UHC Ethics and Compliance Certification
Exam| Questions and Verified Answers| A+
Graded (2023/2024 Update)
QUESTION
In leu of a SOA form, agents must announce the products that will be presented at the formal or
informal marketing/sales event
Answer:
agents may obtain an SOA for future face to face or telephonic appointments if the consumer
requests the future appointment at the marketing/sales event
QUESTION
when conducting face to face or telephonic appointments to present MA and or PDP plans, the
agent MUST
Answer:
1) obtain a signed SOA from the consumer prior to the start of the appointment
2) obtain a new SOA when the consumer or agent requests to discuss a health related product not
identified on the original SOA. once obtained, the new product may be discussed
QUESTION
SOAs must be submitted how?
Answer:
via fax or emailed within 2 business days following the scheduled appointment
QUESTION
contracted agents using the generic SOA form must also include
Answer:
the corresponding fax coversheet
QUESTION
medicare marking guidelines prohibit marketing non-healh related products (annuities, life
insurance, LT disability/disability plans) when presenting what to a consumer?
Answer:
MA plan or PDP plas
THIS IS CONSIDERED CROSS-SELLING AND IS PROHIBITED
QUESTION
SCARE TACTICS ARE
Answer:
PROHIBITED
QUESTION
what is an authorized representitive?
Answer:
is a person who is authorized under state law to complete the enrollment application, make health
care decisions on behalf of the consumer and is authorized to receive health care related on
his/her behalf
QUESTION
in order to determine if a POA or authorized representitive is needed when enrolling a consumer,
the agent MUST___?
Answer:
consider the consumers mental and physical ability to enroll themselves
QUESTION
if a consumer appears to have either a physical and or mental challenges that may impede their
ability to enroll themselves in a plan, you must ask if they have a _ or ?
Answer:
POA or authorized representitive
QUESTION
a person assisting, including an agent cannot sign the enrollment application on behalf of the
Answer:
consumer.
only the consumer, POA, or authorized representative can sign the enrollment application
QUESTION
agents can offer promotional gifts to attendees of any event type as long as such gifts are of
nominal retail value. nominal value is any item _ or less Answer: $15 or less QUESTION the combined value of all giveaway items including food, must not exceed___ per consumer
Answer:
$15
QUESTION
What types of gifts are prohibited regardless of the amount?
Answer:
cash, gift certificates, gift cards, monetary rebates, as well as charitable contributions made on
behalf of the consumers/members
QUESTION
you must state that accepting a gift or prize does not obligate a consumer to
Answer:
enroll
QUESTION
when providing gifts, you must offer to
Answer:
all persons whether or not they’re eigible for medicare
QUESTION
giving gifts to solicit business is
Answer:
prohibited
QUESTION
what is the real on meals for sales/marketing events?
Answer:
it is prohibited including personal and individual marketing appointments
QUESTION
agents may serve light refreshments providing the items cannot be combined to equal a
2023/2024 UHC Certification Exam| Real
Questions and Verified Answers| A+ Grade
QUESTION
A consumer may have to pay a Late Enrollment Penalty (LEP) if they did NOT enroll in a
Medicare Advantage plan with Part D benefits or stand-alone prescription drug plan when they
were first eligible for Medicare Parts A and/or B or went without creditable prescription drug
coverage for __.
Answer:
63 or more continuous days
QUESTION
Through which means is financial assistance offered to a consumer who qualifies for Low
Income Subsidy for their part of Medicare Part D costs?
Answer:
Through subsidies such as lower or no monthly plan premiums and lower or no copayments
QUESTION
Which of the following lists drug tiers from least expensive cost share to most expensive cost
share?
Answer:
Preferred Generics, Generics, Preferred Brand (and some higher-cost generics), Non-Preferred
Drug (and some higher-cost generics), Specialty
QUESTION
Which of the following is NOT true about the Medicare Access and CHIP Reauthorization Act
of 2015 (MACRA) impact to Plans C and F?
Answer:
Consumers already enrolled in Plans C or F are required to change plans.
QUESTION
Which statement is true about medicare supplements?
