AHIP FINAL ACTUAL EXAM 2023 -2024 UPDATE QUESTIONS AND CORRECT ANSWERS ALREADY A GRADED Miguel Sanchez is a relatively new agent who has come to you for advice as to what he can do during the Medicare Advantage Open Enrollment Period (MA-OEP). What advice should you give Miguel? a. During the MA-OEP, Miguel can have one-on-one meetings with beneficiaries who have requested such meetings. Correct: During the MA-OEP, those enrolled in a Medicare Advantage plan have the opportunity to change plans or enroll in Original Medicare. Marketing representatives may respond to beneficiary requests for one-on-one meetings. b. During the MA-OEP Miguel can purchase a list of individuals who have chosen MA plans during Annual Enrollment Period (AEP) and create a marketing plan aimed at targeting them to select a plan he sells. c. During the MA-OEP Miguel can make unsolicited calls to former enrollees who have selected a new plan during the Annual Enrollment Period (AEP). d. During the MA-OEP Miguel can send unsolicited print materials to seniors in his area advertising the opportunity to change from one MA plan to another. Feedback Source: Module 4, Slide - Open Enrollment Period - Marketing Prohibitions and Slide - Promoting Health Plans During Open Enrollment Period. Plan sponsors may undertake the following marketing activities with current Medicare Advantage plan members? a. Market non-health related items such as accident-only plans without the need for obtaining a HIPAA compliant authorization form from an enrollee. b. Market contact information lists of current members to third-party vendors of ancillary health products as permitted by Dodd-Frank legislation. c. Market non-health related items or services such as life insurance or annuities policies to current members as permitted following HIPAA Privacy Rules. Correct: Plan sponsors must obtain HIPAA compliant authorization forms from enrollees before the Plan sponsor may use (or may request a marketing representative to use on their behalf) information about the enrollee to market non-health related items or services such as life insurance or annuity policies. d. Market non-Medicare health-related products, such as financial planning, to current members as permitted by Dodd-Frank legislation. Feedback Source: Module 4, Slide - Required Practices: HIPAA and Confidentiality of Enrollee Information and Slide - Required Practices: Marketing & Non-Health Related Activities. Your friend’s mother just moved to an assisted living facility and he asked if you could present a program for the residents about the MA-PD plans you market. What could you tell him? a. You appreciate the opportunity and your friend would just need to complete scope of appointment forms on behalf of all the residents who would like to attend. b. You appreciate the opportunity and will ask the facility to provide a plan brochure and enrollment application in every resident’s room before the meeting to promote interest in the event. c. You appreciate the opportunity and would be happy to schedule an appointment with anyone at their request. Correct: Marketing representatives may schedule an appointment with a beneficiary in a longterm care facility only upon their request. d. You appreciate the opportunity and would ask the facility to provide enrollment applications for the MA-PD plans you represent. Feedback Source: Module 4, Slide - Marketing Activities: Marketing in a Long-term Care Facility and Slide - Marketing Activities in a Health Care Setting: Example. Agent Armstrong is employed by XYZ Agency, which is under contract with ABC Health Plan, a Medicare Advantage (MA) plan that offers plans in multiple states. XYZ Agency maintains a website marketing the MA plans with which it has contracts. Agent Armstrong follows up with individuals who request more information about ABC MA plans via the website and tries to persuade them to enroll in ABC plans. What statement best describes the marketing and compliance rules that apply to Agent Armstrong? a. Agent Armstrong needs to be licensed and appointed only in the state where ABC Health Plan is headquartered. b. Agent Armstrong needs to be licensed and appointed in every state in which beneficiaries to whom he markets ABC MA plans are located. Correct: State licensure and plan appointment applies to the states where the beneficiaries are being marketed to are located. c. Agent Armstrong needs to be licensed and appointed only in his state of residence. d. Agent Armstrong needs to be licensed and appointed only in the state where XYZ Agency is headquartered. Feedback Source: Module 4, Slide - Requirement to act as Plan Marketing Representative and Slide - Marketing Representatives - State Licensure Case Study Melissa Meadows is a marketing representative for Best Care which has recently introduced a Medicare Advantage plan offering comprehensive dental benefits for $15 per month. Best Care has not submitted any potential posts to CMS for approval. Melissa would like to use the power of social media to reach potential prospects. What advice would you give her? a. Agent Meadows should post a tweet telling readers to contact her directly to learn more about Best Care’s comprehensive dental benefits at only $15 per month. b. Despite the terms of her contract forbidding the use of social media, Agent Meadows could send out a tweet stating that “Best Care offers a Medicare Advantage benefit package offering the lowest cost comprehensive dental benefit package available. Call me direct to learn more.” because the content does not contain any plan-specific information about benefits, premiums, cost-sharing, or Star Ratings. c. Due to cybersecurity dangers, social media cannot be used in the promotion of Medicare Advantage products. d. As soon as CMS approves Best Care's social media posts, Agent Meadows could post a tweet stating that“Best Care offers an array of Medicare Advantage benefit packages. One might be right for you. Call me to find out more!” Correct: Best Care must submit marketing materials, including social media posts to CMS for approval before the plan or its agents may begin posting such marketing content. Feedback Source: Module 4, Slide - Use of Social Media to Market and Slide - Social Media Example. Agent Martinez wishes to solicit Medicare Advantage prospects through e-mail and asks you for advice as to whether this is possible. What should you tell her? a. While unsolicited contacts may be made through print media such as direct mail, marketing representatives may not initiate electronic contact. b. Marketing representatives may initiate electronic contact through e-mail but an opt-out process must be provided. Correct: A marketing representative may initiate electronic contact through e-mail since that is now considered general audience marketing similar to print media. Rules regarding unsolicited contact do not apply to marketing through these materials. However, use of electronic media must provide an opt-out process.