2015 - Adp - Knowledge #1 - Sojo - 10/15/2014

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Questions and Answers
  • 1. 

    Which word or term below best describes the amount you must pay each year before your health plan begins paying?

    • A.

      Ride

    • B.

      Deductible

    • C.

      Single-payer

    • D.

      Co-payment

    Correct Answer
    B. Deductible
    Explanation
    A deductible refers to the amount of money that an individual must pay out of pocket before their health insurance plan starts covering the expenses.

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  • 2. 

    What does PCP stand for?

    • A.

      Premium Cost Plan

    • B.

      Primary Care Physician

    • C.

      Prior Cost Plan

    • D.

      Prescription Cost Plan

    Correct Answer
    B. Primary Care Physician
    Explanation
    PCP stands for Primary Care Physician. A primary care physician is a healthcare professional who serves as the first point of contact for a patient's medical needs. They provide preventive care, diagnose and treat common illnesses, and refer patients to specialists if needed. The term PCP is commonly used in healthcare settings to refer to this essential role in the healthcare system.

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  • 3. 

    Medicare Part A is also known as?

    • A.

      Hospital

    • B.

      Medical

    • C.

      Prescription Drugs

    • D.

      All of the above

    Correct Answer
    A. Hospital
    Explanation
    Medicare Part A is known as Hospital because it covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health care services. It does not cover medical services or prescription drugs, which are covered under Medicare Part B and Part D respectively. Therefore, the correct answer is Hospital.

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  • 4. 

    Applications must be done in which order?

    • A.

      Vision, Dental, MAPD

    • B.

      Dental, Medigap, PDP

    • C.

      Vision, Dental, Medigap, PDP

    • D.

      All of the above apply

    Correct Answer
    D. All of the above apply
    Explanation
    The correct answer is "All of the above apply". This means that applications can be done in any order, whether it is for Vision, Dental, MAPD, Dental, Medigap, PDP, or any combination of these. There is no specific order that needs to be followed when applying for these different types of applications.

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  • 5. 

    What is another name for Medicare Claim Number?

    • A.

      Social Security Number

    • B.

      Driver’s License Number

    • C.

      Health Insurance Claim Number (HICN)

    • D.

      All of the above

    Correct Answer
    C. Health Insurance Claim Number (HICN)
    Explanation
    The correct answer is Health Insurance Claim Number (HICN). This is because the Medicare Claim Number is also referred to as the Health Insurance Claim Number (HICN). It is a unique identification number assigned to individuals who are eligible for Medicare benefits. The HICN is used to process and track Medicare claims and ensure accurate reimbursement for healthcare services provided to Medicare beneficiaries. The other options, Social Security Number and Driver's License Number, are not alternative names for the Medicare Claim Number.

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  • 6. 

    How does Automatic Reimbursement work?

    • A.

      Customer pays the plan premium to insurance company; insurance company forwards receipt of the payment to OneExchange; OneExchange forwards receipt of payment to the Funding Department, and the Funding Department reimburses the customer.

    • B.

      Customer fills out a claim form to be refunded for all premiums.

    • C.

      Customer calls the Funding Department, and they send the money electronically.

    • D.

      All of the above

    Correct Answer
    A. Customer pays the plan premium to insurance company; insurance company forwards receipt of the payment to OneExchange; OneExchange forwards receipt of payment to the Funding Department, and the Funding Department reimburses the customer.
    Explanation
    Automatic Reimbursement works by following a specific process. The customer pays the plan premium to the insurance company, who then forwards the receipt of the payment to OneExchange. OneExchange further forwards the receipt of payment to the Funding Department. Finally, the Funding Department reimburses the customer. This process ensures that the customer receives their reimbursement for the premiums paid.

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  • 7. 

    True or False: HMOs require a Primary Care Physician number.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    HMOs (Health Maintenance Organizations) do require a Primary Care Physician (PCP) number. In an HMO, individuals are required to choose a PCP who acts as their primary healthcare provider and coordinates all their medical care. The PCP number is necessary for tracking and managing the healthcare services provided to the individual within the HMO network. Therefore, the statement "HMOs require a Primary Care Physician number" is true.

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  • 8. 

    How long does the ICEP last?

    • A.

      4 months before, the month of, and 2 months after 65th birthday

    • B.

      3 months before, the month of, and 3 months after 65th birthday

    • C.

      6 months before 65th birthday

    • D.

