? - CORRECT ANSWER
All of the above
The _________ plan is expected to have one of the lowest premiums in
the country! - CORRECT ANSWER Value Script
____ PDPs will be offered across all 50 U.S. states and Washington,
D.C. - CORRECT ANSWER Three
, For PDP Medication Home Delivery, the ____ plan will continue to
offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. -
CORRECT ANSWER Value Plus
The Wellcare preferred pharmacy network includes Walgreens, CVS,
and many grocery chains in 2023. - CORRECT ANSWER True
Value Script and Value Plus PDP products have a ___-tier formulary
structure for 2023. - CORRECT ANSWER 6
Centene has new PPO D-SNP product expansion in CT, IN, KS, KY,
MS, OH, OK, PA, SC, and a new HMO D-SNP in LA. - CORRECT
ANSWER True
Which standalone Prescription Drug Plan is best for a dual-eligible
chooser? - CORRECT ANSWER Classic
The Part D Senior Savings Model (SSM), which reduces member
spending on insulin, will be offered on all Value Script, Value Plus
PDPs, and select Wellcare MAPD plans. - CORRECT ANSWER True
There are ___ LIS copay categories that could be assigned to a member,
depending on the level of need. - CORRECT ANSWER Four
For 2023, Ascension Complete added 27 new counties to their footprint.
- CORRECT ANSWER True
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through
CVS Medication Home Delivery (Mail Order). - CORRECT ANSWER
True
ALREADY GRADED A+ NEW GUARANTEED
When a paper SOA form is used, it must be completed __________
hosting the sales presentation. - CORRECT ANSWER Prior to
A broker/agent who has never had any verbal warnings cannot be
issued a Corrective Action Plan. - CORRECT ANSWER False
A Health Risk Assessment (HRA) can be completed for C-SNP and D-
SNP plans only, before the enrollment application process in Ascend
through the Value Based Enrollment (VBE) portal. - CORRECT
ANSWER False
Health risk assessment (HRA) - CORRECT ANSWER All of the
above
Although options for capturing and submitting SOAs vary by health
plan, Wellcare accepts SOAs in which of the following methods? -
CORRECT ANSWER All of the above
Low-Income Subsidy (LIS)/Medicaid Lookup status verification in
Ascend is:
(Select all that apply.) - CORRECT ANSWER -Available for LIS
level searches in all states
-Available for Medicaid status searches in select states.
-A way to assist brokers/agents with enrolling beneficiaries into the
right plan based on their extra help status.
,When discussing prescription drug coverage, you should:
(Select all that apply.) - CORRECT ANSWER -Explain how to use
the formulary to look up limitations and exclusions (e.g., step therapy,
quantity limits).
-Confirm coverage of the beneficiary's current and/or anticipated
prescriptions.
-Explain formulary tiers as well as drug copayment amounts.
-For drugs that are not covered by the new plan, explain the Transition
Fill program and how to request a coverage exception
Communication of PHI can be:
(Select all that apply.) - CORRECT ANSWER Written
Electronic
Verbal
Wellcare must receive notice of an event change or cancellation as
soon as possible, but no later than 30 minutes after the event start
time. - CORRECT ANSWER False
Which elements are available as part of Wellcare's sales support
model? - CORRECT ANSWER All of the above
Brokers/Agents must meet all required contracting, training, and
certification requirements to be eligible to sell Wellcare's Medicare
Products. - CORRECT ANSWER True
What are some examples of what can trigger a beneficiary complaint?
(Select all that apply.) - CORRECT ANSWER -Did not consent to
enroll in the plan.
-Received incorrect plan benefit information or were dissatisfied with
plan benefits.
,-Had enrollment/disenrollment issues (e.g., disenrollment/cancellation
requests, late enrollment penalty, loss of entitlement).
-Were misled about which providers were in-network
Noting the correct enrollment period on enrollment applications helps
in preventing delayed enrollment processing. - CORRECT ANSWER
True
Key areas you as a broker/agent have control over and impact upon
regarding Star Ratings for quality are: - CORRECT ANSWER All of
the above
Health plan fax numbers vary for health plans that offer fax
enrollment submissions. - CORRECT ANSWER True
Which of the following actions are you required to do when contacted
regarding an allegation of noncompliant activity? - CORRECT
ANSWER All of the above
Which of the following statements about Scope of Appointment (SOA)
is FALSE? - CORRECT ANSWER An electronic SOA submitted in
Ascend must be in a Pending status prior to beginning the
appointment.
The information contained within ACT will equip brokers/agents to
certify, market, and sell which health plans? - CORRECT ANSWER
All of the above
The _________ plan is expected to have one of the lowest premiums in
the country! - CORRECT ANSWER Value Script
____ PDPs will be offered across all 50 U.S. states and Washington,
D.C. - CORRECT ANSWER Three
, For PDP Medication Home Delivery, the ____ plan will continue to
offer a discount for 90-day tier 2, tier 3 and tier 6 prescriptions. -
CORRECT ANSWER Value Plus
The Wellcare preferred pharmacy network includes Walgreens, CVS,
and many grocery chains in 2023. - CORRECT ANSWER True
Value Script and Value Plus PDP products have a ___-tier formulary
structure for 2023. - CORRECT ANSWER 6
Centene has new PPO D-SNP product expansion in CT, IN, KS, KY,
MS, OH, OK, PA, SC, and a new HMO D-SNP in LA. - CORRECT
ANSWER True
Which standalone Prescription Drug Plan is best for a dual-eligible
chooser? - CORRECT ANSWER Classic
The Part D Senior Savings Model (SSM), which reduces member
spending on insulin, will be offered on all Value Script, Value Plus
PDPs, and select Wellcare MAPD plans. - CORRECT ANSWER True
There are ___ LIS copay categories that could be assigned to a member,
depending on the level of need. - CORRECT ANSWER Four
For 2023, Ascension Complete added 27 new counties to their footprint.
- CORRECT ANSWER True
All PDPs will continue to offer $0 tier 1 preferred cost-sharing through
CVS Medication Home Delivery (Mail Order). - CORRECT ANSWER
True
