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UHC ethics and compliance section for certification Test(Questions and Answers)
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UHC ethics and compliance section for certification Test(Questions andAnswers)
What is a servicing agent? - Answers:an inactive, nonemployee who has signed a servicing
agreement in order to receive renewal commisions on medicare advantage and prescription drug
plan enrollments on or after 1-1-2014. the agent must maintain an active resident license and
appointment and pass medicare basics and ethics compliance assessments on an annual basis
What does CMS stand for? - Answers:center for medicare and medicaid services
Who administers the medicare program and contracts with private health care companies to offer
medicaid plans? - Answers:CMS
Who holds the authority to approve or disaprove plans that can be sold, and is the regulating
agency that also monitors our progresses? - Answers:CMS
Who regulates MA's and PDP's - Answers:CMS
Enrolling a customer in a plan when you are not certified in the product is non-compliant and
considered____? - Answers:an unqualified sale
Agents who are not qualified to sell the product will not be? - Answers:compensated and may
receive corrective and or disciplinary action up to an including termination
What is the purpose of an educational event? - Answers:its designed to inform medicare
consumers about original medicare, medicare advantage, prescription drug and other medicare
programs.
Where must educational events be conducted? - Answers:in a public venue
Are the educational events unbiased so that it doesn't steer the consumer towards a specific plan
or limited number of plans? - Answers:yes
,WHat is a marketing/sales event? - Answers:an event designed to steer or attempt to steer,
consumers toward a plan or limited set of plans. Agents may discuss plan specific information
and collect applications.
Can marketing/sales be formal or informal? - Answers:both
What describes a formal marketing/sales event? - Answers:a full plan presentation, given in a
presenter-audience format.
What is an inform marketing/sales event? - Answers:they're passive in nature where the
consumer approaches the agent to engage in conversation. a booth, table, or kiosk is typically
used
What are marketing appointments? - Answers:They're commonly referred to as "in home, face to
face, or one on one appointment" and typically take place in the consumers home.
What other places can marketing appointments happen? - Answers:coffee shop, or even over the
phone
because marketing appointments are not formal and informal marketing sales events, they're not
reported to who? - Answers:UHC or CMS. instead, agents must obtain a completed scope of
appointment prior to conducting the appointment.
To report events, what should agents use? - Answers:an event request form
to ensure that events are in UHC's event reporting application no less than 7 calender days prior
to the event... - Answers:submit the event request form, according to instructions on the form,
NO LESS THAN 14 CALENDAR DAYS
event request forms submitted within7 calendar days will NOT be what? - Answers:processed
, conducting an unreported event is _____? - Answers:prohibited
to schedule a sign language interpreter for a formal marketing/sales event or a
personal/individual marketing appointment, enter the consumer's request direct;y in bconnected
at least? - Answers:14 days prior to the event or appointment
What are marketing materials used for? - Answers:1) draw attention to a plan sponsor or their
plan(s) and
2) influence a consumer's decision when selecting a plan in which to enroll or a member's
decision to remain enrolled in their current plan
Marketing materials contain information about the plan or plans: - Answers:1) benefits or benefit
structure
2) cost sharing ( including premiums, copayments, and deductibles)
3) Measurements or ranking standards ( such as star ratings. comparisons to other plans, or
statistical studies or surveys)
Approval is required for? - Answers:1) ALL medicare marketing materials or
2) ANY material that mentions a plan sponsor ( such as " united health care") one of its affliated
plans or displays any logos
What does generic mean with marketing materials? - Answers:materials that do not meet the
marketing materials criteria and do not carry any plan sponsor information or logos
does generic materials require prior approval? - Answers:no
What methods are considered marketing material? - Answers:newspaper, tv, internet, radio
advertisements, direct mail, postcards, flyers, brochures, magnets, pre-enrollment materials,
websites and social media platforms
what are some examples of generic marketing materials? - Answers:social media sites and
websites
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