      None of the above

    Correct Answer
    B. 3 months before, the month of, and 3 months after 65th birthday
    Explanation
    The correct answer is 3 months before, the month of, and 3 months after 65th birthday. The Initial Enrollment Period (ICEP) for Medicare lasts for a total of 7 months. It begins 3 months before the individual's 65th birthday month, includes the month of their 65th birthday, and extends for 3 months after their 65th birthday. This is the period when individuals can enroll in Medicare Part A and/or Part B without paying any late enrollment penalties.

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  • 9. 

    Are you Guaranteed Issue if you are aging-in?

    • A.

      Yes

    • B.

      No

    Correct Answer
    A. Yes
    Explanation
    If you are aging-in, it means that you are reaching the age where you qualify for certain benefits or insurance plans. In this context, being "Guaranteed Issue" means that you are eligible for coverage without being subject to medical underwriting or having to answer health-related questions. Therefore, the correct answer is "Yes," indicating that if you are aging-in, you are guaranteed issue for certain benefits or insurance plans.

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  • 10. 

    What plan types are available during the ICEP?

    • A.

      Medicare Advantage with Prescription Drug Plan

    • B.

      Medicare Advantage Plan

    • C.

      Prescription Drug Plan

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    During the Initial Coverage Election Period (ICEP), all three plan types are available. The ICEP is the period when individuals can enroll in a Medicare plan for the first time. Medicare Advantage with Prescription Drug Plan, Medicare Advantage Plan, and Prescription Drug Plan are all options that individuals can choose from during this period. Therefore, the correct answer is "All of the above."

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  • 11. 

    What does ICEP stand for?

    • A.

      Initial Conversion Election Period

    • B.

      Initial Coverage Election Period

    • C.

      Initial Coverage Enrollment Period

    • D.

      None of the above

    Correct Answer
    B. Initial Coverage Election Period
    Explanation
    The correct answer is Initial Coverage Election Period. This refers to the period when individuals can first enroll in a Medicare prescription drug plan or Medicare Advantage plan with prescription drug coverage. During this period, individuals have the opportunity to choose a plan that best suits their needs and coverage preferences.

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  • 12. 

    True or False: Customers using ICEP can only enroll during Annual Enrollment?

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Customers using ICEP can enroll at any time, not just during Annual Enrollment. ICEP stands for Initial Coverage Election Period, which is the period when individuals first become eligible for Medicare. During this time, individuals can enroll in a Medicare Advantage plan or a standalone prescription drug plan. Therefore, the statement that customers using ICEP can only enroll during Annual Enrollment is false.

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  • 13. 

    If a customer has ICEP and SEP-LEC, which enrollment period is used for a Legacy customer?

    • A.

      I am new to Medicare.

    • B.

      I am losing group coverage.

    • C.

      I have a disability.

    • D.

      None of the above

    Correct Answer
    A. I am new to Medicare.
    Explanation
    If a customer has ICEP (Initial Coverage Election Period) and SEP-LEC (Special Enrollment Period for Low-Income Individuals), the enrollment period used for a Legacy customer would be "I am new to Medicare." This is because the ICEP is the initial enrollment period for individuals who are new to Medicare and are enrolling in a Medicare Advantage or Medicare Prescription Drug Plan for the first time. The SEP-LEC is a special enrollment period for individuals who qualify for extra help with Medicare prescription drug costs based on their income and resources. Therefore, the combination of these two enrollment periods indicates that the customer is new to Medicare.

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  • 14. 

    A customer aging-in to Medicare will turn 65 on December 1st 2014. What should the Medicare Part A effective date be?

    • A.

      12/01/2014

    • B.

      11/01/2014

    • C.

      12/31/2014

    • D.

      None of the above

    Correct Answer
    B. 11/01/2014
    Explanation
    When a customer ages into Medicare, their Medicare Part A effective date is typically the first day of the month they turn 65. In this case, since the customer will turn 65 on December 1st, 2014, the Medicare Part A effective date should be November 1st, 2014.

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  • 15. 

    Mr. Blakely is aging-in, and will turn 65 on 12/16/2014. What should his Medicare Part A effective date be?

    • A.

      12/01/2014

    • B.

      11/01/2014

    • C.

      12/31/2014

    • D.

      None of the above

    Correct Answer
    A. 12/01/2014
    Explanation
    Mr. Blakely's Medicare Part A effective date should be 12/01/2014. This is because when someone is aging-in, their Medicare Part A coverage begins on the first day of the month they turn 65. In this case, Mr. Blakely will turn 65 on 12/16/2014, so his Medicare Part A coverage should start on 12/01/2014.

