UHC CERTIFICATION LATEST VERSION 2024-2025
ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
On July 19, each of the following consumers met with an agent. Based on the information provided,
which consumer must wait until the Annual Election Period (AEP) or Open Enrollment Period (OEP) to
enroll? - ANSWER-Joy has a cardiovascular disorder, is enrolled in a C-SNP that covers the condition, and
wants to enroll in another CSNP offered by the plan that covers the same condition.
Which service will a C-SNP or D-SNP member in the high risk care management category receive? -
ANSWER-Case Management (telephonic, digital and/or face-to-face) according to individual needs
Which statement is true about provider information on the Chronic Condition Verification Form? -
ANSWER-The provider indicated on the form does not have to be contracted with the plan.
Which statement is true about the Medicaid program? - ANSWER-Benefits vary from state to state.
Which statement is true of D-SNP members? - ANSWER-Members who are QMB+ or are Full DualEligible
are not required to pay copayments for Medicare-covered services obtained from a D-SNP innetwork
provider. Their provider should bill the state Medicaid program, as appropriate, for these costs.
How long do plans using the C-SNP pre-enrollment verification process have to verify the qualifying
chronic condition until they must deny the enrollment request? - ANSWER-Within 21 days of the request
for additional information or the end of the month in which the enrollment request is made (whichever
is longer).
Lucille is no longer eligible for her state Medicaid program and has lost her eligibility for the D-SNP in
which she is enrolled. What is her responsibility for cost sharing? - ANSWER-All, such as premiums,
deductibles, copayments, and coinsurance
What type of event must an agent conduct when they want to be able to collect consumer information,
schedule future appointments, and accept enrollment applications? - ANSWER-Marketing/sales event
,Which of the following does not describe a personal/individual marketing appointment? - ANSWER-It
needs to be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to
the date of the event
When conducting an event, agents should select a site that is compliant with the Americans with
Disabilities Act (ADA). Which of the following is not an ADA requirement? - ANSWER-Extra-wide
sidewalks that accommodate wheelchairs
Which of the following elements does not need to be entered on the NEW Event Request Form when
reporting a new event? - ANSWER-The event venue manager/contact person
Jeff has an informal marketing/sales event scheduled this afternoon, but a consumer has requested an
in-home appointment during that time. He would like to cancel or reschedule the event because he is
certain to get an enrollment application at the appointment. Which of the statements below is correct
about Jeff's event? - ANSWER-Jeff is prohibited from canceling the event because it is within 1 business
day and is not due to inclement weather. Jeff must hold his event or he could work with his manager to
get a replacement to conduct the event.
On October 1, Sam reported the formal marketing/sales event he has scheduled for 9 a.m. on November
19. Luckily, before he had flyers printed, he remembered he has an 8 a.m. dentist appointment
November 19. Just to make sure he can get to his event on time, he advertises the event to start at 9:30
a.m. What event reporting infraction(s) might Sam incur? - ANSWER-(INCORRECT) None, Sam reported
the event prior to advertising and not less than 7 calendar days prior to the date of the event
Marcus is planning an educational event and has decided to place an advertisement in the local paper.
What must the advertisement include? - ANSWER-A statement that makes it clear that the event is for
educational purposes only.
Which of the following food and beverage options may be provided at an educational event if the
nominal retail value of the items when combined with other giveaways does not exceed $15 per person?
(Select 2) - ANSWER-Coffee, juice, fresh fruit, and pastries
Boxed lunch with assorted non-alcoholic beverages
, If you conduct an educational event and invite a provider or vendor to be a part of the event, the
provider/vendor must not do which of the following? - ANSWER-Provide free health screenings such as
blood pressure checks or hearing tests as a marketing activity
Agent John Rogers is planning a formal marketing/sales event and has decided to place an
advertisement in the local paper. What disclaimers must John include in the advertisement? -
ANSWER"For accommodation of persons with special needs at sales meetings, call 555-555-1234, TTY
711."
Janine is conducting a marketing/sales event in a senior center cafeteria. The cafeteria generally provides
a dinner meal from 5pm to 6pm. Can Janine conduct her marketing/sales meeting in the cafeteria
between 5pm and 6pm? - ANSWER-No, she can conduct an event that ends no later than 5pm or wait
until after 6pm.
Agent Rita Garcia must not do which of the following while conducting a marketing/sales event? -
ANSWER-State the plan she is presenting is the best plan on the market.
At a formal marketing/sales event, an agent presented information about prescription drug coverage.
Which statement is not accurate? - ANSWER-Members and providers are not able to ask the plan for
exceptions to any utilization management rules
At an informal marketing/sales event, which of the following activities is not permitted? - ANSWER-
Approaching consumers as they pass by your booth/kiosk/table
Agent Santana has developed a relationship with Dr. Westberry, a Primary Care Provider contracted with
several Medicare Advantage Plans. Dr. Westberry is asked to attend a formal marketing/sales event
conducted by Agent Santana. Which of Dr. Westberry's actions is non-compliant? - ANSWER-Offers blood
pressure screenings as consumers wait for the event to begin
Which of the following best describes the purpose of event observation? - ANSWER-An oversight activity
where an individual evaluates an event as a means to ensure the information provided by the agent was
accurate and compliant.
