AHIP Training Module 4 Marketing Complete Answers

AHIP Training Module 4 Marketing Complete Answers Question 1: As a Medicare agent, you should review CMS' Marketing guidelines to ensure compliance for which type of products? Answer: You should review the guidelines for MA and PDP products. Question 2: Can an agent working for a third-party marketing organization claim they don't need to take the Medicare training or pass a test to market Medicare plans? Answer: No, this is incorrect. Agents selling Medicare plans must comply with all Medicare marketing rules, regardless of their employment status. Question 3: What do you need to do with your marketing materials before using them to market MA and Part D plans? Answer: You must submit your materials to the plan you represent for CMS review and approval to ensure they are accurate. Question 4: What is a correct statement about state laws as they pertain to marketing representatives? Answer: Medicare health plans must comply with requests for information from state insurance departments investigating complaints about a marketing representative. Question 5: If you're seeking to represent an MA plan and a Part D plan but didn't pass the training tests, what can you do? Answer: You will not be able to represent any MA or Part D plan until you complete the training and achieve an adequate score. Question 6: Is it true that agents selling employer/union group plans are exempt from testing? Answer: 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. Question 7: What would be the correct statement to say during a sales presentation about a 5-star rated MA plan with an overall performance rating of 4 stars? Answer: The MA plan received a 4-star overall performance rating, but specifically received a 5-star rating in customer service and care coordination. Question 8: What do you tell a client who asks whether the Medicare agency recommends enrolling in your plan or staying in Original Medicare? Answer: You should tell her that the Medicare agency does not endorse or recommend any specific plan. Question 9: How can Medicare health plans establish provisions in marketing representative contracts to ensure compliance with applicable laws and policies? Answer: Plans can establish provisions in contracts that require agents to comply with applicable laws and policies. If non-compliance occurs, CMS can penalize a plan by requiring it to create a corrective action plan and terminate its contract. Question 10: What must you do before conducting an in-home sales presentation with a client who expressed interest in your Medicare plans? Answer: Prior to conducting the presentation, obtain and document her permission to visit, along with her interest in the specific products you will present. Question 11: What are you permitted to do during an appointment with a client who wants to discuss MA plans and later asks about a stand-alone Part D plan? Answer: You can discuss the Part D plan as long as she signs a new scope of appointment form indicating she wants to discuss the Part D plan. Question 12: How long must you retain scope of appointment forms? Answer: You must retain scope of appointment forms for a period of ten years. 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. ️ You market many different types of insurance and ordinarily you spend time each evening calling potential clients. To be in compliance with requirements for marketing MA and Part D plans, what must you do about contact potential clients to market those plans? ️You will have to AVOID calling any potential client, unless he or she initiates contact with you and specifically asks that you give him/her a call. During a sales presentation for a PFFS plan, which of the following points should you explain? ️That the beneficiary, NOT the plan, is responsible for the entire cost for services she obtains that are not medically necessary. VALESQUEZ asked if the PFFS plan you have discussed is like Original Medicare or a Medigap supplement plan. What should you say about a PFFS plan to explain it to Mr. Valesquez? ️It is NOT Original Medicare and it works differently than a Medicare supplement plan. By contact plans available in your area, you have learned that the plan you represent has a significantly lower monthly premium than the others. Furthermore, you see that the plan you represent has a unique benefit package. What should you do to make sure your clients know about these pieces of information? ️You must present comparative information that has been created and approved by the CMS, such as a print out from the Medicare plan comparison website. One of your colleagues argues that face to face meetings with potential enrollees should be required because they can't make an appropriate decision with the minimal information that can be provided over the phone or in small brochures. ️This is INCORRECT. Brokers and agents CAN'T require face to face meetings in order to answer questions or enroll a Medicare beneficiary. You are scheduled to give a sales presentation at a local senior center. At the beginning of the presentation, which of the following must you do? ️Clearly state that NO obligation exists to enroll if a gift or prize is being offered. Ordinarily, you ask your clients for referrals to people they think would benefit from the products you offer. When selling MA or Part D products, how might you solicit referrals? ️You may solicit referrals from current MA and Part D enrollees and offer one thank you gift per member per year of less than $15, based on retail purchase price of the item, although you may NOT inform enrollees of the availability of the gift in your letter soliciting referrals. When soliciting referrals from current member of an MA or Part D plan, what may you do? ️You MAY request names and mailing addresses. You can give away more than one gift during a single event, but the aggregate retail value CAN'T exceed $15 each. ️ Your friend's mother just moved to an assisted living facility and he asked if you could present a program for the residents about the MA-Pd plans you market. What could you tell him? ️You appreciate the opportunity and would be happy to schedule an appointment with anyone at their request. Plan sponsors may undertake the following marketing activities with current MA members? ️Market non-Medicare health related products, such a dental insurance, to current members as permitted by HIPPA Privacy Rules This year you have decided to focus your efforts on marketing to employer group plans. One employer provides you with a list of their retirees and asks you to contact them to explain the characteristics of the plan they have selected. ️You MAY go ahead and call them. Next week you will be participating in your First educational event. In order to be sure that you do not violate any of the applicable guidelines, in what activities should you plan to engage? ️You should plan to ensure that the educational event is a social event, and must NOT conduct a sales presentation or distribute or accept enrollment forms at the event. If you are to be in compliance with Medicare's guidelines regarding educational events, which of the following would be acceptable activities? ️You may distribute business cards to individuals who request information on how to contact you for further details on the plan(s) you represent. You plan to participate in an educational event sponsored by a large regional health care system. One of your colleagues suggests that you do a presentation on one of the Medicare health plans you market, and modify it to include information about preventive screening tests showcased at the event. How should you respond to your colleague's suggestion? ️You should tell your colleague NO because participation in an educational event may NOT include a sales presentation. Another agent you know has engaged in misconduct that has been verified by the plan she represented. What sort of penalty might the plan impose on this individual? ️The plan may withhold commission, require retraining, report the misconduct to the state dept. of insurance or terminate the contract. The Medicare agency has requested a list of contracted representatives from a PFFS plan that you represent. In this situation, what will the plan do? ️Plans will provide to the Medicare agency a complete list of all of their contracted representatives who are marketing PFFS products, and will authorize the agency to provide those names to state departments of insurance when they request it. With regard to the training you are currently taking, what involvement will CMS have in ensuring that it takes place? ️CMS will conduct oversight of plan training programs and plans must provide the agency with any information necessary for the agency to conduct such oversight. The Medicare agency requires ALL Medicare health plans that contract with marketing representatives to ensure that contracts address which of the following? ️Medicare health plans MUST include in ALL marketing representatives contracts requirements to abide by all guidance from the Federal agency overseeing Medicare and all applicable state laws. 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? ️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.