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All Plan sponsors and contracted downstream entities must retain documents (i.e., books, records and documents, etc.) for a period of ten (10) years - ✔✔True A sales agent may correct anything on a signed enrollment form prior to submission to the plan by initialing next to the change, EXCEPT for: - ✔✔The applicant's date of signature Which activity is porhibited at "Educational Events"? - ✔✔None of the above In 2020, to qualify for Catastrophic Coverage a member must spend at least $6350, in out-of-pocket prescription drug costs. - ✔✔True The Blue Shield 65 Plus plan is available in all counties - ✔✔False What is the time frame for a health plan to render a decision about payment for a medical care or services that a member has already received? - ✔✔60 days When presenting at an event that has been filed as Educational, it is permissible for the sames agent to pass out business cards - ✔✔True Which form fields are critical when completing an enrollment? - ✔✔All of the above Medicare part D is: - ✔✔Prescription Drug Coverage Potential consequences of marketing violations may include: - ✔✔All of the above Appeals and Grievances are the two different types of complaints a member can make - ✔✔True If a member pays for a prescription up front at an out-of-network pharmacy, the member needs to submit a paper claim to Blue Shield for reimbursement - ✔✔True A member can sign up for the first time for one of the two Optional Supplemental Dental Plans at any time - ✔✔True Sales Agents must submit all enrollment forms to Blue Shield of California within 24 hours of the agent's signature date - ✔✔True Allegations from beneficiaries against agents will be investigated and may result in disciplinary action. - ✔✔True An example of a grievance is expressing dissatisfaction with: - ✔✔All of the answers listed For the 2020 benefit year, Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO), and Blue Shield Trio Medicare (HMO) members have a choice of purchasing an Optional Supplemental Dental PPO plan for an additional monthly premium of: - ✔✔$37.90 What documents are included in the Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO), and Blue Shield Trio Medicare (HMO) Welcome Kit that is mailed to the member after his or her enrollment is processed? - ✔✔All of the answers listed Both Blue Shield 65 Plus Choice Plan (HMO) Los Angeles / Orange and Blue Shield 65 Plus (HMO) Los Angeles / Orange use the same network - ✔✔False Sales agents who are presenting Blue Shield Medicare plan benefits must only use materials that have been submitted to and approved by Blue Shield of California and CMS. - ✔✔True
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