UHC ETHICS AND COMPLIANCE TEST
EXAM 2025 QUESTIONS AND ANSWERS
Agent John is planning to conduct a series of events. Some will be strictly educational, others
will be formal presentations of specific UnitedHealthcare plans, and others will be informal
marketing events where he can generate leads and schedule future in-home marketing
appointments. Of the three types of events John plans to conduct, which need to be reported
to UnitedHealthcare? - ANS *******
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? - ANS 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? - ANS 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? -
ANS 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? - ANS Yes, he needs to obtain an SOA from both Mr. and
Mrs. Nelson.
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, Which describes the purpose of educational events? - ANS 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? - ANS Erin should tell Mrs. Rose that the plan has received a
"Below Average" rating.
Which of the following describes Permission to Contact guidelines? - ANS 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? - ANS No. Victor violated United Healthcare permission to contact guidelines by
emailing the cousin without the cousin's permission
Which of the individuals below would not likely have the authority to enroll a consumer in a
Medicare Advantage Plan? - ANS The consumer's spouse, who is neither a Power of Attorney
nor legal guardian.
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer? - ANS When the consumer consented to be contacted for sales activities,
subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal
representative for her father. What must Jacob explain to Emily when completing an
Enrollment Application for her father? - ANS Jacob must explain that Emily will sign the
Enrollment Application and must be able to provide documentation upon request by the Plan
that indicates her legal authority to enroll her father.
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
EXAM 2025 QUESTIONS AND ANSWERS
Agent John is planning to conduct a series of events. Some will be strictly educational, others
will be formal presentations of specific UnitedHealthcare plans, and others will be informal
marketing events where he can generate leads and schedule future in-home marketing
appointments. Of the three types of events John plans to conduct, which need to be reported
to UnitedHealthcare? - ANS *******
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? - ANS 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? - ANS 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? -
ANS 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? - ANS Yes, he needs to obtain an SOA from both Mr. and
Mrs. Nelson.
1 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
, Which describes the purpose of educational events? - ANS 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? - ANS Erin should tell Mrs. Rose that the plan has received a
"Below Average" rating.
Which of the following describes Permission to Contact guidelines? - ANS 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? - ANS No. Victor violated United Healthcare permission to contact guidelines by
emailing the cousin without the cousin's permission
Which of the individuals below would not likely have the authority to enroll a consumer in a
Medicare Advantage Plan? - ANS The consumer's spouse, who is neither a Power of Attorney
nor legal guardian.
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer? - ANS When the consumer consented to be contacted for sales activities,
subsequent telephonic contact has not yet occurred, and the permission has not yet expired.
Agent Jacob learns that Emily, the consumer with whom he is meeting, is the authorized legal
representative for her father. What must Jacob explain to Emily when completing an
Enrollment Application for her father? - ANS Jacob must explain that Emily will sign the
Enrollment Application and must be able to provide documentation upon request by the Plan
that indicates her legal authority to enroll her father.
2 Copyright ©BRIGHSTARS ALL RIGHTS RESERVED 2025