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  • 16. 

    Being new to which of the following would make a customer GI for a Medigap plan?

    • A.

      Medicare Part B

    • B.

      Medicare Part D

    • C.

      OneExchange

    • D.

      None of the above

    Correct Answer
    A. Medicare Part B
    Explanation
    Medicare Part B is the correct answer because being new to Medicare Part B would make a customer eligible to enroll in a Medigap plan. Medigap plans are designed to supplement Medicare coverage, and individuals must have both Medicare Part A and Part B to be eligible for a Medigap plan. Medicare Part B covers medical services such as doctor visits, outpatient care, and preventive services. Therefore, if a customer is new to Medicare Part B, they would be eligible to enroll in a Medigap plan to help cover the costs not covered by Medicare.

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  • 17. 

    If a customer has ICEP and SEP-LEC, which enrollment period is used for a new client?

    • A.

      I have moved from another state.

    • B.

      I am losing group coverage.

    • C.

      I am new to Medicare.

    • D.

      None of the above

    Correct Answer
    B. I am losing group coverage.
    Explanation
    If a customer has ICEP (Initial Coverage Election Period) and SEP-LEC (Special Enrollment Period for Loss of Employer Coverage), the enrollment period used for a new client would be "I am losing group coverage." This is because the SEP-LEC allows individuals who are losing their employer-sponsored health insurance coverage to enroll in Medicare outside of the usual enrollment periods. The other options, such as moving from another state or being new to Medicare, do not specifically mention the loss of group coverage, which is the relevant factor in this scenario.

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  • 18. 

    What does SEP stand for?

    • A.

      Special Enforcement Personnel

    • B.

      Special Enrollment Period

    • C.

      Special Election Period

    • D.

      Both B and C

    Correct Answer
    D. Both B and C
    Explanation
    SEP stands for Special Enrollment Period and Special Election Period. Both options B and C are correct because they represent different contexts in which the term SEP is used. A Special Enrollment Period refers to a specific time frame during which individuals can enroll in or make changes to their health insurance plans outside of the regular enrollment period. On the other hand, a Special Election Period refers to a specific time frame during which individuals can make changes to their Medicare Advantage or Medicare Part D plans.

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  • 19. 

    What does LEC stand for?

    • A.

      Light Emitting Cathode

    • B.

      Losing Employer Coverage

    • C.

      Losing Employer Compensation

    • D.

      Losing Executive Consideration

    Correct Answer
    B. Losing Employer Coverage
    Explanation
    LEC stands for Losing Employer Coverage. This term refers to the situation where an individual loses their health insurance coverage provided by their employer. This can occur due to various reasons such as job loss, change in employment status, or reaching the end of the coverage period. Losing employer coverage often requires individuals to seek alternative healthcare options such as purchasing private insurance or enrolling in government-sponsored programs like Medicaid or COBRA.

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  • 20. 

    True or False: LEC can be a voluntary loss of employer coverage.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    LEC stands for Loss of Employer Coverage. It refers to the situation where an individual loses their health insurance coverage provided by their employer. While this loss of coverage is often involuntary, such as due to job loss or reduction in work hours, it can also be voluntary. For example, an employee may choose to opt-out of their employer's health insurance plan and seek coverage elsewhere. Therefore, the statement that LEC can be a voluntary loss of employer coverage is true.

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  • 21. 

    True or False: You are losing employer coverage, so you are Guaranteed Issue during the 3 months  prior to and 63 following your loss of coverage date. 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    If you are losing employer coverage, you are guaranteed issue during the 3 months prior to and 63 following your loss of coverage date. This means that you have the right to purchase a health insurance plan without being denied or charged more based on your health status.

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  • 22. 

    When are we able to enroll a customer into a plan under the SEP-LEC?

    • A.

      1 month before loss of coverage

    • B.

      63 days before loss of coverage

    • C.

      3 months before loss of coverage

    • D.

      Upon notification of the loss of coverage

    Correct Answer
    C. 3 months before loss of coverage
    Explanation
    Customers are able to enroll in a plan under the SEP-LEC three months before the loss of coverage. This allows customers to have sufficient time to select and enroll in a new plan before their current coverage expires. It also ensures that there is no gap in their healthcare coverage.

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  • 23. 

    What is the most common SEP used at OneExchange?

    • A.

      ICEP (Age-in)

    • B.

      SEP-LTC

    • C.

      SEP-LEC

    • D.

