{"id":119912,"date":"2023-09-16T19:15:41","date_gmt":"2023-09-16T19:15:41","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=119912"},"modified":"2023-09-16T19:15:45","modified_gmt":"2023-09-16T19:15:45","slug":"uhc-united-healthcare-ethics-and-compliance-exams-real-questions-and-verified-answers-new-updates-bundled-together-a-grade","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/09\/16\/uhc-united-healthcare-ethics-and-compliance-exams-real-questions-and-verified-answers-new-updates-bundled-together-a-grade\/","title":{"rendered":"UHC: United Healthcare \u2013 Ethics and Compliance Exams | Real Questions and Verified Answers (NEW UPDATES BUNDLED TOGETHER) |A+ GRADE"},"content":{"rendered":"\n<p>UHC: United Healthcare \u2013 Ethics and<br>Compliance Exam V1| Real Questions and<br>Verified Answers (NEW 2023-2024) |A+<br>GRADE<br>QUESTION<br>When marketing UnitedHealthcare Medicare Advantage plans to consumers, which of the<br>following must an agent do?<br>Answer:<br>Provide current marketing materials that have been approved by CMS and UnitedHealthcare.<br>QUESTION<br>What is the definition of Waste?<br>Answer:<br>NOT<strong>*<\/strong> Waste includes any practice that results in the provision of services that are not<br>medically necessary.<br>QUESTION<br>Which of the issues below are examples of Fraud, Waste and\/or Abuse? (Select 3)<br>Answer:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Falsifying signatures or medical records.<\/li>\n\n\n\n<li>The pharmacy splits the original prescription to receive additional dispensing fees.<\/li>\n\n\n\n<li>Using another person&#8217;s medical insurance information to obtain prescriptions.<br>QUESTION<br>Which of the following materials is an agent NOT permitted to display and\/or distribute at a<br>marketing\/sales event?<\/li>\n<\/ul>\n\n\n\n<p>Answer:<br>5-dollar gift cards to an in-network pharmacy.<br>QUESTION<br>Rina, a consumer, has requested an appointment with Connor, an agent, to discuss DSNPs. Prior<br>to the appointment Rina completed a Scope of Appointment (SOA) form. On the day of the<br>appointment, Rina brings her friend Shelley, who is Medicare-eligible, to the meeting. Shelley<br>also wants to talk about DSNPs. What should Connor do when he sees both Rina and Shelley at<br>the appointment?<br>Answer:<br>Ask Shelley to complete an SOA before the start of the meeting.<br>QUESTION<br>Educational events allow for which of the following to occur?<br>Answer:<br>Provide objective information about the Medicare program and\/or health improvement and<br>wellness.<br>QUESTION<br>Agent Bryan wants to grow his book of business. Which of the following lead generating<br>activities is NOT compliant?<br>Answer:<br>At each appointment he asks the consumer for the name and phone number of at least one<br>acquaintance who is 65 or older and calls the referred individual.<br>QUESTION<br>Which of the following is not considered unsolicited contact with a Medicare eligible consumer<br>according to CMS regulations and UnitedHealthcare&#8217;s rules, policies, and procedures?<br>Answer:<\/p>\n\n\n\n<p>UHC: United Healthcare \u2013 Ethics and<br>Compliance Exam V2| Real Questions and<br>Verified Answers (NEW 2023-2024) |A+<br>GRADE<br>QUESTION<br>Select the option that describes the coverage combinations a member can be enrolled in at the<br>same time.<br>MA-Only PFFS plan and a stand-alone PDP<br>MA-Only non-PFFS plan and a stand-alone PDP<br>Medicare Supplement plan and MA-PD plan<br>Answer:<br>Medicare Supplement plan and MA-PD plan &#8211; WRONG<br>QUESTION<br>In which situation will a member be involuntarily disenrolled from their MA plan?<br>The member lost entitlement to either Medicare Part A or Part B.<br>The member did not pay plan premiums on a timely basis.<br>The member engaged in disruptive behavior.<br>Premiums are not paid on a timely basis.<br>Answer:<br>The member lost entitlement to either Medicare Part A or Part B.<br>QUESTION<br>Rosanna is enrolled in a Medicare Advantage Only (MA-Only) Private Fee-for-Service (PFFS)<br>Plan. The plan is suitable for her needs and service area. She has decided she wants to add<br>prescription drug coverage. Which option is available to Rosanna (assuming she is in a valid<br>election period)?<br>Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone PDP.