UHC ETHICS AND COMPLIANCE KEY
POLICIES STANDARDS GUIDE
◉ Which of the following statements is true about using a five star
special enrollment period (SEP)? Answer: It can be used once from
December 8 through November 30 and coverage will start the first
of the month following recipient of the enrollment application
◉ Which statement regarding star ratings is true Answer: Medicare
uses a five star rating system to illustrate the plans performance and
quality
◉ In which of the following situations can a telephonic contract be
made with a Medicare eligible consumer? Answer: When the
consumer consented to be contracted for sales activities, and the
permission has not yet expired
◉ What information should be obtained from the consumer when
conducting a thorough needs assessment? (Select 2) Answer: • their
current health care coverage, including what they like about it, and
what they don't
• the providers they see in medication they take to determine
network and formulary status
, ◉ Will using LEAN to complete an enrollment application with the
consumer agent Jeff learns the consumer does not have an email
address. What should Jeff do? Answer: The consumer/member
would not receive plan related, corresponds, intent for him/her
◉ What is the purpose of the statement of understanding? Answer:
It ensures that when consumers complete the Medicare Advantage
and/or Part D Enrollment Application, they are acknowledging their
understanding that they are actually enrolling, in which plan they
are enrolling, and standard disclosures.
◉ What is scope of appointment? Answer: The agreement obtained
from the consumer to that identifies the scope of products that can
be discussed at a personal/individual marketing appointment
◉ Which statement is accurate when a consumer has a power of
authority (POA) Answer: If the POA signed the enrollment
application, they must be able to provide documentation upon
request for the plan that indicates authority under state law to enroll
the consumer
◉ What happens on the plan effective date when a member enrolled
in a Medicare supplement insurance plan and standalone PDP enroll
in a Medicare vantage plan that includes drug coverage Answer:
Automatic disenrollment from the standalone PDP
POLICIES STANDARDS GUIDE
◉ Which of the following statements is true about using a five star
special enrollment period (SEP)? Answer: It can be used once from
December 8 through November 30 and coverage will start the first
of the month following recipient of the enrollment application
◉ Which statement regarding star ratings is true Answer: Medicare
uses a five star rating system to illustrate the plans performance and
quality
◉ In which of the following situations can a telephonic contract be
made with a Medicare eligible consumer? Answer: When the
consumer consented to be contracted for sales activities, and the
permission has not yet expired
◉ What information should be obtained from the consumer when
conducting a thorough needs assessment? (Select 2) Answer: • their
current health care coverage, including what they like about it, and
what they don't
• the providers they see in medication they take to determine
network and formulary status
, ◉ Will using LEAN to complete an enrollment application with the
consumer agent Jeff learns the consumer does not have an email
address. What should Jeff do? Answer: The consumer/member
would not receive plan related, corresponds, intent for him/her
◉ What is the purpose of the statement of understanding? Answer:
It ensures that when consumers complete the Medicare Advantage
and/or Part D Enrollment Application, they are acknowledging their
understanding that they are actually enrolling, in which plan they
are enrolling, and standard disclosures.
◉ What is scope of appointment? Answer: The agreement obtained
from the consumer to that identifies the scope of products that can
be discussed at a personal/individual marketing appointment
◉ Which statement is accurate when a consumer has a power of
authority (POA) Answer: If the POA signed the enrollment
application, they must be able to provide documentation upon
request for the plan that indicates authority under state law to enroll
the consumer
◉ What happens on the plan effective date when a member enrolled
in a Medicare supplement insurance plan and standalone PDP enroll
in a Medicare vantage plan that includes drug coverage Answer:
Automatic disenrollment from the standalone PDP