      SEP-MOV

    Correct Answer
    C. SEP-LEC
    Explanation
    SEP-LEC is the most common SEP used at OneExchange. This is because SEP-LEC stands for Special Enrollment Period - Loss of Employer Coverage, which allows individuals to enroll in a new health insurance plan outside of the regular enrollment period if they have lost their employer-provided coverage. Since many individuals may experience a loss of employer coverage at some point, SEP-LEC is likely to be the most commonly used SEP at OneExchange.

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  • 24. 

    When does the SEP-LEC end?

    • A.

      After the plan has gone into effect

    • B.

      2 months after loss of coverage

    • C.

      30 days after loss of coverage

    • D.

      A and B

    Correct Answer
    D. A and B
    Explanation
    The SEP-LEC (Special Enrollment Period - Loss of Employer Coverage) ends after the plan has gone into effect and also 2 months after the loss of coverage. This means that individuals have a limited time frame to enroll in a new health insurance plan after their employer coverage has ended. The combination of both options A and B ensures that individuals have sufficient time to find a suitable alternative for their health insurance needs.

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  • 25. 

    What plan types are available during the SEP-LEC?

    • A.

      Medicare Advantage with prescription drug coverage (MAPD)

    • B.

      Medicare Advantage (MA)

    • C.

      Medicare Part D (PDP)

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    During the SEP-LEC, all plan types mentioned are available. This includes Medicare Advantage with prescription drug coverage (MAPD), Medicare Advantage (MA), and Medicare Part D (PDP). Therefore, the correct answer is "All of the above."

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  • 26. 

    What situations would allow a customer to enroll into Medicare prior to age 65?

    • A.

      End Stage Renal Disease

    • B.

      Disability

    • C.

      Because they asked Medicare nicely

    • D.

      A & B

    Correct Answer
    D. A & B
    Explanation
    The correct answer is A & B. Customers can enroll into Medicare prior to age 65 if they have End Stage Renal Disease or if they have a disability. These situations qualify individuals for early enrollment in Medicare, allowing them to access healthcare benefits before reaching the standard age requirement of 65.

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  • 27. 

    If the customer has two homes (e.g."snowbirds"), which one should you use as the address on the application?

    • A.

      Wherever they are when you are speaking to them

    • B.

      The address Medicare/IRS has as their permanent address

    • C.

      The address AARP has on file

    • D.

      Their Approved (HIPAA) Representative’s address

    Correct Answer
    B. The address Medicare/IRS has as their permanent address
    Explanation
    The correct answer is to use the address that Medicare/IRS has as their permanent address. This is because the permanent address is the official address that is recognized by the government and other organizations. It is important to use this address for accurate record-keeping and communication purposes. Using any other address may lead to confusion and potential issues in the future.

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  • 28. 

    If you have a Power of Attorney (POA) with a customer on the line and the customer is able to act for himself/herself, how would you process the application?

    • A.

      Let either of them answer any question because, in the eyes of the law, they are the same person for this call

    • B.

      Address only the POA since the customer is too old to understand any of this anyway

    • C.

      Address only the customer and ignore the POA because they don’t need to be there if the customer doesn’t need help

    • D.

      Treat the POA as a HIPAA Representative; do not complete the POA section of the application; take the voice signature from the customer.

    Correct Answer
    D. Treat the POA as a HIPAA Representative; do not complete the POA section of the application; take the voice signature from the customer.
    Explanation
    The correct answer is to treat the POA as a HIPAA Representative, not complete the POA section of the application, and take the voice signature from the customer. This is because a Power of Attorney (POA) allows the designated individual (in this case, the customer) to act on behalf of another person (the POA). However, if the customer is able to act for themselves, the POA is only needed as a HIPAA Representative to ensure compliance with privacy laws. Therefore, the application should be processed by addressing the customer and taking their voice signature, while acknowledging the presence of the POA as a HIPAA Representative.

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  • 29. 

    If you have answered every question “NO” on the application, what does that mean and what should happen?

    • A.

      The application is perfectly uncomplicated and nothing bad will happen.

    • B.

      The application guide was not followed, and the application will need to be corrected before you submit it.

    • C.

      The customer knows what the answers should be, so they know what will happen if they don’t get it right.

    • D.

      The customer will be arrested for fraud because not all the answers can be “NO.”

    Correct Answer
    B. The application guide was not followed, and the application will need to be corrected before you submit it.
    Explanation
    The correct answer suggests that if every question is answered "NO" on the application, it means that the application guide was not followed. As a result, the application will need to be corrected before it can be submitted. This implies that answering "NO" to every question is not the correct way to complete the application and adjustments need to be made to ensure the application is filled out correctly.