<br>Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a Medicare Advantage<br>Prescription Drug (MA-PD) plan.<\/p>\n\n\n\n<p>Rosanna could disenroll from her MA-Only PFFS plan and enroll in an MA-Only HMO plan and<br>a stand-alone PDP.<br>Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a Medicare Supplement<br>Plan.<br>Answer:<br>Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a Medicare Advantage<br>Prescription Drug (MA-PD) plan. &#8211; WRONG<br>Rosanna could stay enrolled in her MA-Only PFFS plan and enroll in a stand-alone PDP &#8211;<br>CORRECT<br>QUESTION<br>In what product should agents enroll consumers?<br>A product that meets the sales goal of the Centers for Medicare and Medicaid Services,<br>UnitedHealthcare and the Social Security Administration.<br>A product that provides a financial advantage to a network of providers.<br>A product that meets the interest the agent has in the transaction, for example commissions<br>received for the sale.<br>A product that is suitable for the consumer&#8217;s needs, goals and financial resources.<br>Answer:<br>A product that is suitable for the consumer&#8217;s needs, goals and financial resources.<br>QUESTION<br>Why must an agent present accurate, complete, and factual plan information to consumers?<br>(Select 3)<br>To help avoid confusing the consumer<br>To help the consumer focus on plan-specific information, such as benefits and costs<br>To help the consumer gain confidence in the agent&#8217;s expertise<br>To help avoid misunderstandings<br>Answer:<br>To help avoid confusing the consumer<br>To help the consumer focus on plan-specific information, such as benefits and costs<br>To help avoid misunderstandings<\/p>\n\n\n\n<p>QUESTION<br>Which statement about discussing benefits with the consumer before an enrollment is true?<br>The agent does not need to cover any benefits, provided the Summary of Benefits is emailed to<br>the consumer.<br>The agent does not need to disclose the monthly premium.<br>The agent only needs to review benefits in which the consumer is interested.<br>The agent must explain any provider and\/or pharmacy network limitations.<br>Answer:<br>The agent only needs to review benefits in which the consumer is interested. &#8211; WRONG<br>QUESTION<br>Whose email address may the agent enter into the applicant information section of the LEAN<br>enrollment application?<br>Answer:<br>Only the Consumer&#8217;s email<br>QUESTION<br>When must the Scope of Appointment be obtained from the consumer for an in-person or<br>telephonic sales presentation (unless an exception applies)?<br>No less than 48 hours before the marketing appointment<br>Anytime during the marketing appointment<br>When the marketing appointment has concluded<br>Before the start of a marketing appointment<br>Answer:<br>No less than 48 hours before the marketing appointment<br>QUESTION<br>What happens on the plan effective date when a member enrolled in a Medicare Supplement<br>Insurance Plan and stand-alone PDP enrolls in a Medicare Advantage plan that includes drug<br>coverage?<br>Automatic disenrollment from the Medicare Supplement Insurance Plan and the stand-alone<br>PDP.<\/p>\n\n\n\n<p>UHC: United Healthcare \u2013 Ethics and<br>Compliance Exam V3| Real Questions and<br>Verified Answers (NEW 2023-2024) |A+<br>GRADE<br>QUESTION<br>What type of events must an agent report to UnitedHealthcare?<br>-Informal marketing,\/sales events only<br>-Formal and informal marketing\/sales events<br>-Formal marketing\/sa[es events only<br>-Marketing\/sales events (formal and informal) and educational events<br>Answer:<br>Formal and informal marketing\/sales events<br>QUESTION<br>When completing an enrollment application in LEAN, why is an agent<br>prohibited from entering his or her own email address in a field<br>available for the consumer&#8217;s email address?<br>-The consumer\/member would not receive plan related correspondence intended for him\/her.<br>-The agent may experience commission payment processing issues.<br>-The enrollment application may be denied.<br>Answer:<br>The consumer\/member would not receive plan related correspondence intended for him\/her.<br>QUESTION<br>Which election period runs from October 15 to December 7 and<br>allows consumers to elect to join a Medicare Advantage Plan or<br>switch to a different plan?