UHC ETHICS AND COMPLIANCE
COMPREHENSIVE STUDY GUIDE 2026
◉ When completing an enrollment application in LEAN, why is an
agent prohibited from entering his or her own email address in a
field available for the consumer's email address? Answer: The
consumer/member would not receive plan related correspondence
intended for him/her.
◉ Which election period runs from October 15 to December 7 and
allows consumers to elect to join a Medicare Advantage Plan or
switch to a different plan? Answer: Annual Election Period (AEP)
◉ Dino, an agent, received a phone call on September 29 from a
consumer interested in Medicare Advantage plans for the new plan
year. Dino proceeded to verify the consumer's Medicare eligibility,
describe the costs and benefit coverage of the plan, and explained
that he could not accept an enrollment application until October 15.
What did Dino do that was NOT compliant? Answer: Dino presented
a plan prior to October 1.
◉ Mr. and Mrs. Nelson, who are current members, unexpectedly
walk into Jake's insurance agency office and ask him to discuss
Medicare Advantage Plans. Does Jake need to obtain a Scope of
, Appointment (SOA) form? Answer: Yes, he needs to obtain an SOA
from both Mr. and Mrs. Nelson.
◉ Which describes the purpose of educational events? Answer:
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? Answer:
Erin should tell Mrs. Rose that the plan has received a "Below
Average" rating.
◉ Which of the following describes Permission to Contact
guidelines? Answer: It is method specific (e.g., telephone, email),
short term (i.e., expires when contact is made), and event specific
(i.e., limited to the products identified).
◉ Julie, a consumer, is having difficulty understanding the
information her agent, Victor, is presenting at her in-home
appointment. She provides Victor with her cousin's telephone
number and email address and asks him to explain the plan to her
cousin, who frequently assists with her health care decisions. The
next day, Victor emails Julie's cousin. Has Victor been compliant?
Answer: No. Victor violated United Healthcare permission to contact
guidelines by emailing the cousin without the cousin's permission
COMPREHENSIVE STUDY GUIDE 2026
◉ When completing an enrollment application in LEAN, why is an
agent prohibited from entering his or her own email address in a
field available for the consumer's email address? Answer: The
consumer/member would not receive plan related correspondence
intended for him/her.
◉ Which election period runs from October 15 to December 7 and
allows consumers to elect to join a Medicare Advantage Plan or
switch to a different plan? Answer: Annual Election Period (AEP)
◉ Dino, an agent, received a phone call on September 29 from a
consumer interested in Medicare Advantage plans for the new plan
year. Dino proceeded to verify the consumer's Medicare eligibility,
describe the costs and benefit coverage of the plan, and explained
that he could not accept an enrollment application until October 15.
What did Dino do that was NOT compliant? Answer: Dino presented
a plan prior to October 1.
◉ Mr. and Mrs. Nelson, who are current members, unexpectedly
walk into Jake's insurance agency office and ask him to discuss
Medicare Advantage Plans. Does Jake need to obtain a Scope of
, Appointment (SOA) form? Answer: Yes, he needs to obtain an SOA
from both Mr. and Mrs. Nelson.
◉ Which describes the purpose of educational events? Answer:
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? Answer:
Erin should tell Mrs. Rose that the plan has received a "Below
Average" rating.
◉ Which of the following describes Permission to Contact
guidelines? Answer: It is method specific (e.g., telephone, email),
short term (i.e., expires when contact is made), and event specific
(i.e., limited to the products identified).
◉ Julie, a consumer, is having difficulty understanding the
information her agent, Victor, is presenting at her in-home
appointment. She provides Victor with her cousin's telephone
number and email address and asks him to explain the plan to her
cousin, who frequently assists with her health care decisions. The
next day, Victor emails Julie's cousin. Has Victor been compliant?
Answer: No. Victor violated United Healthcare permission to contact
guidelines by emailing the cousin without the cousin's permission