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  • 30. 

    When is AEP (Annual Enrollment Period)?

    • A.

      November 15 – December 15

    • B.

      January 1 – March 31

    • C.

      October 15 – December 7

    • D.

      None of the above

    Correct Answer
    C. October 15 – December 7
    Explanation
    The correct answer is October 15 - December 7. This is the time period when individuals can enroll in or make changes to their Medicare coverage. It is also known as the Annual Enrollment Period (AEP). During this time, individuals can switch from Original Medicare to Medicare Advantage, or vice versa. They can also switch between different Medicare Advantage plans or enroll in a Part D prescription drug plan. Outside of this period, individuals may only make changes to their coverage under certain circumstances, such as qualifying for a Special Enrollment Period.

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  • 31. 

    What does HMO stand for?

    • A.

      Health Maintenance Organization

    • B.

      Health Management Organization

    • C.

      Holistic Medicine Organization

    • D.

      Happy Management Organization

    Correct Answer
    A. Health Maintenance Organization
    Explanation
    HMO stands for Health Maintenance Organization, which is a type of health insurance plan that provides healthcare services through a network of doctors, hospitals, and other healthcare providers. HMOs typically require members to choose a primary care physician who acts as a gatekeeper for accessing specialized care. This model emphasizes preventive care and focuses on managing and coordinating healthcare services to keep costs down and improve overall health outcomes.

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  • 32. 

    Which of the following best describes an arrangement by employers to set aside pre-tax money for medical expenses for their employees?

    • A.

      Health Reimbursement Arrangement (HRA) or Funding

    • B.

      Co-Payment

    • C.

      Deductible

    • D.

      Rationing

    Correct Answer
    A. Health Reimbursement Arrangement (HRA) or Funding
    Explanation
    A Health Reimbursement Arrangement (HRA) or Funding is an arrangement by employers to set aside pre-tax money for medical expenses for their employees. This allows employees to be reimbursed for eligible medical expenses not covered by their insurance plans. It is a benefit offered by employers to help employees manage their healthcare costs and provide them with financial assistance for medical expenses.

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  • 33. 

    What does HIPAA stand for?

    • A.

      Health Insurance Patient and Accountability Act

    • B.

      Health Insurance Portability and Accountability Act

    • C.

      Health Insurance Plan and Accountability Act

    • D.

      None of the above

    Correct Answer
    B. Health Insurance Portability and Accountability Act
    Explanation
    HIPAA stands for Health Insurance Portability and Accountability Act. This act was enacted in 1996 in the United States to protect the privacy and security of individuals' health information. It establishes guidelines for the electronic exchange, privacy, and security of health information. The act also provides individuals with certain rights regarding their health information, such as the right to access and amend their records. Additionally, HIPAA sets standards for healthcare providers, health plans, and other entities that handle health information to ensure compliance and safeguard patient privacy.

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  • 34. 

    When securing the call with the customer, which pieces of information must be obtained in order to be compliant?

    • A.

      Full Name, Date of Birth, Zip Code, & Gender

    • B.

      Full Name, Last 4 of Social Security Number, Date of Birth, & Phone Number

    • C.

      Full Name, Date of Birth, Address, & Zip Code

    • D.

      A & C

    Correct Answer
    B. Full Name, Last 4 of Social Security Number, Date of Birth, & Phone Number
    Explanation
    In order to be compliant when securing the call with the customer, the pieces of information that must be obtained are the full name, last 4 of the social security number, date of birth, and phone number. This information is crucial for verifying the customer's identity and ensuring compliance with regulations regarding customer data protection.

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  • 35. 

    True or False: The POA can complete the entire enrollment process even if the customer is not present.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because a Power of Attorney (POA) is a legal document that grants an individual the authority to act on behalf of someone else. In the context of the enrollment process, if the customer has granted a POA to another person, then that person can complete the entire enrollment process on behalf of the customer, even if the customer is not physically present. The POA allows the designated individual to make decisions and take actions as if they were the customer themselves.

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  • 36. 

    Mr. and Mrs. Smith chose the same plans, and they are completing both applications jointly. They have their son and daughter-in-law on the phone assisting. Who does Mrs. Smith have to authorize as a HIPAA Approved Representative?

    • A.

      The son & daughter-in-law

    • B.

      The son, Mr. Smith, & Mrs. Smith

    • C.

      The son, daughter-in-law, & Mr. Smith

    • D.

