UHC Ethic and Compliance 2021 Study Guide, Q&A COMPLETE SOLUTION GUIDE.pdf

UIDE What type of events must an agent report to UnitedHealthcare? - Only the marketing/sales events, both formal and informal. While using LEAN to complete an enrollment application with a consumer, Agent Jeff learns the consumer does not have an email address. What should Jeff do? - Leave any field requesting a consumer email address blank. Which election period occurs from October 15 to December 7? - Annual Election Period (AEP) Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event? - 5 dollar gift cards to an in-network pharmacy. 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? - Before you can start the appointment with both consumers, ask the consumer's friend to complete an SOA. Which describes the purpose of educational events? - Educational events provide objective information about the Medicare program and/or health improvement and wellness. How should agent Erin respond when consumer Mrs. Rose notices that the presented MA Plan has a Star Rating of 2 stars? - Erin should tell Mrs. Rose that the plan has received a "Below Average" rating. When does Permission to Contact for Medicare Advantage and/or Prescription Drug Plans expire? - 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.Consumer Gary gives his friend's telephone number and email address to agent Bethany. What should Bethany do? - Bethany may accept the information, but must observe permission to contact and unsolicited contact guidelines, which will limit her to using postal mail to contact Bethany's friend. 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? - 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. In which of the following situations can telephonic contact be made with a Medicare eligible consumer? - When the consumer consented to be contacted for sales activities, subsequent telephonic contact has not yet occurred, and the permission has not yet expired. To sign an enrollment application on behalf of a consumer, what authority must the individual have? - 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). Which of the following must you not do when marketing UnitedHealthcare Medicare Advantage or Prescription Drug Plans to consumers? - In what product should agents enroll consumers? - A product that is suitable for the consumer's needs, goals and financial resources. What is the purpose of the Statement of Understanding? - 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 Abuse? - Abuse includes any practice that results in the provision of services that are not medically necessary