2015 Smmc Open Enrollment Quiz

15 Questions | Total Attempts: 338

SettingsSettingsSettings
Please wait...
2015 Smmc Open Enrollment Quiz

Questions and Answers
  • 1. 
    The recipient’s Open Enrollment period starts on 10/01/2015, and continues through 11/30/2015. If the recipient calls when they receive their OE letter and changes the plan on 09/06/2015, when will the new plan start?
    • A. 

      09/01/2015

    • B. 

      10/01/2015

    • C. 

      11/01/2015

    • D. 

      12/01/2015

  • 2. 
    After changing the plan during his Open Enrollment period (03/01/2015 through 04/30/2015) Ben Johnson’s new plan became effective on 05/01/2015. When will the 90 day change period start?
    • A. 

      05/01/2015

    • B. 

      06/01/2015

    • C. 

      07/01/2015

    • D. 

      No 90 day change period. After Open Enrollment member will enter in a no change period.

  • 3. 
    The recipient changed the plan during the Lock-In period using a Good Cause 1. The plan change was approved and the new plan will become effective on 05/01/2015. When will the 90 day change period start?
    • A. 

      08/01/2015

    • B. 

      05/01/2015

    • C. 

      07/01/2015

    • D. 

      06/01/2015

  • 4. 
    Where should Open Enrollment dates be verified?
    • A. 

      Span information in HealthTrack

    • B. 

      FMMIS

    • C. 

      Hover in HealthTrack

    • D. 

      History in HealthTrack

  • 5. 
    Oscar Wilde changed his plan during his Open Enrollment period (5/6/2015 to 07/31/2015). When will his new plan start?
    • A. 

      08/01/2015

    • B. 

      09/01/2015

    • C. 

      10/01/2015

    • D. 

      11/01/2015

  • 6. 
    The enrollment cycle has the following components:
    • A. 

      Initial 90 day change period, Lock-In period and 60 days of Open Enrollment period.

    • B. 

      Lock-In period plus Open Enrollment period.

    • C. 

      30 day change period, Lock-In period, and Open Enrollment period.

    • D. 

      None of the above.

  • 7. 
    How can a member change the plan during the Open Enrollment period? Select ALL that apply.
    • A. 

      Member can change the plan online.

    • B. 

      Member can change the plan via IVR.

    • C. 

      Member may change the plan over the phone.

    • D. 

      Member may change the plan face to face.

  • 8. 
    When will recipients be notified of the upcoming Open Enrollment period?
    • A. 

      Recipients will be notified prior to their Open Enrollment period.

    • B. 

      Recipients will be notified during their Open Enrollment period.

    • C. 

      Recipients will not be notified of their Open Enrollment period.

    • D. 

      None of the above.

  • 9. 
    Which MMA regions will enter into the new Open Enrollment cycle first?
    • A. 

      Any region

    • B. 

      Regions 2, 3 and 4

    • C. 

      Regions 10 and 11

    • D. 

      Regions 4, 5, and 6

  • 10. 
    How many members will be listed in the Mandatory Open Enrollment Letter?
    • A. 

      The letter will list all the members that are in Open Enrollment (one letter per case).

    • B. 

      The letter will list all the members in the case regardless of their Open Enrollment dates.

    • C. 

      The letter will only contain general information on Open Enrollment.

    • D. 

      The letter will list one recipient per letter.

  • 11. 
    Member's Open Enrollment period starts on 2/3/2015 and ends on 04/30/2015. When is the last day the member may call in to change their plan?
    • A. 

      04/30/2015

    • B. 

      05/01/2015

    • C. 

      06/01/2015

    • D. 

      04/29/2015

  • 12. 
    Susy Bermudez is currently enrolled into Staywell and calls in during her Open Enrollment to change the plan to Molina Healthcare of Florida. Before the Open Enrollment period ends, she calls in again and states that she needs to go back to Staywell.  How do you proceed?
    • A. 

      Process the plan change through the SMMC Wizard because HealthTrack will allow you to process the plan change if the current plan has an end date.

    • B. 

      Place this request on the Discrepancy Log.

    • C. 

      Process the plan change through the SMMC Wizard and send an email to Marsha and Lisa to request an earlier effective date.

    • D. 

      Advise the caller to call back during the 90 day change period.

  • 13. 
    Molly Smith calls to change her plan during Open Enrollment to United Healthcare. She calls back, before Open Enrollment is over, because she changed her mind and would rather enroll with Better Health because she wants to see a new doctor. How do you proceed?
    • A. 

      Place this request on the Discrepancy Log.

    • B. 

      Process the plan change through the SMMC Wizard.

    • C. 

      Process the plan change through the SMMC Wizard and send a request to Marsha and Lisa for an earlier effective date.

    • D. 

      Refer the case to your Supervisor or Lead.

  • 14. 
    Caller says: "Why does it take 2 months for my plan to start?"  How should you respond?
    • A. 

      It is a system process set by the state, would you like to file a complaint?

    • B. 

      This time gives you the opportunity to make sure your doctors, specialists, and hospitals you want to go to accept your plan. You should also consider the expanded benefits each plan offers.

    • C. 

      In region 2, 3, and 4, it takes 2 months for adults and 1 month for children.

    • D. 

      There is a waiting period to see if the plan is going to accept you. Some plans don't accept people because of their medical conditions.

  • 15. 
    The new open enrollment change will also affect LTC.
    • A. 

      True

    • B. 

      False

Back to Top Back to top