Marketing, Sales Compliance, and Ethics Flashcards
6 cards from real AHIP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Marketing, Sales Compliance, and Ethics flashcards as text
What does the term 'slamming' refer to in Medicare sales compliance?
Answer: Enrolling a beneficiary in a plan without their knowledge or consent
Slamming refers to the unauthorized enrollment of a beneficiary into a Medicare plan without their knowledge or consent.
Under CMS rules, agents selling Medicare plans are required to complete training and certification:
Answer: Annually for each carrier whose products they sell
CMS requires agents to complete annual training and pass certification tests for each plan sponsor (carrier) whose Medicare products they sell.
Which document defines the products and benefits an agent agreed to discuss with a beneficiary before a sales meeting?
Answer: Scope of Appointment (SOA)
The Scope of Appointment (SOA) form documents which Medicare plan types (e.g., MA, PDP, Medigap) the beneficiary agreed to discuss at the upcoming meeting.
If a beneficiary requests information about a Medicare plan online or via an enrollment form, an agent may follow up by telephone:
Answer: Immediately, as the request constitutes prior permission
When a beneficiary initiates contact or requests information (such as by submitting an online inquiry), the agent has permission to follow up by telephone.
What is the agent's obligation if a beneficiary wants to discuss a product not listed on the Scope of Appointment (SOA)?
Answer: Obtain a new SOA for the additional product types before discussing them
If a beneficiary wants to discuss products not listed on the original SOA, a new or amended SOA must be completed and signed before those products are discussed.
An agent who misrepresents the benefits of a Medicare Advantage plan to persuade a beneficiary to enroll may face:
Answer: Suspension of certification, fines, and potential exclusion from Medicare programs
Misrepresentation is a serious compliance violation that can result in suspension or termination of agent certification, civil monetary penalties, and exclusion from Medicare programs.