WellCare ACT Mastery Exam ACTUAL FINAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS - VERIFIED ANSWERS ALREADY GRADED
A+ NEW GUARANTEED
20. Beneficiary-facing marketing materials developed by a Third-Party Marketing
Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can be
reviewed by just one MA organization, submitted to the Centers for Medicare & Medicaid
Services (CMS) in the Health Plan Management System (HPMS), and opted in by the health
plan after distribution. - CORRECT ANSWER FALSE
Enrollment applications must be received by Wellcare no later than ___ calendar day(s)
following receipt from the beneficiary. - CORRECT ANSWER 1
Which elements are available as part of Wellcare's Sales Support model? - CORRECT
ANSWER All of these
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan
premiums - CORRECT ANSWER False
Prior to completing the enrollment form, broker/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists - CORRECT ANSWER True
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of
85% or higher to successfully complete this course - CORRECT ANSWER True
Brokers/Agents may be investigated after being suspected of noncompliant activity reported
through a - CORRECT ANSWER Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action
Plan. - CORRECT ANSWER False
Wellcare does not need to be informed of all marketing/sales events at which plans or materials
will be presented or distributed (formaland informal). - CORRECT ANSWER False
Marketing benefits in a service area where those benefits are not available is prohibited and
considered misleading unless that is unavoidable because of local/regional or media use. -
CORRECT ANSWER True
CustomPoint sales material order dates will be posted on Wellcare.com - CORRECT ANSWER
False
,The online Centene Workbench self-service portal enables you to - CORRECT ANSWER All
of these
The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one
MA plan provider. The disclaimer must be: - CORRECT ANSWER Included in any marketing
materials, including print materials and television advertisements developed, used, or
distributed by the TPMO.
Verbally conveyed within the first minute of a sales call.
Prominently displayed on TPMO websites (regardless of content).
Electronically conveyed when communicating with a beneficiary through email, online chat, or
other electronic means of communication (regardless of content).
Brokers/Agents can access the following resources under the Shared Resources section in
Centene Workbench. - CORRECT ANSWER All of these
Which of the following is not an example of Protected Health Information (PHI)? - CORRECT
ANSWER Library Card
When a paper SOA form is used, it must be completed __________ hosting the sales
presentation. - CORRECT ANSWER 48 Hours prior to
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted
electronic enrollments. - CORRECT ANSWER True
When explaining the provider network for D-SNPs and C-SNPs: - CORRECT ANSWER
Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk
members.
If a member is not connected to a primary care provider (PCP), we should always encourage
and assist with connecting them with an in-network doctor
If a requested effective date is available for the special election period being selected, ensure
you are requesting a date within the correct time frame for the member based on their
eligibility date or change date needed. - CORRECT ANSWER True
Wellcare's _____ plan is designed for Low-Income Subsidy members. - CORRECT ANSWER
Classic
Which LIS category is assigned to members whose costs are fully subsidized and who receive
the most assistance? - CORRECT ANSWER Three
,The _________ plan is expected to have one of the lowest premiums in the country! -
CORRECT ANSWER Value Script
The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery chains
in 2024. - CORRECT ANSWER True
Wellcare continues to expand its reach by offering more products in a wider geography. ____
new Wellcare plans are going to market. - CORRECT ANSWER Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - CORRECT ANSWER
Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary structure
for 2024? - CORRECT ANSWER Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic drugs for
the remainder of the year once their total out of pocket costs reach $8,000. - CORRECT
ANSWER Zero
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act.
- CORRECT ANSWER True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - CORRECT ANSWER True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - CORRECT ANSWER True
____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and Washington,
D.C. - CORRECT ANSWER Three
Noting the correct enrollment period on enrollment applications helps in preventing delayed
enrollment processing. - CORRECT ANSWER True
When verifying a D-SNP beneficiary's Medicaid eligibility through the Ascend Medicaid search
tool, you should confirm their current Medicaid status qualifies for the selected D-SNP being
enrolled in and explain that changes in Medicaid eligibility may affect enrollment and/or cost
sharing. - CORRECT ANSWER True
Which of the following statements about Scope of Appointment (SOA) is FALSE? - CORRECT
ANSWER An electronic SOA submitted in Ascend must be in a Pending status prior to
beginning the appointment.
, Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for
quality are: - CORRECT ANSWER All of these
Beneficiary-facing marketing materials for multiple MA organizations or plans must be
submitted to the HPMS Marketing Module by the third-party marketing organization (TPMO)
no later than 30 days of use. - CORRECT ANSWER False
When completing an enrollment, be sure to use the correct enrollment application for the
desired plan year. - CORRECT ANSWER True
Providers may create co-branded marketing pieces using the Wellcare name and logo, as long
as they are using the current, approved logo. - CORRECT ANSWER False
Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts
SOAs in which of the following methods? - CORRECT ANSWER All of these
Failure to inform a beneficiary that a trusted provider is out-of-network or is not available in
the newly selected plan can cause a sales allegation. - CORRECT ANSWER True
Which of the following is not considered a grievance? - CORRECT ANSWER A dispute of the
appeal of an organization determination, coverage determination, or a Late Enrollment
Penalty (LEP) determination.
Brokers/Agents can access and download enrollment materials through CustomPoint. -
CORRECT ANSWER True
______ events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug, or other Medicare programs without going into the specifics of a particular
carrier. - CORRECT ANSWER Educational
Materials that include plan comparisons or cost-sharing do not require CMS submission. -
CORRECT ANSWER False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy.
Wellcare's quality focus consists of six drivers. Which of the following is not a Wellcare quality
driver? - CORRECT ANSWER Member Payments
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will
impact which plan(s)? - CORRECT ANSWER Both PDP & MAPD
A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories depending
on the level of need. - CORRECT ANSWER Four
CORRECT DETAILED ANSWERS - VERIFIED ANSWERS ALREADY GRADED
A+ NEW GUARANTEED
20. Beneficiary-facing marketing materials developed by a Third-Party Marketing
Organization (TPMO) for multiple Medicare Advantage (MA) organizations or plans can be
reviewed by just one MA organization, submitted to the Centers for Medicare & Medicaid
Services (CMS) in the Health Plan Management System (HPMS), and opted in by the health
plan after distribution. - CORRECT ANSWER FALSE
Enrollment applications must be received by Wellcare no later than ___ calendar day(s)
following receipt from the beneficiary. - CORRECT ANSWER 1
Which elements are available as part of Wellcare's Sales Support model? - CORRECT
ANSWER All of these
Low-Income Subsidy (LIS), which is often referred to as Extra Help, reduces all Part D plan
premiums - CORRECT ANSWER False
Prior to completing the enrollment form, broker/agents should always confirm the
beneficiary's primary care provider (PCP) and/or specialists - CORRECT ANSWER True
At the end of this course, there will be a Mastery Exam. Agents must achieve a passing score of
85% or higher to successfully complete this course - CORRECT ANSWER True
Brokers/Agents may be investigated after being suspected of noncompliant activity reported
through a - CORRECT ANSWER Complaint Tracking Module (CTM)
Grievance
Secret Shop Finding
A broker/agent who has never had any verbal warnings cannot be issued a Corrective Action
Plan. - CORRECT ANSWER False
Wellcare does not need to be informed of all marketing/sales events at which plans or materials
will be presented or distributed (formaland informal). - CORRECT ANSWER False
Marketing benefits in a service area where those benefits are not available is prohibited and
considered misleading unless that is unavoidable because of local/regional or media use. -
CORRECT ANSWER True
CustomPoint sales material order dates will be posted on Wellcare.com - CORRECT ANSWER
False
,The online Centene Workbench self-service portal enables you to - CORRECT ANSWER All
of these
The TPMO disclaimer must be used by any TPMO that sells plans on behalf of more than one
MA plan provider. The disclaimer must be: - CORRECT ANSWER Included in any marketing
materials, including print materials and television advertisements developed, used, or
distributed by the TPMO.
Verbally conveyed within the first minute of a sales call.
Prominently displayed on TPMO websites (regardless of content).
Electronically conveyed when communicating with a beneficiary through email, online chat, or
other electronic means of communication (regardless of content).
Brokers/Agents can access the following resources under the Shared Resources section in
Centene Workbench. - CORRECT ANSWER All of these
Which of the following is not an example of Protected Health Information (PHI)? - CORRECT
ANSWER Library Card
When a paper SOA form is used, it must be completed __________ hosting the sales
presentation. - CORRECT ANSWER 48 Hours prior to
Ascend is a fast, easy, and compliant way for brokers/agents to submit agent-assisted
electronic enrollments. - CORRECT ANSWER True
When explaining the provider network for D-SNPs and C-SNPs: - CORRECT ANSWER
Avoid submitting applications with no primary care provider (PCP) to assist these higher-risk
members.
