UHC 2026
UHC Ethics and Compliance Certification Exam: Complete
2026/2027 Edition – 200 Evidence-Based Questions with
Expert-Verified Answers and Detailed Rationales for
Medicare Advantage Agent Certification Success
UHC Ethics and Compliance Certification Exam
2026/2027 Edition | Medicare Advantage Certification
QUESTION 1:
Which statement is true regarding the purpose of the Statement of Understanding?
A. It serves as a binding contract between the consumer and the Medicare Advantage plan.
B. It ensures consumers acknowledge their understanding that they are actually enrolling, in which
plan they are enrolling, and standard disclosures.
C. It replaces the need for a Scope of Appointment form for all marketing appointments.
D. It provides the agent with permission to contact the consumer for future sales activities.
ANSWER:
B. It ensures consumers acknowledge their understanding that they are actually enrolling, in which
plan they are enrolling, and standard disclosures.
RATIONALE:
The Statement of Understanding is a critical enrollment document that confirms the consumer's
awareness and comprehension of their enrollment decision. It ensures that when consumers
complete 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 . Option A is incorrect because the Statement of Understanding is not a contract; it is an
acknowledgment form. Option C is incorrect because the Statement of Understanding does not
replace the Scope of Appointment requirement. Option D is incorrect because the Statement of
Understanding is not a permission-to-contact mechanism.
QUESTION 2:
Melanie is currently enrolled in an HMO MAPD, and she is talking to sales agent Brenda about
enrolling in a Medicare Supplement Insurance Plan. What should Brenda tell Melanie?
A. She can keep her MA Plan and add the Medicare Supplement Plan for additional coverage.
B. She will need to wait until the Annual Election Period to make any changes.
C. She is automatically disenrolled from her MA Plan if she enrolls in a Medicare Supplement
Insurance Plan.
D. She must first obtain a referral from her primary care physician before enrolling.
, UHC 2026
ANSWER:
C. She is automatically disenrolled from her MA Plan if she enrolls in a Medicare Supplement
Insurance Plan.
RATIONALE:
Federal regulations prohibit consumers from being enrolled in both a Medicare Advantage Plan and
a Medicare Supplement Insurance Plan simultaneously. If a consumer enrolls in a Medicare
Supplement Insurance Plan while already enrolled in a Medicare Advantage Plan, they are
automatically disenrolled from their MA Plan . Option A is incorrect because consumers cannot
maintain both types of coverage. Option B is incorrect because enrollment in a Medicare
Supplement Plan is not limited to the Annual Election Period. Option D is incorrect because a referral
is not required for Medicare Supplement enrollment.
QUESTION 3:
Which of the following is NOT considered prohibited unsolicited contact with a Medicare eligible
consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures?
A. Approaching a consumer in a common area of a senior living complex.
B. Emailing a marketing brochure to a consumer whose email address was obtained on a purchased
lead list.
C. Mailing a marketing brochure to the consumer via postal mail.
D. Placing a marketing brochure on the door handle of the consumer's residence.
ANSWER:
C. Mailing a marketing brochure to the consumer via postal mail.
RATIONALE:
CMS regulations and UnitedHealthcare's policies generally prohibit unsolicited contact with
Medicare-eligible consumers through most channels. However, mailing a marketing brochure via
postal mail is NOT considered prohibited unsolicited contact . Options A, B, and D all represent forms
of unsolicited contact that are prohibited. Approaching consumers in common areas, emailing to
purchased lists, and placing materials on door handles are all considered impermissible methods of
initiating contact without prior permission.
QUESTION 4:
Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her
Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or
Prescription Drug plan?
A. March 1 through July 31
B. April 1 through October 31
C. July 1 through December 30
D. June 1 through July 31
ANSWER:
B. April 1 through October 31
, UHC 2026
RATIONALE:
The Initial Election Period (IEP) for Medicare Advantage and Prescription Drug Plans is a seven-
month period that begins three months before the month an individual first becomes entitled to
both Medicare Part A and Part B, includes the month of entitlement, and ends three months after.
Since Cynthia's Part A and Part B are effective July 1, her IEP runs from April 1 through October 31 .
Option A incorrectly starts in March, Option C extends too far beyond the three-month post-
entitlement window, and Option D incorrectly limits the period to only two months.
QUESTION 5:
What does the acronym SOA stand for in the context of Medicare marketing and sales?
A. Statement of Authorization
B. Scope of Appointment
C. Sales Opportunity Assessment
D. Standard Operating Agreement
ANSWER:
B. Scope of Appointment
RATIONALE:
SOA stands for Scope of Appointment . The Scope of Appointment is an agreement obtained from
the consumer that identifies the scope of products that can be discussed at a personal/individual
marketing appointment, whether in-person or telephonic . It captures the consumer's permission to
discuss certain products and is required from each Medicare-eligible consumer present at any face-
to-face or telephonic marketing appointment to discuss MA and/or PDP plans . Options A, C, and D
are not correct acronym definitions for SOA.
