Questions and Answers
Which of the following types of events conducted by Agent John need to be reported to UnitedHealthcare?
Whose email address may the agent enter into the LEAN enrollment application?
Only the consumer's (or leave it blank).
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?
Annual Election Period (AEP)
Which of the following materials is an agent NOT permitted to display and/or distribute at a marketing/sales event?
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What should Connor do when he sees both Rina and Shelley at the appointment?
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Educational events allow for which of the following to occur?
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What should Josh tell Janine regarding changing her current plan to a 5-star plan?
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Which of the following describes Permission to Contact guidelines?
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Which method of contact is permitted for Agent Ralph to market Medicare Advantage Plans in his neighborhood?
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An individual with Power of Attorney is an example of what type of authority?
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Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare's rules?
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Who has the authority to sign an Enrollment Application?
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When marketing UnitedHealthcare Medicare Advantage plans to consumers, what must an agent do?
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As an agent, you have an obligation to only enroll a consumer in a product that is suitable for what?
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What is the purpose of the Statement of Understanding?
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What is the definition of Fraud?
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Which of the following are ways to report potential Fraud, Waste, and Abuse?
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Study Notes
Event Reporting
- All events conducted by agents, whether educational, formal, or informal, must be reported to UnitedHealthcare.
Consumer Email in LEAN Enrollment
- Only the consumer's email address may be entered in the LEAN enrollment application or left blank.
Election Periods
- Annual Election Period (AEP) occurs from October 15 to December 7, allowing consumers to join or switch Medicare Advantage Plans.
Marketing Materials Restrictions
- Agents are prohibited from displaying or distributing $5 gift cards to an in-network pharmacy at marketing/sales events.
Scope of Appointment (SOA) Requirement
- Agents must request that additional Medicare-eligible attendees, like friends, complete an SOA before attending the appointment.
Educational Events
- These events should provide objective information related to Medicare and health improvements without steering consumers toward specific plans.
Changing Plans
- Consumers can only change to a 5-star plan outside of the Annual Election Period if they qualify for a Special Enrollment Period (SEP) once per year.
Permission to Contact Guidelines
- Guidelines for contacting consumers include being method-specific, event-specific, and short-term, expiring once contact is made.
Approved Marketing Methods
- Agents can send flyers for marketing/sales events via postal mail but cannot hand them out directly in common areas or leave them unlawfully on cars.
Authority of Power of Attorney
- An individual with Power of Attorney has legal authority under state law to act on someone else's behalf.
Unsolicited Contact Definition
- Unsolicited contact does not include mailing marketing brochures via postal mail, but includes emailing brochures from purchased leads.
Enrollment Application Signatures
- Enrollment Applications can be signed by the consumer or their authorized legal representative, such as someone with Power of Attorney.
Marketing Obligations
- Agents must provide current marketing materials approved by CMS and UnitedHealthcare during consumer interactions.
Consumer-Suited Enrollment
- Agents must only enroll consumers in plans that align with their needs, goals, and financial resources.
Statement of Understanding
- This document ensures consumers acknowledge understanding their enrollment process and the plan in which they are enrolling.
Definition of Fraud
- Fraud is defined as the intentional misrepresentation or concealment of facts to acquire something of value.
Reporting Potential Fraud, Waste, and Abuse (FWA)
- Potential FWA can be reported through a hotline and the Producer Help Desk (PHD).
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Description
Test your knowledge about the types of events that Agent John is planning to conduct for UnitedHealthcare. This quiz covers whether educational, formal presentations, and informal marketing events need to be reported. Evaluate your understanding of reporting requirements in an insurance context.