AHIP Certification - Part 4
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1. b: Mr. Prentice has many clients who are Medicare beneficiaries. He should review
the Centers for Medicare & Medicaid Services' Marketing Guidelines to ensure he
is compliant for which type of products?
a. Medigap plans
b. Medicare Advantage (MA) and Prescription Drug (PDP) plans
c. Section 1332 waiver plans.
d. Long-Term Care policies for Medicare beneficiaries
2. c: 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 requirements as the plans themselves. How should you respond to such
a statement?
a. Your coworker is correct. You may use any marketing techniques that do not
involve providing misinformation to potential enrollees.
b. Your coworker is correct because employed agents have to follow a stricter set of
rules than do independent agents, such as yourself.
c. 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.
d. Your coworker is correct. You are subject only to requirements issued by your state
department of insurance.
3. c: You work for a company that has marketed Medigap products for many years.
The company has added Medicare Advantage and Part D plans and you will begin
marketing those plans this fall. You are planning what materials to use to easily show
the differences 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?
a. Only scripts and marketing practices must be approved by CMS, so you do not
need to do anything further with your marketing materials, as long as you make them
available to anyone who attends the marketing event
b. You do not need to get CMS approval of the materials, so long as the materials
are not misleading or materially inaccurate.
c. You must submit your materials to the plan you represent, so CMS can review
and approve the materials to ensure they are accurate.
d. You need to include a statement that the plans you are marketing are approved
by the Centers for Medicare & Medicaid Services and the Department of Health and
Human Services.
, AHIP Certification - Part 4
Study online at https://quizlet.com/_51ry0j
4. d: Which of the following is a correct statement about state laws as they pertain
to marketing representatives?
a. State licensure laws are pre-empted and do not apply to marketing representa-
tives marketing MA and Part D plans
b. Plan sponsors can use any marketing representative, as long as they are licensed
in at least one state.
c. Plans must contract only with marketing representatives who reside in the state
where they intend to work.
d. Medicare health plans must comply with requests for information from state
insurance departments investigating complaints about a marketing representative.
5. b: 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?
a. Your name will be registered with the Medicare agency by the plans you are
seeking to represent and you will be unable to contract with any Medicare Advantage
or Part D plan.
b. 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.
c. You will have to attend one of several remedial training events sponsored by the
Medicare agency before being allowed to retake the test.
d. You will have to repeat the tests in three months, but may begin enrolling
beneficiaries while you are waiting.
6. c: 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. What could you say to her?
a. You could tell her she is wrong and that only agents employed by the plans are
exempt from training and testing requirements.
b. You could tell her she is right and ask if you could get a contract with the TMO
too.
c. 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
, AHIP Certification - Part 4
Study online at https://quizlet.com/_51ry0j
requirements.
d. You could tell her she was right, but new rules will require her to take the training
and pass the test at least every other year.
7. d: Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple
states. XYZ Agency maintains a website marketing the MA plans with which it has
contracts. Agent Armstrong follows up with individuals who request more information
about ABC MA plans via the website and tries to persuade them to enroll in ABC
plans. What statement best describes the marketing and compliance rules that apply
to Agent Armstrong?
a. Agent Armstrong needs to be licensed and appointed only in his state of
residence.
b. Agent Armstrong needs to be licensed and appointed only in the state where ABC
Health Plan is headquartered.
c. Agent Armstrong needs to be licensed and appointed only in the state where XYZ
Agency is headquartered.
d. Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
8. b: You are mailing invitations to new Medicare beneficiaries for a marketing event.
You want an idea of how many people to expect, so you would like to request RSVPs.
What should you keep in mind?
a. You may not require RSVPs, but when people arrive, you may require completion
of contact information on a sign-up sheet.
b. You may request RSVPs, but you are not permitted to require contact information.
c. You are not permitted to request RSVPs, so you will need to find a different way
to estimate how many people are coming.
d. You may require RSVPs and an e-mail address so you can follow up in the event
of a cancellation.
9. d: Agent Antonio is preparing for a presentation on Medicare and Medicare
Advantage before a local senior citizen civic group where he hopes to enroll some
attendees. Which of the following steps should he take in order to be in compliance
with Medicare marketing rules?
a. Antonio should include a statement that due to the venue limitations accommo-
dations for persons with special needs will not be available.
b. Antonio should include on the invitation that food will be served and alcoholic
beverages will be available free of charge.