Which of the following statements describes compliant activity during a formal marketing/sales event? -
ANSWER-Not one plan fits all
ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY GRADED A+
On July 19, each of the following consumers met with an agent. Based on the information provided,
which consumer must wait until the Annual Election Period (AEP) or Open Enrollment Period (OEP) to
enroll? - ANSWER-Joy has a cardiovascular disorder, is enrolled in a C-SNP that covers the condition, and
wants to enroll in another CSNP offered by the plan that covers the same condition.
Which service will a C-SNP or D-SNP member in the high risk care management category receive? -
ANSWER-Case Management (telephonic, digital and/or face-to-face) according to individual needs
Which statement is true about provider information on the Chronic Condition Verification Form? -
ANSWER-The provider indicated on the form does not have to be contracted with the plan.
Which statement is true about the Medicaid program? - ANSWER-Benefits vary from state to state.
Which statement is true of D-SNP members? - ANSWER-Members who are QMB+ or are Full DualEligible
are not required to pay copayments for Medicare-covered services obtained from a D-SNP innetwork
provider. Their provider should bill the state Medicaid program, as appropriate, for these costs.
How long do plans using the C-SNP pre-enrollment verification process have to verify the qualifying
chronic condition until they must deny the enrollment request? - ANSWER-Within 21 days of the request
for additional information or the end of the month in which the enrollment request is made (whichever
is longer).
Lucille is no longer eligible for her state Medicaid program and has lost her eligibility for the D-SNP in
which she is enrolled. What is her responsibility for cost sharing? - ANSWER-All, such as premiums,
deductibles, copayments, and coinsurance
What type of event must an agent conduct when they want to be able to collect consumer information,
schedule future appointments, and accept enrollment applications? - ANSWER-Marketing/sales event
,Which of the following does not describe a personal/individual marketing appointment? - ANSWER-It
needs to be reported to UnitedHealthcare prior to advertising and not less than 7 calendar days prior to
the date of the event
When conducting an event, agents should select a site that is compliant with the Americans with
Disabilities Act (ADA). Which of the following is not an ADA requirement? - ANSWER-Extra-wide
sidewalks that accommodate wheelchairs
Which of the following elements does not need to be entered on the NEW Event Request Form when
reporting a new event? - ANSWER-The event venue manager/contact person
Jeff has an informal marketing/sales event scheduled this afternoon, but a consumer has requested an
in-home appointment during that time. He would like to cancel or reschedule the event because he is
certain to get an enrollment application at the appointment. Which of the statements below is correct
about Jeff's event? - ANSWER-Jeff is prohibited from canceling the event because it is within 1 business
day and is not due to inclement weather. Jeff must hold his event or he could work with his manager to
get a replacement to conduct the event.
On October 1, Sam reported the formal marketing/sales event he has scheduled for 9 a.m. on November
19. Luckily, before he had flyers printed, he remembered he has an 8 a.m. dentist appointment
November 19. Just to make sure he can get to his event on time, he advertises the event to start at 9:30
a.m. What event reporting infraction(s) might Sam incur? - ANSWER-(INCORRECT) None, Sam reported
the event prior to advertising and not less than 7 calendar days prior to the date of the event
Marcus is planning an educational event and has decided to place an advertisement in the local paper.
What must the advertisement include? - ANSWER-A statement that makes it clear that the event is for
educational purposes only.
Which of the following food and beverage options may be provided at an educational event if the
nominal retail value of the items when combined with other giveaways does not exceed $15 per person?
(Select 2) - ANSWER-Coffee, juice, fresh fruit, and pastries
Boxed lunch with assorted non-alcoholic beverages
, If you conduct an educational event and invite a provider or vendor to be a part of the event, the
provider/vendor must not do which of the following? - ANSWER-Provide free health screenings such as
blood pressure checks or hearing tests as a marketing activity
Agent John Rogers is planning a formal marketing/sales event and has decided to place an
advertisement in the local paper. What disclaimers must John include in the advertisement? -
ANSWER"For accommodation of persons with special needs at sales meetings, call 555-555-1234, TTY
711."
Janine is conducting a marketing/sales event in a senior center cafeteria. The cafeteria generally provides
a dinner meal from 5pm to 6pm. Can Janine conduct her marketing/sales meeting in the cafeteria
between 5pm and 6pm? - ANSWER-No, she can conduct an event that ends no later than 5pm or wait
until after 6pm.
Agent Rita Garcia must not do which of the following while conducting a marketing/sales event? -
ANSWER-State the plan she is presenting is the best plan on the market.
At a formal marketing/sales event, an agent presented information about prescription drug coverage.
Which statement is not accurate? - ANSWER-Members and providers are not able to ask the plan for
exceptions to any utilization management rules
At an informal marketing/sales event, which of the following activities is not permitted? - ANSWER-
Approaching consumers as they pass by your booth/kiosk/table
Agent Santana has developed a relationship with Dr. Westberry, a Primary Care Provider contracted with
several Medicare Advantage Plans. Dr. Westberry is asked to attend a formal marketing/sales event
conducted by Agent Santana. Which of Dr. Westberry's actions is non-compliant? - ANSWER-Offers blood
pressure screenings as consumers wait for the event to begin
Which of the following best describes the purpose of event observation? - ANSWER-An oversight activity
where an individual evaluates an event as a means to ensure the information provided by the agent was
accurate and compliant.
Which of the following statements describes compliant activity during a formal marketing/sales event? -
ANSWER-Not one plan fits all