QUESTION 6:
A consumer currently has Original Medicare and is enrolled in a stand-alone Prescription Drug Plan
(PDP). What will happen if the consumer enrolls in an MA Plan that has integrated prescription drug
coverage?
A. The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in
the MA Plan.
B. The consumer will maintain both coverages and have dual prescription drug benefits.
C. The consumer will need to actively disenroll from their stand-alone PDP before the MA Plan
enrollment is effective.
D. The consumer will have a 30-day grace period to decide which coverage to keep.
ANSWER:
A. The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in
the MA Plan.
RATIONALE:
Medicare regulations provide that when a consumer enrolls in a Medicare Advantage Plan that
includes integrated prescription drug coverage, they are automatically disenrolled from their stand-
, UHC 2026
alone PDP . This prevents consumers from having dual prescription drug coverage and ensures
proper coordination of benefits. Option B is incorrect because dual coverage is not permitted.
Option C is incorrect because the automatic disenrollment occurs without requiring active
disenrollment. Option D is incorrect because there is no grace period for maintaining both
coverages.
QUESTION 7:
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer?
A. When the agent obtains the consumer's phone number from a purchased lead list.
B. When the consumer consents to be contacted for sales activities and the permission has not yet
expired.
C. When the agent has previously met the consumer at a community event.
D. When the consumer's neighbor provides the phone number as a referral.
ANSWER:
B. When the consumer consents to be contacted for sales activities and the permission has not yet
expired.
RATIONALE:
CMS regulations and UnitedHealthcare policies require that telephonic contact with Medicare-
eligible consumers only occur when the consumer has provided consent to be contacted for sales
activities and that permission has not yet expired . Option A is incorrect because purchased lead lists
do not constitute valid consent for telephonic contact. Option C is incorrect because prior in-person
meeting does not automatically grant telephonic contact permission. Option D is incorrect because
third-party referrals do not provide the required consumer consent.
QUESTION 8:
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or
her own email address in a field available for the consumer's email address?
A. It would cause the enrollment application to be delayed for manual review.
B. The enrollment application may be denied.
C. It is a violation of the agent's compensation agreement.
D. It would require additional documentation to be submitted.
ANSWER:
B. The enrollment application may be denied.
RATIONALE:
Agents are prohibited from entering their own email address in the consumer's email field when
completing an enrollment application in LEAN. If an agent enters his or her own email address, the
enrollment application may be denied . The consumer's email address must belong to the consumer,
and entering inaccurate or misleading information on an enrollment application is a compliance
UHC Ethics and Compliance Certification Exam: Complete
2026/2027 Edition – 200 Evidence-Based Questions with
Expert-Verified Answers and Detailed Rationales for
Medicare Advantage Agent Certification Success
UHC Ethics and Compliance Certification Exam
2026/2027 Edition | Medicare Advantage Certification
QUESTION 1:
Which statement is true regarding the purpose of the Statement of Understanding?
A. It serves as a binding contract between the consumer and the Medicare Advantage plan.
B. It ensures consumers acknowledge their understanding that they are actually enrolling, in which
plan they are enrolling, and standard disclosures.
C. It replaces the need for a Scope of Appointment form for all marketing appointments.
D. It provides the agent with permission to contact the consumer for future sales activities.
ANSWER:
B. It ensures consumers acknowledge their understanding that they are actually enrolling, in which
plan they are enrolling, and standard disclosures.
RATIONALE:
The Statement of Understanding is a critical enrollment document that confirms the consumer's
awareness and comprehension of their enrollment decision. It ensures that when consumers
complete 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 . Option A is incorrect because the Statement of Understanding is not a contract; it is an
acknowledgment form. Option C is incorrect because the Statement of Understanding does not
replace the Scope of Appointment requirement. Option D is incorrect because the Statement of
Understanding is not a permission-to-contact mechanism.
QUESTION 2:
Melanie is currently enrolled in an HMO MAPD, and she is talking to sales agent Brenda about
enrolling in a Medicare Supplement Insurance Plan. What should Brenda tell Melanie?
A. She can keep her MA Plan and add the Medicare Supplement Plan for additional coverage.
B. She will need to wait until the Annual Election Period to make any changes.
C. She is automatically disenrolled from her MA Plan if she enrolls in a Medicare Supplement
Insurance Plan.
D. She must first obtain a referral from her primary care physician before enrolling.
, UHC 2026
ANSWER:
C. She is automatically disenrolled from her MA Plan if she enrolls in a Medicare Supplement
Insurance Plan.
RATIONALE:
Federal regulations prohibit consumers from being enrolled in both a Medicare Advantage Plan and
a Medicare Supplement Insurance Plan simultaneously. If a consumer enrolls in a Medicare
Supplement Insurance Plan while already enrolled in a Medicare Advantage Plan, they are
automatically disenrolled from their MA Plan . Option A is incorrect because consumers cannot
maintain both types of coverage. Option B is incorrect because enrollment in a Medicare
Supplement Plan is not limited to the Annual Election Period. Option D is incorrect because a referral
is not required for Medicare Supplement enrollment.
