UHC ethics and compliance section for certification (score card 100%)

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What is a servicing agent? - ANSWER an inactive, nonemployee who has signed a servicing agreement in order to receive renewal commissions on Medicare advantage and prescription drug plan enrollments o... n or after 1-1-2014. the agent must maintain an active resident license and appointment and pass medicare basics and ethics compliance assessments on an annual basis What does CMS stand for? - ANSWER center for medicare and medicaid services Who administers the medicare program and contracts with private health care companies to offer medicaid plans? - ANSWER CMS Who holds the authority to approve or disapprove plans that can be sold, and is the regulating agency that also monitors our progresses? - ANSWER CMS Who regulates MA's and PDP's - ANSWER CMS Enrolling a customer in a plan when you are not certified in the product is non-compliant and considered____? - ANSWER an unqualified sale Agents who are not qualified to sell the product will not be? - ANSWER compensated and may receive corrective and or disciplinary action up to an including termination What is the purpose of an educational event? - ANSWER its designed to inform medicare consumers about original medicare, medicare advantage, prescription drug and other medicare programs. Where must educational events be conducted? - ANSWER in a public venue Are the educational events unbiased so that it doesn't steer the consumer towards a specific plan or limited number of plans? - ANSWER yes What is a marketing/sales event? - ANSWER an event designed to steer or attempt to steer, consumers toward a plan or limited set of plans. Agents may discuss plan specific information and collect applications. Can marketing/sales be formal or informal? - ANSWER both What describes a formal marketing/sales event? - ANSWER a full plan presentation, given in a presenter-audience format. What is an inform marketing/sales event? - ANSWER they're passive in nature where the consumer approaches the agent to engage in conversation. a booth, table, or kiosk is typically used What are marketing appointments? - ANSWER They're commonly referred to as "in home, face to face, or one on one appointment" and typically take place in the consumers home. What other places can market appointments happen? - ANSWER coffee shop, or even over the phone because marketing appointments are not formal and informal marketing sales events, they're not reported to who? - ANSWER UHC or CMS. instead, agents must obtain a completed scope of appointment prior to conducting the appointment. To report events, what should agents use? - ANSWER an event request form to ensure that events are in UHC's event reporting application no less than 7 calendar days prior to the event... - ANSWER submit the event request form, according to instructions on the form, NO LESS THAN 14 CALENDAR DAYS event request forms submitted within7 calendar days will NOT be what? - ANSWER processed [Show More]

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