2020 AHIP
A client wants to give you an enrollment application on October 1st prior to the beginning of the Annual
Election Period because he is leaving on vacation for tow weeks and does not want to forget about
turning it in. What should you tell him?
CORRECT ANSWER - You must tell him you are not permitted to take the form. If he sends the form
directly to the plan, the plan will process the enrollment on the day the Annual Election Period begins.
Agent Chan is conducting a sales presentation on senior issues where he hopes to enroll some attendees
in the Medicare Advantage (MA) plans he represents. What action(s) may Agent Change take during the
event?
CORRECT ANSWER - Discuss plan specific information such as premiums and benefits.
Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual
Open Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, Mrs.
O'Malley disenrolls on February 12th following a move outside the plan's service area. What impact will
this have on Agent Higgins compensation?
CORRECT ANSWER - AB MA does not have to recoup Agent Higgins' compensation because she as
moved away from its service area.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and ask you for advice as
to whether this is possible. What should you tell her?
CORRECT ANSWER - Marketing representatives may initiate electronic contact through e-mail but an
opt-out process must be provided.
Agent Roderick enrolls retiree Mrs. Martinez in a medicare savings account (MSA) Medicare health plan.
The MSA plan does not offer prescription drug coverage, so Agent Roderick also enrolls Mrs. Martinez in
a stand-alone prescription drug plan (PDP). What CMS compensation rules apply to this situiation?
CORRECT ANSWER - This situation is considered a "dual enrollment," and CMS compensation rules are
applied to the two plans at once and independently of each other.
Alice is enrolled in a MA-PD plan. she makes a permanent move across the country and wonders what
her options are for continuing MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)?
, CORRECT ANSWER - She is likely to qualify for a SEP. She can choose an effective date of up to three
months after the month in which the enrollment form is received by the new plan, but the effective date
may not be earlier than the date of her permanent move.
By contacting 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?
CORRECT ANSWER - You may make comparisons between plans if you can support them by studies or
statistical data and such comparisons are factually based.
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for
pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most
appropriate for him?
CORRECT ANSWER - C-SNP
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr.
Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor
told him about. What should his agent do?
CORRECT ANSWER - Since Mr. Peters requested a description of the Part D plan, his agent must have Mr.
Peters sign a new scope of appointment form that includes Part D, and then the agent may discuss the
Part D plan so Mr. Peters can compare plans and make an informed enrollment choice during the
appointment.
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants to keep that plan, what
type of Medicare health plan could the individual enroll in, without being automatically dis-enrolled
from the stand-alone prescription drug plan?
CORRECT ANSWER - The beneficiary could enroll in a private fee-for-service (PFFS) plan that does not
include prescription drug coverage; an 1876 Cost Plan; or a Medicare Medical Savings Account (MSA)
plan.
Last year Agent Melanie Meyers marketed an enrolled several clients in Medicare Advantage (MA)
health plans. This year she has decided to focus on non-MA products. What advice would you give
Melanie if she wishes to continue to receive renewal fees?
CORRECT ANSWER - Melanie must remain trained, tested, licensed and appointed, regardless of
whether she is actively selling MA products.
Monica is an agent focused on serving seniors eligible for Medicare. As she reviews her records, she is
trying to determine which of the following items are considered compensation. What do you tell her?
I. Commissions
II. Bonuses
A client wants to give you an enrollment application on October 1st prior to the beginning of the Annual
Election Period because he is leaving on vacation for tow weeks and does not want to forget about
turning it in. What should you tell him?
CORRECT ANSWER - You must tell him you are not permitted to take the form. If he sends the form
directly to the plan, the plan will process the enrollment on the day the Annual Election Period begins.
Agent Chan is conducting a sales presentation on senior issues where he hopes to enroll some attendees
in the Medicare Advantage (MA) plans he represents. What action(s) may Agent Change take during the
event?
CORRECT ANSWER - Discuss plan specific information such as premiums and benefits.
Agent Higgins helps Mrs. O'Malley to enroll in AB Medicare Advantage (MA) plan during the Annual
Open Enrollment Period. Mrs. O'Malley's effective enrollment date is January 1st. Subsequently, Mrs.
O'Malley disenrolls on February 12th following a move outside the plan's service area. What impact will
this have on Agent Higgins compensation?
CORRECT ANSWER - AB MA does not have to recoup Agent Higgins' compensation because she as
moved away from its service area.
Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and ask you for advice as
to whether this is possible. What should you tell her?
CORRECT ANSWER - Marketing representatives may initiate electronic contact through e-mail but an
opt-out process must be provided.
Agent Roderick enrolls retiree Mrs. Martinez in a medicare savings account (MSA) Medicare health plan.
The MSA plan does not offer prescription drug coverage, so Agent Roderick also enrolls Mrs. Martinez in
a stand-alone prescription drug plan (PDP). What CMS compensation rules apply to this situiation?
CORRECT ANSWER - This situation is considered a "dual enrollment," and CMS compensation rules are
applied to the two plans at once and independently of each other.
Alice is enrolled in a MA-PD plan. she makes a permanent move across the country and wonders what
her options are for continuing MA-PD coverage. What would you say to her in regard to a special
enrollment period (SEP)?
, CORRECT ANSWER - She is likely to qualify for a SEP. She can choose an effective date of up to three
months after the month in which the enrollment form is received by the new plan, but the effective date
may not be earlier than the date of her permanent move.
By contacting 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?
CORRECT ANSWER - You may make comparisons between plans if you can support them by studies or
statistical data and such comparisons are factually based.
Daniel is a middle-income Medicare beneficiary. He has chronic bronchitis, putting him at severe risk for
pneumonia. Otherwise, he has no problems functioning. Which type of SNP is likely to be most
appropriate for him?
CORRECT ANSWER - C-SNP
During an appointment scheduled to discuss a Medicare Advantage Prescription Drug plan (MA-PD), Mr.
Peters asked his agent to describe a stand-alone prescription drug plan (Part D plan) that his neighbor
told him about. What should his agent do?
CORRECT ANSWER - Since Mr. Peters requested a description of the Part D plan, his agent must have Mr.
Peters sign a new scope of appointment form that includes Part D, and then the agent may discuss the
Part D plan so Mr. Peters can compare plans and make an informed enrollment choice during the
appointment.
If a beneficiary is enrolled in a stand-alone prescription drug plan and wants to keep that plan, what
type of Medicare health plan could the individual enroll in, without being automatically dis-enrolled
from the stand-alone prescription drug plan?
CORRECT ANSWER - The beneficiary could enroll in a private fee-for-service (PFFS) plan that does not
include prescription drug coverage; an 1876 Cost Plan; or a Medicare Medical Savings Account (MSA)
plan.
Last year Agent Melanie Meyers marketed an enrolled several clients in Medicare Advantage (MA)
health plans. This year she has decided to focus on non-MA products. What advice would you give
Melanie if she wishes to continue to receive renewal fees?
CORRECT ANSWER - Melanie must remain trained, tested, licensed and appointed, regardless of
whether she is actively selling MA products.
Monica is an agent focused on serving seniors eligible for Medicare. As she reviews her records, she is
trying to determine which of the following items are considered compensation. What do you tell her?
I. Commissions
II. Bonuses