Study online at https://quizlet.com/_51ry0j
1. b: Mr. Prentice has many clients who are Medicare beneficiaries. He should review
the Centers for Medicare & Medicaid Services' Marketing Guidelines to ensure he
is compliant for which type of products?
a. Medigap plans
b. Medicare Advantage (MA) and Prescription Drug (PDP) plans
c. Section 1332 waiver plans.
d. Long-Term Care policies for Medicare beneficiaries
2. c: 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 requirements as the plans themselves. How should you respond to such
a statement?
a. Your coworker is correct. You may use any marketing techniques that do not
involve providing misinformation to potential enrollees.
b. Your coworker is correct because employed agents have to follow a stricter set of
rules than do independent agents, such as yourself.
c. 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.
d. Your coworker is correct. You are subject only to requirements issued by your state
department of insurance.
3. c: You work for a company that has marketed Medigap products for many years.
The company has added Medicare Advantage and Part D plans and you will begin
marketing those plans this fall. You are planning what materials to use to easily show
the differences 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?
a. Only scripts and marketing practices must be approved by CMS, so you do not
need to do anything further with your marketing materials, as long as you make them
available to anyone who attends the marketing event
b. You do not need to get CMS approval of the materials, so long as the materials
are not misleading or materially inaccurate.
c. You must submit your materials to the plan you represent, so CMS can review
and approve the materials to ensure they are accurate.
d. You need to include a statement that the plans you are marketing are approved
by the Centers for Medicare & Medicaid Services and the Department of Health and
Human Services.
, AHIP Certification - Part 4
Study online at https://quizlet.com/_51ry0j
4. d: Which of the following is a correct statement about state laws as they pertain
to marketing representatives?
a. State licensure laws are pre-empted and do not apply to marketing representa-
tives marketing MA and Part D plans
b. Plan sponsors can use any marketing representative, as long as they are licensed
in at least one state.
c. Plans must contract only with marketing representatives who reside in the state
where they intend to work.
d. Medicare health plans must comply with requests for information from state
insurance departments investigating complaints about a marketing representative.
5. b: 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?
a. Your name will be registered with the Medicare agency by the plans you are
seeking to represent and you will be unable to contract with any Medicare Advantage
or Part D plan.
b. 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.
c. You will have to attend one of several remedial training events sponsored by the
Medicare agency before being allowed to retake the test.
d. You will have to repeat the tests in three months, but may begin enrolling
beneficiaries while you are waiting.
6. c: 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. What could you say to her?
a. You could tell her she is wrong and that only agents employed by the plans are
exempt from training and testing requirements.
b. You could tell her she is right and ask if you could get a contract with the TMO
too.
c. 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
, AHIP Certification - Part 4
Study online at https://quizlet.com/_51ry0j
requirements.
d. You could tell her she was right, but new rules will require her to take the training
and pass the test at least every other year.
7. d: Agent Armstrong is employed by XYZ Agency, which is under contract with
ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple
states. XYZ Agency maintains a website marketing the MA plans with which it has
contracts. Agent Armstrong follows up with individuals who request more information
about ABC MA plans via the website and tries to persuade them to enroll in ABC
plans. What statement best describes the marketing and compliance rules that apply
to Agent Armstrong?
a. Agent Armstrong needs to be licensed and appointed only in his state of
residence.
b. Agent Armstrong needs to be licensed and appointed only in the state where ABC
Health Plan is headquartered.
c. Agent Armstrong needs to be licensed and appointed only in the state where XYZ
Agency is headquartered.
d. Agent Armstrong needs to be licensed and appointed in every state in which
beneficiaries to whom he markets ABC MA plans are located.
8. b: You are mailing invitations to new Medicare beneficiaries for a marketing event.
You want an idea of how many people to expect, so you would like to request RSVPs.
What should you keep in mind?
a. You may not require RSVPs, but when people arrive, you may require completion
of contact information on a sign-up sheet.
b. You may request RSVPs, but you are not permitted to require contact information.
c. You are not permitted to request RSVPs, so you will need to find a different way
to estimate how many people are coming.
d. You may require RSVPs and an e-mail address so you can follow up in the event
of a cancellation.
9. d: Agent Antonio is preparing for a presentation on Medicare and Medicare
Advantage before a local senior citizen civic group where he hopes to enroll some
attendees. Which of the following steps should he take in order to be in compliance
with Medicare marketing rules?
a. Antonio should include a statement that due to the venue limitations accommo-
dations for persons with special needs will not be available.
b. Antonio should include on the invitation that food will be served and alcoholic
beverages will be available free of charge.
