2021 United HealthCare - Ethics and Compliance
Exam Review/ Q&A.
John has Power of Attorney to act on behalf of his mother. What does that mean
when it comes to his mother enrolling in a Medicare Advantage Plan? - Answer:
John may sign the Enrollment Application and must be able to provide
documentation upon request by the Plan that indicates his authority under state
law to enroll his mother.
Which of the following is not considered unsolicited contact with a Medicare
eligible consumer according to CMS regulations and UnitedHealthcare's rules,
policies, and procedures? - Answer: Mailing a marketing brochure to the
consumer via postal mail.
To sign an enrollment application on behalf of a consumer, what authority must
the individual have? - Answer: The individual must be legally authorized in the
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, state in which the consumer resides to act on behalf of the consumer (e.g. Power
of Attorney).
As an agent, you must not do which of the following when marketing
UnitedHealthcare Medicare Advantage plans to consumers? - Answer: Use
providers or provider groups to distribute printed information comparing benefits
of different health plans without approval.
As an agent, you have an obligation to only enroll a consumer in a product: -
Answer: That is suitable for the consumer's needs, goals, and financial resources.
What is the purpose of the Statement of Understanding? - Answer: It ensures that
when consumers sign 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 the definition of Fraud? - Answer: Fraud is intentionally misrepresenting
or concealing facts to obtain something of value.
Which of the items listed are examples of Fraud, Waste, and Abuse (FWA)? -
Answer: - Submitting claims for services or supplies that were never provided
- Consulting with a number of doctors in order to obtain multiple prescriptions for
the same drug.
- Billing for brand name drugs when generics were dispensed.
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Exam Review/ Q&A.
John has Power of Attorney to act on behalf of his mother. What does that mean
when it comes to his mother enrolling in a Medicare Advantage Plan? - Answer:
John may sign the Enrollment Application and must be able to provide
documentation upon request by the Plan that indicates his authority under state
law to enroll his mother.
Which of the following is not considered unsolicited contact with a Medicare
eligible consumer according to CMS regulations and UnitedHealthcare's rules,
policies, and procedures? - Answer: Mailing a marketing brochure to the
consumer via postal mail.
To sign an enrollment application on behalf of a consumer, what authority must
the individual have? - Answer: The individual must be legally authorized in the
Page 1 of 10
, state in which the consumer resides to act on behalf of the consumer (e.g. Power
of Attorney).
As an agent, you must not do which of the following when marketing
UnitedHealthcare Medicare Advantage plans to consumers? - Answer: Use
providers or provider groups to distribute printed information comparing benefits
of different health plans without approval.
As an agent, you have an obligation to only enroll a consumer in a product: -
Answer: That is suitable for the consumer's needs, goals, and financial resources.
What is the purpose of the Statement of Understanding? - Answer: It ensures that
when consumers sign 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 the definition of Fraud? - Answer: Fraud is intentionally misrepresenting
or concealing facts to obtain something of value.
Which of the items listed are examples of Fraud, Waste, and Abuse (FWA)? -
Answer: - Submitting claims for services or supplies that were never provided
- Consulting with a number of doctors in order to obtain multiple prescriptions for
the same drug.
- Billing for brand name drugs when generics were dispensed.
Page 2 of 10