<br>-Annual Election Period (AEP)<br>-Special Election Period (SEP)<br>-Open Enrollment Period (OEP)<br>-Initial Coverage Election Period (ICEP)<\/p>\n\n\n\n<p>Answer:<br>AEP<br>QUESTION<br>Which of the following materials is an agent NOT permitted to display and\/or distribute at a<br>marketing\/sales event?<br>-Generic business reply cards for Medicare products.<br>-Medicare Made Clear brochures from the UnitedHealthcare Toolkit.<br>-5-dollar gift cards to an in-network pharmacy.<br>-Pens and notepads that contain the agent&#8217;s contact information.<br>Answer:<br>5-dollar gift cards to an in-network pharmacy.<br>QUESTION<br>Kira has scheduled an appointment and obtained a Scope of<br>Appointment (SOA) form to discuss Medicare Advantage Plans with a<br>consumer. When she arrives at the appointment, a friend of the<br>consumer who is Medicare-eligible is present to hear your<br>presentation. What should Kira do?<br>-Ask the consumer&#8217;s friend to leave since the friend had not scheduled the appointment.<br>-Before Kira can start the appointment with both consumers, she must ask the consumer&#8217;S friend<br>to complete an SOA.<br>-Ask the consumer&#8217;s friend to complete the SOA and schedule a separate appointment.<br>-Tell the consumer that you will come back another day,<br>Answer:<br>Before Kira can start the appointment with both consumers, she must ask the consumer&#8217;S friend<br>to complete an SOA.<br>QUESTION<br>Educational events allow for which of the following to occur?<br>-Provide objective information about the Medicare program and\/or health improvement and<br>wellness.<\/p>\n\n\n\n<p>-Provide an opportunity to give an introductory presentation followed by an informal<br>marketing\/sales event.<br>-Provide an opportunity to steer a consumer toward a specific or limited number of plans.<br>-Provide an opportunity to review benefits, premiums, and product information with consumers.<br>Answer:<br>Provide objective information about the Medicare program and\/or health improvement and<br>wellness.<br>QUESTION<br>Agent Brenda is presenting Medicare Advantage plan options to her<br>consumer, Melanie. During the presentation, Brenda tells Melanie<br>that Medicare gives each plan a Star Rating. Which of the following is<br>not an appropriate response when Melanie asks what the Star Rating<br>means?<br>-Brenda should tell Melanie that the Star Rating is the same for every plan and it does not<br>accurately reflect a plan&#8217;s performance in certain categories.<br>Brenda should tell Melanie that the Star Ratings helps consumers and members compare plans<br>based on quality and performance.<br>-Brenda should tell Melanie that Medicare indicates a plan&#8217;s overall performance and quality<br>with 1 to 5 stars; 1<br>star denotes poor quality and 5 stars represent excellent quality.<br>-Brenda should tell Melanie that Medicare uses several measures to determine how well plan<br>sponsors perform. Detecting and preventing illness is one example of the measures Medicare<br>uses.<br>Answer:<br>Brenda should tell Melanie that the Star Rating is the same for every plan and it does not<br>accurately reflect a plan&#8217;s performance in certain categories.<br>QUESTION<br>Which of the following describes Permission to Contact guidelines?<br>-It allows the agent to discuss the products identified during the marketing appointment.<br>-It is method specific (e.g., telephone, email), short term (i.e., expires when contact is made), and<br>event specific (i.e., limited to the products identified),<br>-It does not have to be provided by the consumer but can be provided by the consumer&#8217;s spouse<br>or adult child.<br>Answer:<\/p>\n","protected":false},"excerpt":{"rendered":"<p>UHC: United Healthcare \u2013 Ethics andCompliance Exam V1| Real Questions andVerified Answers (NEW 2023-2024) |A+GRADEQUESTIONWhen marketing UnitedHealthcare Medicare Advantage plans to consumers, which of thefollowing must an agent do?Answer:Provide current marketing materials that have been approved by CMS and UnitedHealthcare.QUESTIONWhat is the definition of Waste?Answer:NOT* Waste includes any practice that results in the provision of 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