If a member is not connected to a primary care provider (PCP), we should always encourage
and assist with connecting them with an in-network doctor
If a requested effective date is available for the special election period being selected, ensure
you are requesting a date within the correct time frame for the member based on their
eligibility date or change date needed. - CORRECT ANSWER True
Wellcare's _____ plan is designed for Low-Income Subsidy members. - CORRECT ANSWER
Classic
Which LIS category is assigned to members whose costs are fully subsidized and who receive
the most assistance? - CORRECT ANSWER Three
,The _________ plan is expected to have one of the lowest premiums in the country! -
CORRECT ANSWER Value Script
The Wellcare preferred pharmacy network includes Walgreens, CVS, and some grocery chains
in 2024. - CORRECT ANSWER True
Wellcare continues to expand its reach by offering more products in a wider geography. ____
new Wellcare plans are going to market. - CORRECT ANSWER Twenty-three
All Prescription Drug Plans (PDPs) will off er a $___ copay for most Part D preventive
vaccines, regardless of which network pharmacy is used by members. - CORRECT ANSWER
Zero
Which of the Prescription Drug Plan (PDP) products is new to the 6-tier formulary structure
for 2024? - CORRECT ANSWER Classic
In the Catastrophic Coverage stage, the member will pay $___ for brand and generic drugs for
the remainder of the year once their total out of pocket costs reach $8,000. - CORRECT
ANSWER Zero
Members are no longer required to pay a partial deductible due to the Inflation Reduction Act.
- CORRECT ANSWER True
Wellcare has new All-Dual D-SNP products in AL, AR, FL, GA, KY, LA, MI, MS, NC, NM,
OH, OK, TX, and WI. - CORRECT ANSWER True
All Prescription Drug Plans (PDPs) will feature a $0 Tier 1 benefit when filled at preferred
pharmacies. - CORRECT ANSWER True
____ Prescription Drug Plans (PDPs) will be offered across all 50 U.S. states and Washington,
D.C. - CORRECT ANSWER Three
Noting the correct enrollment period on enrollment applications helps in preventing delayed
enrollment processing. - CORRECT ANSWER True
When verifying a D-SNP beneficiary's Medicaid eligibility through the Ascend Medicaid search
tool, you should confirm their current Medicaid status qualifies for the selected D-SNP being
enrolled in and explain that changes in Medicaid eligibility may affect enrollment and/or cost
sharing. - CORRECT ANSWER True
Which of the following statements about Scope of Appointment (SOA) is FALSE? - CORRECT
ANSWER An electronic SOA submitted in Ascend must be in a Pending status prior to
beginning the appointment.
, Key areas you as a broker/agent have control over and impact upon regarding Star Ratings for
quality are: - CORRECT ANSWER All of these
Beneficiary-facing marketing materials for multiple MA organizations or plans must be
submitted to the HPMS Marketing Module by the third-party marketing organization (TPMO)
no later than 30 days of use. - CORRECT ANSWER False
When completing an enrollment, be sure to use the correct enrollment application for the
desired plan year. - CORRECT ANSWER True
Providers may create co-branded marketing pieces using the Wellcare name and logo, as long
as they are using the current, approved logo. - CORRECT ANSWER False
Although options for capturing and submitting SOAs vary by health plan, Wellcare accepts
SOAs in which of the following methods? - CORRECT ANSWER All of these
Failure to inform a beneficiary that a trusted provider is out-of-network or is not available in
the newly selected plan can cause a sales allegation. - CORRECT ANSWER True
Which of the following is not considered a grievance? - CORRECT ANSWER A dispute of the
appeal of an organization determination, coverage determination, or a Late Enrollment
Penalty (LEP) determination.
Brokers/Agents can access and download enrollment materials through CustomPoint. -
CORRECT ANSWER True
______ events are designed to inform the people who attend about Medicare Advantage,
Prescription Drug, or other Medicare programs without going into the specifics of a particular
carrier. - CORRECT ANSWER Educational
Materials that include plan comparisons or cost-sharing do not require CMS submission. -
CORRECT ANSWER False
Medicare Star Ratings and performance are at the forefront of Wellcare's quality strategy.
Wellcare's quality focus consists of six drivers. Which of the following is not a Wellcare quality
driver? - CORRECT ANSWER Member Payments
The Pharmacy Benefit Manager (PBM) migration to Express Scripts effective 1/1/2024 will
impact which plan(s)? - CORRECT ANSWER Both PDP & MAPD
A Low-Income Subsidy (LIS) member will be assigned one of ____ copay categories depending
on the level of need. - CORRECT ANSWER Four
