AHIP module 4 LATEST UPDATE
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? - ANSWER c. Medicare Advantage (MA) and Prescription Drug (PDP) plans Correct
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? - ANSWER 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. Correct
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? -
ANSWER b. You must submit your materials to the plan you represent, so CMS can review and approve
the materials to ensure they are accurate. Correct
Which of the following is a correct statement about state laws as they pertain to marketing
representatives? - ANSWER d. Medicare health plans must comply with requests for information from
state insurance departments investigating complaints about a marketing representative. Correct
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? - ANSWER a. 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. Correct
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? - ANSWER d.
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 requirements. Correct
, 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
You are meeting with Mrs. Hall in her home. On her scope of appointment form she asked to discuss
Medicare Advantage plans. During the meeting, she asks to discuss a stand-alone prescription drug plan.
She is leaving the next day to visit her family for a week in another state, so it is important to her to
make a decision before she leaves. What must happen before that additional discussion can take place? -
ANSWER a. Since Mrs. Hall specifically asked that you discuss the stand-alone Part D plan, you may do so,
as long as she signs a new scope of appointment form first, indicating that she wants to discuss the Part
D plan. Correct
Which of the following statements best describes how business reply cards (BRCs) may be employed in
the marketing of Medicare Advantage products? - ANSWER b. A BRC may be used to document a
beneficiary's scope of appointment agreement provided it has been submitted to CMS for approval and
includes a statement informing the beneficiary that a salesperson may call. Correct
Ordinarily, you obtain referrals from a third-party that initiates contact with potential clients and usually
sets up appointments for you. How would the guidelines for marketing Medicare Advantage and Part D
plans apply to this practice? - ANSWER c. 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 Medicare Advantage or Part D plans. Correct
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 Medicare Advantage and Part D
plans, what must you do about contacting potential clients to market those plans? - ANSWER d. You will
have to avoid calling any potential client, unless he or she initiates contact with you and specifically asks
that you give him or her a call. Correct
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for advice
as to whether this is possible. What should you tell her? - ANSWER c. Marketing representatives may
initiate electronic contact through e-mail but the subject line must say "marketing" and an opt-out
process must be provided. Correct
Winthrop Brokerage wishes to place an advertisement in the local newspaper that says: "We offer
Medicare Advantage plans offered by AB Health and Top Choice Health. Contact us if you would like to
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? - ANSWER c. Medicare Advantage (MA) and Prescription Drug (PDP) plans Correct
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? - ANSWER 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. Correct
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? -
ANSWER b. You must submit your materials to the plan you represent, so CMS can review and approve
the materials to ensure they are accurate. Correct
Which of the following is a correct statement about state laws as they pertain to marketing
representatives? - ANSWER d. Medicare health plans must comply with requests for information from
state insurance departments investigating complaints about a marketing representative. Correct
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? - ANSWER a. 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. Correct
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? - ANSWER d.
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 requirements. Correct
, 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
You are meeting with Mrs. Hall in her home. On her scope of appointment form she asked to discuss
Medicare Advantage plans. During the meeting, she asks to discuss a stand-alone prescription drug plan.
She is leaving the next day to visit her family for a week in another state, so it is important to her to
make a decision before she leaves. What must happen before that additional discussion can take place? -
ANSWER a. Since Mrs. Hall specifically asked that you discuss the stand-alone Part D plan, you may do so,
as long as she signs a new scope of appointment form first, indicating that she wants to discuss the Part
D plan. Correct
Which of the following statements best describes how business reply cards (BRCs) may be employed in
the marketing of Medicare Advantage products? - ANSWER b. A BRC may be used to document a
beneficiary's scope of appointment agreement provided it has been submitted to CMS for approval and
includes a statement informing the beneficiary that a salesperson may call. Correct
Ordinarily, you obtain referrals from a third-party that initiates contact with potential clients and usually
sets up appointments for you. How would the guidelines for marketing Medicare Advantage and Part D
plans apply to this practice? - ANSWER c. 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 Medicare Advantage or Part D plans. Correct
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 Medicare Advantage and Part D
plans, what must you do about contacting potential clients to market those plans? - ANSWER d. You will
have to avoid calling any potential client, unless he or she initiates contact with you and specifically asks
that you give him or her a call. Correct
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for advice
as to whether this is possible. What should you tell her? - ANSWER c. Marketing representatives may
initiate electronic contact through e-mail but the subject line must say "marketing" and an opt-out
process must be provided. Correct
Winthrop Brokerage wishes to place an advertisement in the local newspaper that says: "We offer
Medicare Advantage plans offered by AB Health and Top Choice Health. Contact us if you would like to
