AHIP Marketing, Sales Compliance, and Ethics 3

Question 1

What does the term 'slamming' refer to in Medicare sales compliance?

Accepted Answer

Enrolling a beneficiary in a plan without their knowledge or consent

Answer

Submitting fraudulent claims for services not rendered

Answer

Misrepresenting plan benefits during a sales presentation

Answer

Offering improper inducements to enroll

Question 2

Under CMS rules, agents selling Medicare plans are required to complete training and certification:

Accepted Answer

Annually for each carrier whose products they sell

Answer

Once, at initial licensure

Answer

Every three years per CMS requirements

Answer

Only when a compliance complaint is filed against them

Question 3

Which document defines the products and benefits an agent agreed to discuss with a beneficiary before a sales meeting?

Accepted Answer

Scope of Appointment (SOA)

Answer

Evidence of Coverage (EOC)

Answer

Annual Notice of Change (ANOC)

Answer

Summary of Benefits (SB)

Question 4

If a beneficiary requests information about a Medicare plan online or via an enrollment form, an agent may follow up by telephone:

Accepted Answer

Immediately, as the request constitutes prior permission

Answer

Within 12 months of the request

Answer

Never — telephone follow-up is always prohibited

Answer

Within 48 hours of receiving a marketing event lead

Question 5

What is the agent's obligation if a beneficiary wants to discuss a product not listed on the Scope of Appointment (SOA)?

Accepted Answer

Obtain a new SOA for the additional product types before discussing them

Answer

Proceed with discussing all plan types since the beneficiary is present

Answer

Discuss the additional products but note it on the original SOA

Answer

Contact the plan sponsor for verbal permission to expand the discussion

Question 6

An agent who misrepresents the benefits of a Medicare Advantage plan to persuade a beneficiary to enroll may face:

Accepted Answer

Suspension of certification, fines, and potential exclusion from Medicare programs

Answer

A verbal warning from the plan sponsor only

Answer

A 30-day probationary period before normal activities resume

Answer

Mandatory retraining with no further consequences