Before Starting An Enrollment What Benefit Information Are Agents

Question: Gene got Medicare before he turned 65 and enrolled into a Medicare Advantage plan. He calls in February the month before his 65th birthday and is unhappy with his current plan. On the date of the call, what can Gene do about his coverage?

Answer: On the day he called, he can enroll in a different Medicare Advantage plan with an effective date of March 1.

Question: 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.

Question: Which of the following is not considered unsolicited contact with a Medicare eligible consumer according to CMS regulations and UnitedHealthcare’s rules, policies, and procedures?

Answer: Mailing a marketing brochure to the consumer via postal mail.

Question: Which statement is true about discussing benefits with the consumer before an enrollment?

Answer: The agent must accurately and completely disclose any benefits discussed.

Question: Which statement about discussing benefits with the consumer before an enrollment is true?

Answer: The agent must explain any provider and/or pharmacy network limitations.

Question: 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.

Question: What is the purpose of the Statement of Understanding?

Answer: It ensures that when consumers complete the Medicare Advantage and/or Part D Enrollment Application, they are acknowledging their understanding that they are actually enrolling, in which plan they are enrolling, and standard disclosures.

Question: What is Scope of Appointment?

Answer: The agreement obtained from the consumer that identifies the scope of products that can be discussed at a personal/individual marketing appointment (in-person or telephonic)

Question: 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.

Question: In which situation MAY the Medicare Advantage (MA) organization disenroll a member from an MA plan?

(if question says

it is not the same answer)

Answer: Premiums are not paid on a timely basis.