QUESTION 3:
Which of the following is NOT considered prohibited unsolicited contact with a Medicare eligible
consumer according to CMS regulations and UnitedHealthcare's rules, policies, and procedures?
A. Approaching a consumer in a common area of a senior living complex.
B. Emailing a marketing brochure to a consumer whose email address was obtained on a purchased
lead list.
C. Mailing a marketing brochure to the consumer via postal mail.
D. Placing a marketing brochure on the door handle of the consumer's residence.
ANSWER:
C. Mailing a marketing brochure to the consumer via postal mail.
RATIONALE:
CMS regulations and UnitedHealthcare's policies generally prohibit unsolicited contact with
Medicare-eligible consumers through most channels. However, mailing a marketing brochure via
postal mail is NOT considered prohibited unsolicited contact . Options A, B, and D all represent forms
of unsolicited contact that are prohibited. Approaching consumers in common areas, emailing to
purchased lists, and placing materials on door handles are all considered impermissible methods of
initiating contact without prior permission.
QUESTION 4:
Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1. Using her
Initial Election Period (IEP), when can she submit an application for a Medicare Advantage or
Prescription Drug plan?
A. March 1 through July 31
B. April 1 through October 31
C. July 1 through December 30
D. June 1 through July 31
ANSWER:
B. April 1 through October 31
, UHC 2026
RATIONALE:
The Initial Election Period (IEP) for Medicare Advantage and Prescription Drug Plans is a seven-
month period that begins three months before the month an individual first becomes entitled to
both Medicare Part A and Part B, includes the month of entitlement, and ends three months after.
Since Cynthia's Part A and Part B are effective July 1, her IEP runs from April 1 through October 31 .
Option A incorrectly starts in March, Option C extends too far beyond the three-month post-
entitlement window, and Option D incorrectly limits the period to only two months.
QUESTION 5:
What does the acronym SOA stand for in the context of Medicare marketing and sales?
A. Statement of Authorization
B. Scope of Appointment
C. Sales Opportunity Assessment
D. Standard Operating Agreement
ANSWER:
B. Scope of Appointment
RATIONALE:
SOA stands for Scope of Appointment . The Scope of Appointment is an agreement obtained from
the consumer that identifies the scope of products that can be discussed at a personal/individual
marketing appointment, whether in-person or telephonic . It captures the consumer's permission to
discuss certain products and is required from each Medicare-eligible consumer present at any face-
to-face or telephonic marketing appointment to discuss MA and/or PDP plans . Options A, C, and D
are not correct acronym definitions for SOA.
QUESTION 6:
A consumer currently has Original Medicare and is enrolled in a stand-alone Prescription Drug Plan
(PDP). What will happen if the consumer enrolls in an MA Plan that has integrated prescription drug
coverage?
A. The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in
the MA Plan.
B. The consumer will maintain both coverages and have dual prescription drug benefits.
C. The consumer will need to actively disenroll from their stand-alone PDP before the MA Plan
enrollment is effective.
D. The consumer will have a 30-day grace period to decide which coverage to keep.
ANSWER:
A. The consumer will be automatically disenrolled from their stand-alone PDP upon enrollment in
the MA Plan.
RATIONALE:
Medicare regulations provide that when a consumer enrolls in a Medicare Advantage Plan that
includes integrated prescription drug coverage, they are automatically disenrolled from their stand-
, UHC 2026
alone PDP . This prevents consumers from having dual prescription drug coverage and ensures
proper coordination of benefits. Option B is incorrect because dual coverage is not permitted.
Option C is incorrect because the automatic disenrollment occurs without requiring active
disenrollment. Option D is incorrect because there is no grace period for maintaining both
coverages.
QUESTION 7:
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer?
A. When the agent obtains the consumer's phone number from a purchased lead list.
B. When the consumer consents to be contacted for sales activities and the permission has not yet
expired.
C. When the agent has previously met the consumer at a community event.
D. When the consumer's neighbor provides the phone number as a referral.
ANSWER:
B. When the consumer consents to be contacted for sales activities and the permission has not yet
expired.
RATIONALE:
CMS regulations and UnitedHealthcare policies require that telephonic contact with Medicare-
eligible consumers only occur when the consumer has provided consent to be contacted for sales
activities and that permission has not yet expired . Option A is incorrect because purchased lead lists
do not constitute valid consent for telephonic contact. Option C is incorrect because prior in-person
meeting does not automatically grant telephonic contact permission. Option D is incorrect because
third-party referrals do not provide the required consumer consent.
QUESTION 8:
When completing an enrollment application in LEAN, why is an agent prohibited from entering his or
her own email address in a field available for the consumer's email address?
A. It would cause the enrollment application to be delayed for manual review.
B. The enrollment application may be denied.
C. It is a violation of the agent's compensation agreement.
D. It would require additional documentation to be submitted.
ANSWER:
B. The enrollment application may be denied.
RATIONALE:
Agents are prohibited from entering their own email address in the consumer's email field when
completing an enrollment application in LEAN. If an agent enters his or her own email address, the
enrollment application may be denied . The consumer's email address must belong to the consumer,
and entering inaccurate or misleading information on an enrollment application is a compliance
