UNITED HEALTHCARE (UHC) – 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 1 / 3
application for a Medicare Advantage or Prescription Drug plan? - ANSWER- April 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 insurance- related 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? - ANSWER-
An 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 2 / 3
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? - ANSWER- Provide 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? - ANSWER- John may sign the Enrollment Application and must be able to provide
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