Answer:
Insured members have the freedom to choose any doctor who accepts Medicare patients.
QUESTION
Cynthia is turning 65 on July 5. Her Medicare Part A and Part B will be effective on July 1.
Using her Initial Election Period (IEP), when can she submit an application for a Medicare
Advantage or Prescription Drug plan?
Answer:
April 1 through October 31
QUESTION
Annual Election Period (AEP) is a time when. . .
Answer:
Consumers can elect to switch to a different plan or join a Medicare Advantage plan or
Prescription Drug Plan.
QUESTION
Mrs. Violet asks agent Bob where she can find the Star Rating for the plan he has been
presenting. Which statement is correct?
Answer:
Mrs. Violet can access the Star Rating for a plan on Medicare.gov or in the Enrollment Guide.
QUESTION
In which of the following situations can telephonic contact be made with a Medicare eligible
consumer?
Answer:
When the consumer consented to be contacted for sales activities and the permission has not yet
expired.
QUESTION
Which statement is true about discussing benefits with the consumer before an enrollment?
Answer:
The agent must accurately and completely disclose any benefits discussed.
QUESTION
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?
Answer:
The consumer/member would not receive plan related correspondence intended for him/her.
QUESTION
The __ ensures that when consumers provide their verbal agreement during the
telephonic enrollment, they acknowledge and understand they are actually enrolling, in which
plan they are enrolling, as well as the standard disclosures.
Answer:
Statement of Understanding
QUESTION
What is Scope of Appointment?
Answer:
UHC Certification Exam (Latest 2023/2024) |
Actual Questions and Verified Answers| A+
Grade
QUESTION
Being 65 or older, being under 65 years of age with certain disabilities for more than 24 months,
and being any age with ESRD or ALS are each eligibility requirements for which program?
Medicaid
Original Medicare
Low Income Subsidy
Answer:
Original Medicare
QUESTION
To be eligible for this plan type, consumers must meet the following requirements:- Entitled to
Medicare Part A and enrolled in Part B- Reside in the plan’s service areaWhich plan is being
described?
Medicare Advantage
Prescription Drug
Medicaid
Original Medicare
Answer:
Medicare Advantage
QUESTION
What must be explained to consumers enrolling in an HMO (Health Maintenance Organization)
MA Plan? (Select 3)
They must see contracted network providers in order to receive coverage under the plan.
In most cases, they will pay the entire cost of the service if they see an out-of-network provider.
Most benefits are covered out-of-network but at a higher cost.
The exception to the provider network requirement is emergency visits, urgent care and renal
dialysis services, which can be obtained from out-of-network providers.
Answer:
QUESTION
What must be explained to consumers enrolling in an HMO (Health Maintenance Organization)
MA Plan? (Select 3)
They must see contracted network providers in order to receive coverage under the plan.
In most cases, they will pay the entire cost of the service if they see an out-of-network provider.
Most benefits are covered out-of-network but at a higher cost.
The exception to the provider network requirement is emergency visits, urgent care and renal
dialysis services, which can be obtained from out-of-network providers.
Answer:
In most cases, they will pay the entire cost of the service if they see an out-of-network provider.
Most benefits are covered out-of-network but at a higher cost.
The exception to the provider network requirement is emergency visits, urgent care and renal
dialysis services, which can be obtained from out-of-network providers.
QUESTION
When does Medicare Supplement Open Enrollment take place?
During the three months prior to the consumer’s 65th birthday, the month of their birthday, and
the three months following the month of their 65th birthday and enrolled in Medicare Part B.
During the first six months a consumer is 65 or older and enrolled in Medicare Part B.
Annually from October 15 to December 7.
During the first three months a consumer is 65 or older and enrolled in Medicare Part B.
Answer:
During the first six months a consumer is 65 or older and enrolled in Medicare Part B.
QUESTION
How does the Medicare Advantage Out-of-Pocket (OOP) maximum work?
The OOP maximum is a feature that limits the amount of money a consumer will have to spend
on Medicare-covered health care services each year.
The OOP maximum is a feature that limits the amount of money a consumer will have to spend
on all health care services each year.