AHIP Marketing, Sales Compliance, and Ethics

Question 1

Under CMS marketing guidelines, when can an agent conduct a marketing/sales event at a healthcare facility such as a hospital or skilled nursing facility?

Accepted Answer

Never — CMS prohibits marketing events at healthcare facilities

Answer

Anytime with facility management permission

Answer

Only in common areas with prior facility consent and CMS-approved materials

Answer

Only for current plan members during annual renewal

Question 2

Which of the following agent activities is PROHIBITED under CMS marketing rules?

Accepted Answer

Offering gifts or meals of more than nominal value to influence enrollment

Answer

Providing CMS-approved plan comparison materials

Answer

Conducting a sales presentation during a community education event

Answer

Answering a beneficiary's question about plan benefits

Question 3

An agent who sells Medicare Advantage or Part D plans must be licensed in the state where the beneficiary:

Accepted Answer

Resides

Answer

Was born

Answer

Works

Answer

Receives medical care

Question 4

Before conducting a Medicare sales presentation, an agent must:

Accepted Answer

Provide the beneficiary with a Scope of Appointment (SOA) form and have it signed

Answer

File a pre-sales report with CMS

Answer

Obtain a referral from the beneficiary's physician

Answer

Complete a needs assessment approved by the plan

Question 5

What is the 'cooling-off period' related to Medicare marketing?

Accepted Answer

The 48-hour period after a sales event during which the agent cannot call the beneficiary back

Answer

A 30-day period after enrollment during which the plan cannot charge a premium

Answer

A 60-day window for rescinding a prior authorization denial

Answer

The period between AEP close and coverage effective date

Question 6

CMS requires that all marketing materials used by Medicare Advantage and Part D plans be:

Accepted Answer

Submitted to CMS for review and approval before distribution

Answer

Approved by the state insurance department before use

Answer

Pre-approved by a third-party compliance vendor

Answer

Submitted to CMS within 90 days after first use