UNITED HEALTHCARE (UHC)\u2013 ETHICS AND
COMPLIANCE LATEST EXAM 2023-2024 REAL
EXAM 230 QUESTIONS AND CORRECT
ANSWERS|AGRADE
melanie is currently enrolled in an HMO MAPD, and she is talking to sales agent
Brenda about enrolling in a Medicare Supplement Insurance Plan. What should
Brenda tell Melanie? – ANSWER- Brenda should tell her that she is automatically
disenrolled from her MA Plan if she enrolls in a Medicare Supplement Insurance
Plan
In which situation must the Medicare Advantage (MA) organization disenroll a
member from an MA plan? – ANSWER- The member loses entitlement to either
Medicare Part A or Part B
Dennis, a consumer, is currently enrolled in Original Medicare plus a Medicare
Supplement Plan. His current plan is suitable for his medical needs, but he would
like to add prescription drug coverage only. Since Dennis wants to keep his current
coverage, which option is available to Dennis (assuming he is in a valid election
period)? – ANSWER- Dennis should stay enrolled in Original Medicare and his
Medicare Supplement Plan and enroll in a stand-alone PDP.
In what product should agents enroll consumers? – ANSWER- A product that is
suitable for the consumer’s needs, goals and financial resources
To avoid confusing or misleading a consumer, what type of information must the
agent provide when presenting a plan? (Select 3) – ANSWER- Accurate
Complete
Factual
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.
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<\/p>\n\n\n\n
application for a Medicare Advantage or Prescription Drug plan? – ANSWERApril 1 through October 31
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.
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
Before starting an enrollment, what benefit information are agents required to
provide to the consumer? – ANSWER- The agent must accurately and completely
disclose any benefits discussed
While using LEAN to complete an enrollment application with a consumer, Agent
Jeff learns the consumer does not have an email address. What should Jeff do? –
ANSWER- Leave the field requesting applicant email address blank
Jane, an agent, is speaking to Albert about a Prescription Drug plan. Albert seems
confused and is struggling to understand the information Jane is explaining. Which
option should Jane consider? – ANSWER- Jane should ask Albert if someone, such
as an Authorized Legal Representative, helps him make health care or insurancerelated decisions and should be present.
Melanie is currently enrolled in a MAPD, and she is interested in enrolling in a
PDP. Which statement is true? – ANSWERAn agent should only enroll a consumer in a product – ANSWER- That is suitable
for the consumer’s needs, goals and financial resources
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? –
ANSWER- AEP
In terms of events, which of the following is true? – ANSWER- WRONG – Agents
must report formal marketing\/sales events only to UnitedHealthcare
When completing an enrollment application in LEAN, why is an agent prohibited
from entering their own email address in a field available for the consumer’s email<\/p>\n\n\n\n
address? – ANSWER- The consumer\/member would not receive plan related
correspondence intended for him\/her.
Annual Election Period (AEP) is a time when: – ANSWER- Consumers can elect
to join a Medicare Advantage Plan or switch to a different plan.
You have scheduled an appointment and obtained a Scope of Appointment (SOA)
form to discuss Medicare Advantage Plans with a consumer. When you arrive at
the appointment, a friend of the consumer who is Medicare-eligible is present to
hear your presentation. What should you do? – ANSWER- Before you can start the
appointment with both consumers, ask the consumer’s friend to complete an SOA.
Educational events allow for which of the following to occur? – ANSWERProvide objective information about the Medicare program and\/or health
improvement and wellness.
Agent Brenda is presenting Medicare Advantage plan options to her consumer,
Melanie. During the presentation, Brenda tells Melanie that Medicare gives each
plan a Star Rating. Which of the following is not an appropriate response when
Melanie asks what the Star Rating means? – ANSWER- Brenda should tell
Melanie that the Star Rating is the same for every plan and it does not accurately
reflect a plan’s performance in certain categories.
When does Permission to Contact for Medicare Advantage and\/or Prescription
Drug Plans expire? – ANSWER- Once contact is made or 9 months from the date
the consumer provided permission (e.g. consumer signature date on BRC) or 90
days if on federal do not call list, whichever comes first.
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? – ANSWER- No. Victor
violated United Healthcare permission to contact guidelines by emailing the cousin
without the cousin’s permission.
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? – ANSWERJohn may sign the Enrollment Application and must be able to provide<\/p>\n","protected":false},"excerpt":{"rendered":"
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