2015 Selecthealth

16 Questions | Total Attempts: 719

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2015 Selecthealth

Questions and Answers
  • 1. 
    Integration is a term that describes the collaboration and alignment between SelectHealth and:
    • A. 

      CMS

    • B. 

      Our clinical partners

    • C. 

      AARP

    • D. 

      The Department of Insurance

  • 2. 
    As a SelectHealth appointed agent, you agree that you are responsible to:
    • A. 

      Practice fair and ethical business

    • B. 

      Port concerns of misconduct

    • C. 

      Maintain confidentiality and privacy of member Personal Health Information

    • D. 

      Protect the interests of SelectHealth

    • E. 

      All of the above

  • 3. 
    Formulary restrictions on a drug plan include:
    • A. 

      Quantity Limits

    • B. 

      Step Therapy

    • C. 

      Prior Authorization

    • D. 

      All of the above

  • 4. 
    The SelectHealth Advantage Part D coverage has a $___ deductible.
    • A. 

      $300

    • B. 

      $310

    • C. 

      $320

    • D. 

      $0

  • 5. 
    On a Part D plan, the drug costs that count toward the Initial Coverage Limit include:
    • A. 

      What the member pays

    • B. 

      What the plan pays

    • C. 

      Both what the member and plan pay

    • D. 

      Drug discounts from pharmaceutical companies

  • 6. 
    Which of the following is/are true about the Part D LEP?
    • A. 

      The LEP amount is determined by Medicare

    • B. 

      The penalty is lifetime

    • C. 

      The penalty may change from year-to-year

    • D. 

      All of the above

  • 7. 
    SelectHealth Advantage has minimal co-insurances and is structured with fixed copays, which provides predictability of costs:
    • A. 

      True

    • B. 

      False

  • 8. 
    SelectHealth Advantage is a(n):
    • A. 

      HMO plan

    • B. 

      PPO plan

    • C. 

      PFFS plan

    • D. 

      HMO-POS plan

  • 9. 
    Point of Service (POS) gives members the option and flexibility to go to any out-of-network doctor, specialist, or hospital that accepts Medicare.
    • A. 

      True

    • B. 

      False

  • 10. 
    Members are required to choose one of our network providers to be their Primary Care Provider (PCP)
    • A. 

      True

    • B. 

      False

  • 11. 
    Members are required to obtain a referral to receive services that are covered by the plan
    • A. 

      True

    • B. 

      False

  • 12. 
    Under the SelectHealth Advantage Wellness benefit, members can be reimbursed up to $240/year for:
    • A. 

      Silver Sneakers approved facilities only

    • B. 

      Silver & Fit approved locations only

    • C. 

      Any commercial or community gym or fitness center

    • D. 

      Either Silver Sneakers or Silver & Fit locations only

  • 13. 
    The 2014 Medicare Annual Election Period begins on October __ and ends on December __.
    • A. 

      1, 7

    • B. 

      15, 31

    • C. 

      15, 7

    • D. 

      1, 31

  • 14. 
    Agents can create their own scripting to present the SelectHealth Advantage plan.
    • A. 

      True

    • B. 

      False

  • 15. 
    SelectHealth requires agents to collect and submit correct forms and documentation for an Authorized Legal Representative with the enrollment application.
    • A. 

      True

    • B. 

      False

  • 16. 
    All Telephonic Enrollments must be conducted on an inbound call from the Medicare beneficiary.
    • A. 

      True

    • B. 

      False