Anthem Foundation/Basics Asses 2021
When reviewing an enrollment application with a prospective member, which of the following steps should NOT be done?
Collect plan premiums at the time of enrollment
Which of the following is not a valid reason for involuntary disenrollment?
Moving to a new address in the same plan service area
What dates reflect the Annual Election Period (AEP)?
October 15 through December 7
If a beneficiary has agreed to an in-home appointment to discuss a PDP product, an agent can discuss an HMO product with them during that same meeting, if the beneficiary requests it and a new scope of appointment form is completed.
True
Prior to making an enrollment decision, beneficiaries must review and complete the pre-enrollment checklist.
True
The Dual/LIS Special Election Period (SEP) begins the month the beneficiary becomes eligible for Low Income Subsidy (LIS) or receives any type of assistance from Medicaid. It is available one time per-calendar-quarter during the first nine months of the year.
True
How does a cancellation differ from a disenrollment?
a. A cancellation applies if a request is received prior to a member's effective date or by the date on the Outbound Enrollment Verification (OEV) letter b. Cancellation requests are initiated by the member and can be received either verbally or in writing c. Both A and B are correct d. Neither A nor B are correct
Which of the following statements is NOT true about a disenrollment?
a. A disenrollment applies if coverage ends after a member's effective date b. Disenrollment requests can be taken verbally c. Disenrollment can be voluntary or involuntary d. Voluntary disenrollments are initiated by the member and can generally only occur during specific periods such as AEP or OEP (MA/MA-PD plans only)
Which of the following statements about the Star Ratings Program are true?
a. Ratings are comprised of measures that cover both Part C and Part D b. Plans are ranked annually at the contract level on a scale of 1 to 5 Stars (5 is the highest) c. One time each plan year, beneficiaries can use a SEP to enroll into a 5-Star plan d. All of the above statements are true
An agent must not:
a. Use the Scope of Appointment form from another carrier that has not been approved by CMS. b. Rewrite or make their own version of a Scope of Appointment form c. Substitute dates or make changes to the Scope of Appointment markup after the appointment d. All of the above are prohibited