2014 - Ba - Readiness Quiz 3 - Ga/Df

A new Benefit Advisor is required to transfer the SST call to the SST pool. This means that instead of handling the call themselves, they need to redirect it to a designated team or department that specializes in handling SST calls. This ensures that the call is appropriately handled by experts who are trained and experienced in dealing with SST-related inquiries or issues.

The section that is not found in the client guide is "Available plans". The client guide provides information on various topics such as mailers, funding, and enrollment, but it does not include a section specifically dedicated to available plans. This suggests that the client guide focuses on other aspects of the service or product being discussed, rather than providing details on the specific plans that are available.

The carrier guide can help with finding a doctor, finding a hospital, and finding value-added benefits. However, it cannot help with finding quotable premium. This means that the carrier guide does not provide information or assistance in obtaining quotes for insurance premiums.

The tab "Medicare costs" is not found under work resources.

Part A of Medicare covers hospital insurance, not physician services. Physician services are covered under Part B of Medicare. Therefore, the correct answer is False.

The correct answer is "It helps subsidize their new premiums." This means that the HRA (Health Reimbursement Arrangement) assists in covering the costs of retirees' new insurance premiums. It does not necessarily pay for all their expenses or prevent them from paying out of pocket. However, it does provide financial support specifically for their premiums.

HMOs (Health Maintenance Organizations) typically require their members to have a primary care physician (PCP) who acts as the main point of contact for their healthcare needs. The PCP manages and coordinates the patient's healthcare, including referrals to specialists and other healthcare services. This requirement helps ensure that the patient receives coordinated and comprehensive care within the HMO network.

Part B is also known as Medical insurance. This statement is true. Part B refers to the medical insurance component of Medicare, which covers services such as doctor visits, outpatient care, medical supplies, and preventive services. It is one of the two main parts of Medicare, with Part A covering hospital insurance.

To verify doctor networks in Sharepoint, you would look in the "Carrier Guide". This resource is likely to contain information related to the networks of doctors that are available and accepted by the carrier. The other options, such as "Client Guide", "Work Resources", and "Medicare Resources" may provide valuable information, but they are not specifically focused on doctor networks. Therefore, the most appropriate place to find this information would be the "Carrier Guide".

The statement is incorrect. Medigaps are not always the first options when selling a plan. Medigap plans, also known as Medicare Supplement plans, are additional insurance policies that can be purchased to cover the gaps in Original Medicare coverage. However, there are other options available such as Medicare Advantage plans, which are an alternative to Original Medicare and may offer additional benefits. Therefore, Medigaps are not always the first choice when selling a plan.

A Select Gap plan is different because it has network restrictions. This means that the plan will only cover medical expenses if the individual seeks treatment from healthcare providers within the plan's network. Going outside of the network may result in limited coverage or no coverage at all. This is different from regular gap plans, which may have a broader network or no network restrictions at all. Additionally, Select Gap plans may cost a little more than regular gap plans due to the added benefit of network restrictions. They may also offer drug coverage, but this is not the primary distinguishing factor. These plans are only offered to select individuals, but this is not the main difference.

The correct answer is AEP, which stands for Annual Enrollment Period. The AEP is a specific time frame each year when individuals can make changes to their Medicare coverage. It typically runs from October 15th to December 7th. In this scenario, the 70-year-old caller is not losing group coverage, so they would need to wait for the AEP to make any changes to their coverage.

Medicare Advantage plans do not necessarily offer superior coverage for those who travel. While some Medicare Advantage plans may provide coverage for travel, it is important to carefully review the specific plan's details and restrictions. Additionally, traditional Medicare may offer more flexibility for those who frequently travel, as it allows beneficiaries to see any healthcare provider that accepts Medicare. Therefore, the statement that Medicare Advantage plans offer superior coverage for travelers is false.

The statement is incorrect. A Cost plan may require a part D plan to go with it. A Cost plan is a type of Medicare health plan that is offered by private insurance companies. It provides coverage for both medical services and prescription drugs. However, not all Cost plans include prescription drug coverage, so a separate part D plan may be needed to cover prescription medications. Therefore, the correct answer is False.

The statement is false because the HRA amount can indeed be a factor in determining the plans that a person sells. The HRA (Health Reimbursement Arrangement) amount is a type of employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses. Depending on the HRA amount, an employee may opt for a more comprehensive health insurance plan to cover higher medical costs or choose a more basic plan if their HRA amount is sufficient to cover their anticipated expenses. Therefore, the HRA amount can influence the choice of plans sold.

A new client losing group coverage after December 7th would need to use the Special Enrollment Period (SEP). The SEP allows individuals to enroll in a health insurance plan outside of the regular enrollment period due to certain qualifying events, such as losing group coverage. This allows the client to have an opportunity to obtain coverage even though it is outside of the typical enrollment period.

The statement suggests that the fastest way to access the client guide during a call with a customer is through the SSC (presumably referring to a customer service center). This implies that the customer service center has the necessary resources or information readily available to assist the customer with their query. Therefore, the answer is true, indicating that the SSC is indeed the fastest route to access the client guide during a call with a customer.

The correct answer is "All of the above" because the question asks about what the HRA (Health Reimbursement Arrangement) will cover in what area. The options provided include SSC, Client guide, and Sharepoint, indicating that the HRA will cover information related to all of these areas. Therefore, selecting "All of the above" implies that the HRA will cover information in SSC, Client guide, and Sharepoint.

New clients (Initial Campaign) show up in green in the Client Guide.

The statement suggests that the client's contact number can always be found in the client guide. However, the correct answer is false, indicating that this statement is not true. This means that the client's contact number may not always be available in the client guide.