AHIP MODULE 4
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George just became eligible for Medicare and asked you to
call to discuss Medicare Advantage and Part D plans that you market. What are
you permitted to say during your conversation with him?
You must disclose to him that he does not have to provide you with any information
You market many different types
of insurance and ordinarily you spend time each evening calling potential
clients. To be in compliance with requirements for marketing Medicare
Advantage and Part D plans, what must you do about contacting potential clients
to market those plans?
- You will have to avoid calling any potential client, unless he or she initiates
- contact with you and specifically asks that you give him or her a call
Mrs. Hopkins has a Medigap plan
and she wants to understand how a Private Fee-for-Service (PFFS) plan will work
compared to the Medigap plan. Which of the following would be helpful
statements to say to her?
- plans do not pay after Medicare, but instead of Medicare, and the beneficiary
- will have to pay any applicable cost-sharing.
are meeting with Mrs. Hall in her home. On her scope of appointment form she
asked to discuss Medicare Advantage plans. During the meeting, she asks to
discuss a stand-alone prescription drug plan. She is leaving the next day to
visit her family for a week in another state, so it is important to her to make
a decision before she leaves. What must happen before that additional
discussion can take place?
- Mrs. Hall specifically asked that you discuss the stand-alone Part D plan, you
- may do so, as long as she signs a new scope of appointment form first,
- indicating that she wants to discuss the Part D plan
Another agent you know has engaged in misconduct that has
been verified by the plan she represented. What sort of penalty might the
plan impose on this individual?
- plan may withhold commission, require retraining, report the misconduct to a
- state department of insurance or terminate the contract
are holding a sales event in a few days and one of the other agents you are
working with asks you about whether or not you can provide gifts. What should
you tell the other agent?
- may offer gifts or prizes with a total retail value not exceeding
- $15 per attendee
This year you have decided to focus your efforts on marketing
to employer group plans. One employer provides you with a list of their
retirees and asks you to contact them to explain the characteristics of the
plan they have selected. What should you do?
- may go ahead and call them
You are meeting with Mrs. Fairchild to provide her with
information about the MA plans you represent. She wants to look at as few of
the pre-enrollment materials as possible because she doesn't like a lot of
clutter and doesn't want to get confused. You explain that you must give her
certain pre-enrollment materials. Which of the following is NOT required
to be provided with an enrollment form?
- explanation of the plan’s grievance and appeals processes and a notice that the
- plan may not be available next year.
Another agent, who will be giving a sales presentation on a
Private Fee-for-Service (PFFS) plan, tells you he knows that there is a
disclaimer that must be used in connection with marketing these plans, but
can't remember the specifics of when it should be used. What should you tell
- PFFS disclaimer should be used in all marketing materials, sales presentations,
- and individual appointments with Medicare beneficiaries
You would like to market an MA plan at a neighborhood
pharmacy. What should you keep in mind to comply with the marketing
requirements for MA plans?
- must set up your table, make marketing presentations, and accept enrollment
- applications only in common areas outside of where the patient waits for
- services from the pharmacist
What would you like to do?
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