Academicmaterials

Any time you see or suspect a violation of our Code, the law or our policies, you must report it. Ways to report your concerns include: - Calling the Ethics Hotline Emailing Medicare Compliance directly Discussing the issue with your manager Once submitted, who can cancel an enrollment application before the effective date? - The client The client's Legal Authorized Representative/POA Aetna strictly enforces our enrollment procedures. If you receive an Enrollment Process Exception Notice...

HNO (HMO on ACAS) QPOS & HMO - -Nicknames: QPOS/HMO - PCP uses CAP ID and not PIN -PCP Required: Yes -Referrals Required: Yes -Levels of Benefits: QPOS - 2 ; HMO - 1 -Network: MHMO open choice / PPO - - Nicknames: OC; PPO -PCP Required: No -Referrals Required: No -Levels of Benefits: 2 -Network: MPPO managed choice - -Nicknames: MC -PCP Required: Yes -Referrals Required: Yes -Levels of Benefits: 2 Network: MCEPO open access elect choice - -Nicknames: OA EC -PCP Required: No -Ref...

Each pharmacy component of an MAPD plan consists of a formulary, a pharmacy network and benefit designs (cost sharing and tier structure). Select one: True False - True What is a Special Needs Plan (SNP)? a.A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limits enrollment to people with specific diseases or characteristics. b.An MA plan that tailors benefits, provider choices, and drug formularies to meet specific needs of the groups they serve. c.An MA...

A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. True or False - True A) A type of MAPD plan designed to provide targeted care and services to individuals with specific needs. B) A MA plan that tailors benefits, provider choices and drug formularies to meet specific needs of the groups they serve. C) A MA plan for those who are eligible for Medicare and Medicaid. D) A MA plan required to contract with a state Medicaid agency. E)...

There are three ways to verify your ready-to-sell status. - True Producers may only use CMS and Aetna-approved marketing materials that have been created by our marketing team, approved by us, and filed with CMS by us when discussing Aetna Individual Medicare plans. - True Agent Oversight routinely monitors the third-party secret shopper surveillance program. - True What report(s) are available on Aetna Producer World? a.Medicare Book of Business Report b.Commission Reports c.Licensing R...

Aetna Medicare Case Management has teams of registered nurses, social workers, behavioral health professionals, and pharmacists who help members navigate the health care system and access services. - True What is a Special Needs Plan (SNP)? - All of the above or A type of Medicare Advantage Prescription Drug (MAPD) coordinated care plan that limits enrollment to people with specific diseases or characteristics. Aetna offers a variety of Aetna Medicare Advantage plan types. Which plan type ...

Producers may only use CMS and Aetna-approved marketing materials that have been created by our marketing team, approved by us and filed with CMS by us when discussing Aetna Individual Medicare plans. - True You are prohibited from soliciting referral clients through cold calling, door-to-door visits, or other actions prohibited under state or federal law. - True The Permission to Contact form is used by Aetna sales representatives and external agents to contact beneficiaries and must be c...

A conflict of interest may arise when personal interests or activities appear to improperly influence our ability to act in the best interests of the company. Any potential conflict of interest should be reported immediately. - True If submitted after the first month of eligibility, the effective date for enrollments in the Initial Enrollment Period (IEP) must be the first of the month following the month the enrollment is submitted. - True If the requested premium payment method is Social...

Plan performance summary ratings are issued in October and reflect the previous plan contract year. Therefore, enrollment kits fulfilled prior to November will reflect the previous year's star rating. After release, you should download the updated star ratings sheet from the SilverScript Agent Portal, print copies of the updated document and replace the form that is in the kits you have in your office supply to ensure you distributed current information to your prospects. - True A conflict...

Where is the Aetna Medicare Individual SilverScript® Prescription Drug Plan available? a.All states, except California b.All fifty states and DC c.All US Territories only d.All fifty states - All fifty states and DC Once submitted, who can cancel an enrollment application before the effective date? a.The client b.The client's writing agent, as long as they do so before the effective date of the plan c.The client's doctor d.Both A and C - The client Before meeting with an applicant, ...

NRF EXAM PACKAGE DEAL, SCORED A+

off-price retailers - offer brand name merchandise at a discount. the merchandise typically consists of excess inventory, closeouts and irregulars closeout stores - off-price stores that offer an assortment of brand-name merchandise at a significant discount off the manufacturer's price commercial cue - advertising message that impacts purchase decisions comparison shopper - the customer who spends time searching for the best price or deal on the item she is looking to purchase convenien...

T/F: You should allow customers with disabilities to express their own needs and limits; your job is to accommodate those needs and make shopping a positive experience. - True Which is an appropriate reasons for following up with a customer? - You finally located an item the customer asked for a while back T/F: Customer follow-up is always a good idea, no matter what the situation. - False How would you handle a situation where a customer wants a brand that you don't carry? - Get permissi...

Merchandise without an expiration date like electronics, tools and home goods typically have longer - shelf life Which if the following key performance indicators can be used to measure whether each store is meeting its sales goals? - number of sales per store location In the retail product cycle, what step comes after distribution and products? - selling What item is a retail product - car tire A large facility that manufacturers sent large quantities of product to then distributed to sto...

Which of the following are good reasons to ask customers for their business cards? • So you can build up your client records with names of potential customers • So you can claim these customers as your own and keep co-workers from making sales to them • To learn more about them so you can suggest items that you think they can afford • When customers show interest in an upcoming event and you offer to remind them - When customers show interest in an upcoming event and you offer to re...

Diverse shopper - This buyer is hard to predict or to understand. He shops in many different places and is not obviously influenced by any one retail element Closeout stores - Off-price stores that offer an assortment of brand-name merchandise at a significant discount off the the manufacturer's price Commercial cue - Advertising message that impacts purchase decisions convenience stores - These stores aim at providing their customers a convenient shopping experience. These general mercha...

problems - You know when you have all the information you need to successfully sell the products in your store when you can Solve routine ______. Benefits - Advantages or rewards of product features Customer Service - The acting of taking care of the customer's needs by providing and delivering professional, helpful, high quality service and assistance before, during and after the customer's requirements are met. Features - Those things that are physical in nature Color, size Appeal to...

Extended Warranty or Service Plan - Customers can lengthen the time that a warranty is in effect. (common with appliances, electronics) explain it early in the conversation Product Features - physical characteristics of an item. (size, shape, color, texture, taste, smell) Product Benefits - Advantages that a customer gets from the product feature. What is the best way to explain product features and benefits to a customer - Demonstrate it! What should you do before demonstrating a product? ...

effective communication - requires you to meet them where they are, rather than where you'd like the conversation to be. Service Recovery - an action the retailer provides to address a service failure. The Four-step Service Recovery Process - 1. Keep your composure, 2. Apologize and thank the customer, 3. Listen carefully and investigate the situation, 4. Propose solution options 8% - Amount of retail sales resulting in a return or exchange. clientele - The collective group of customers t...

Upselling - A sales associate who sells a slightly higher item to a customer who originally wanted a lower priced item loss - when assets of a business are stolen or missing due to error Physical Inventory - a type of inventory control in which every piece of merchandise in the store is counted Planogram - a visual map that shows shelf heights, merchandise and signage placement that maximizes the display space Pre-priced Inventory - merchandise that arrives at the store with price tags al...