Qm - Quiz 1

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| By Bthorup
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Bthorup
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Quizzes Created: 41 | Total Attempts: 28,779
Questions: 10 | Attempts: 207

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Qm - Quiz 1 - Quiz

Questions and Answers
  • 1. 

    Customer calls in and has already placed a plan in their cart. The attribution shows the BA's name; however, the BA went straight to the application. The MIR does not need to be read, since they did not go over the plan benefits or quote premiums. 

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    When ever a plan is placed in the cart, the MIR must be read

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  • 2. 

    ADP reads Plan F benefits: Covers 100% of the yearly Part B deductible ($147.00 for 2013). The ADP read: Covers 100% of the yearly Part B deductible ($147.00), but did not say for 2013. This is a 2014 plan. Should this line item be marked down?

    • A.

      Yes

    • B.

      No

    Correct Answer
    B. No
    Explanation
    No, I would not change the benefits because it covers 100%

    Rate this question:

  • 3. 

    If an BA tells the customer they’re eligible for a 5% spouse discount and it’s not available in the customers state

    • A.

      Coaching

    • B.

      Red Flag

    • C.

      Prohibited Practice

    • D.

      None of the above since it's not a required benefit

    Correct Answer
    C. Prohibited Practice
    Explanation
    If a BA misquotes benefits then it would be a prohibited practice

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  • 4. 

    CID: 14850751; 14850752 Call ID: 7111108      Time stamp 00:40:03-00:41:39 Listen to the call at the time stamp provided. How would you score this section?

    • A.

      Wouldn't mark down as the information is correct

    • B.

      Coaching since the ADP stated "but they reserve the right"

    • C.

      Prohibited Practice

    • D.

      Minor under line item 12/Potential Medicare Supplement Plan rate increase

    Correct Answer
    C. Prohibited Practice
    Explanation
    Prohibited Practice: Explain, interpret or offer opinions, advice or recommendations on, insurance coverage’s, exposures, limits, premiums, rates, deductibles, payment plans, or any other insurance contract, or potential insurance contract, terms to any potential insurance customer

    At time stamp 00:41:28, stated "It's not very likely that they will up the rates on you though." We score by what was stated last

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  • 5. 

    If the BA doesn’t review all the information pertaining to the specific drug asked about, this should be scored as a red flag.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    True, this could cause an escalation if the Customer is not aware that there are limitations on their medications.

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  • 6. 

    Mr. and Mrs. call in with an appoved HIPAA on the line. Both of their full names are obtained, but during secure the call, the HIPAA provides Mr.'s DOB and Mrs. DOB. Mrs. then provides her last 4 and Mr. then provides his last 4. Is the account fully secured?

    • A.

      Yes

    • B.

      No

    Correct Answer
    A. Yes
    Explanation
    Yes, the if the HIPAA is already approved, then the it is acceptable to obtain information from

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  • 7. 

    CSR takes call from the Customer who is calling in to enroll into a plan. CSR verifies the profile information, asks situation analysis questions and then reads the MIR. After reading the MIR, the CSR transfers to the BA. BA would not need to read the MIR again since the CSR read it prior to transferring the call.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The MIR must be read by the BA prior to presenting plans or adding them to the cart. CSR's are not required to read the MIR.

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  • 8. 

    When verifing that the Customer has an AARP membership prior to enrolling the Customer into the AARP Plan N, the ADP informs the Customer that he shows that they have a membership, but it has expired. The ADP then informs the Customer that AARP will contact the Customer to get the membership renewed by mail. This is correct, since the Customer previoulsy had an AARP membership and a membership is only required for Plan F.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    If the Customer is enrolling into a AARP Medigap plan, an active AARP membership is required at the time of enrollment. This should be Red Flagged as it could cause the application to be rejected.

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  • 9. 

    Mrs. Lois Black is completing her Medigap application with her daughter on the line to assist. The HIPAA scripting was not read during the opening script. When the ADP asks the question "Have you had coverage under any other health insurance within the last 63 days ?", Mrs. Black does not answer, so her daughter says "No". The Customer then says "oh sorry, no" Should this be marked down and if so where?

    • A.

      #40-Minor-Someone other than the Customer provided the answer

    • B.

      #10-Major-Skipped the HIPAA scripting

    • C.

      #47-Minor-Someone other than the Customer provided the answer

    • D.

      None of the above

    Correct Answer
    D. None of the above
    Explanation
    If the Customer repeats the answer, then this line item should not be marked down

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  • 10. 

    On a joint application, Customers are on the line and also have a HIPAA. The HIPAA scripting must be read to each spouse and then again for the HIPAA?

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Yes, they would have to authorize each spouse as a HIPAA (required for joint) and the again for the HIPAA on the line.

    Rate this question:

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jan 02, 2014
    Quiz Created by
    Bthorup
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