      None of the above

    Correct Answer
    C. The son, daughter-in-law, & Mr. Smith
    Explanation
    Mrs. Smith has to authorize the son, daughter-in-law, and Mr. Smith as HIPAA Approved Representatives because they are completing both applications jointly and they are assisting Mrs. Smith on the phone.

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  • 37. 

    The BA put the AARP membership number in the notes for Mr. and Mrs. Smith’s Medigap applications. What action do you take?

    • A.

      Verify Mr. Smith’s number

    • B.

      Trust that the BA verified the number

    • C.

      Verify Mrs. Smith’s number

    • D.

      A & C

    Correct Answer
    D. A & C
    Explanation
    The correct answer is A & C. In this scenario, the BA (Business Analyst) mistakenly put the AARP membership number in the notes for Mr. and Mrs. Smith's Medigap applications. To rectify this error, it is necessary to verify both Mr. Smith's and Mrs. Smith's numbers separately. By doing so, the correct membership numbers can be accurately recorded for their respective applications.

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  • 38. 

    When should you use the Application Guide?

    • A.

      When you feel like it

    • B.

      Always

    • C.

      When you don’t know the answer on the application

    • D.

      All of the above

    Correct Answer
    B. Always
    Explanation
    The Application Guide should be used always because it provides valuable information and guidance for filling out the application. It ensures that all necessary information is included and helps to avoid mistakes or omissions. By using the Application Guide consistently, applicants can increase their chances of submitting a complete and accurate application.

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  • 39. 

    True or False: An Approved Representative (HIPAA Rep) can authorize another Approved Representative (HIPAA Rep).

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    According to the given statement, an Approved Representative (HIPAA Rep) cannot authorize another Approved Representative (HIPAA Rep). This means that one HIPAA Rep does not have the authority to grant authorization to another HIPAA Rep. Therefore, the correct answer is False.

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  • 40. 

    True or False: A POA can authorize an Approved Representative (HIPAA Rep).

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    A POA (Power of Attorney) can indeed authorize an Approved Representative, also known as a HIPAA Rep (Health Insurance Portability and Accountability Act Representative). This individual is granted legal authority to make healthcare decisions on behalf of the person who granted the POA. The HIPAA Rep is responsible for ensuring the privacy and confidentiality of the patient's medical information, as mandated by HIPAA regulations. Therefore, the statement "A POA can authorize an Approved Representative (HIPAA Rep)" is true.

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  • 41. 

    The customer is 58 years old and Medicare-eligible due to disability. They are losing employer coverage on 11/30/2014. Which enrollment period do you use?

    • A.

      SEP-LEC

    • B.

      ICEP

    • C.

      AEP

    • D.

      None of the above

    Correct Answer
    A. SEP-LEC
    Explanation
    The customer is losing employer coverage on 11/30/2014, which qualifies them for a Special Enrollment Period (SEP). The SEP for Loss of Employer Coverage (LEC) allows individuals to enroll in Medicare outside of the Annual Enrollment Period (AEP). Since the customer is Medicare-eligible due to disability, they can use the SEP-LEC to enroll in Medicare. Therefore, the correct answer is SEP-LEC.

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  • 42. 

    If a customer has elected AR, when will they receive their first reimbursement?

    • A.

      Within 3-5 business days of making the payment

    • B.

      On the effective date

    • C.

      Within 2-3 months of the effective date of the plan

    • D.

      As soon as they submit the claim

    Correct Answer
    C. Within 2-3 months of the effective date of the plan
  • 43. 

    You are filling out an application with the POA and the customer.  The customer started the application but is not feeling well and leaves to take a nap. Can the POA give the voice signature?

    • A.

      Yes

    • B.

      No

    • C.

      Only after you authorize them as a HIPAA

    • D.

      Only if the customer listened to the disclaimer

    Correct Answer
    B. No
    Explanation
    No, the POA cannot give the voice signature. The customer started the application but left before completing it. Therefore, the customer's presence is required to provide the voice signature.

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  • 44. 

    True or False: It is acceptable to give the customer their Part A and Part B effective dates.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    It is not acceptable to give the customer their Part A and Part B effective dates. The effective dates for Part A and Part B of Medicare are determined by the government and can only be provided by the official sources. Giving the customer their own effective dates may lead to confusion and misinformation. It is important to direct the customer to the appropriate resources for accurate and official information regarding their Medicare coverage.

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  • 45. 

    True or False: Mr. Jones, who has plans in the cart, is on the phone with Mrs. Jones, but he is not completing his applications today. You still have to secure the call for Mr. Jones.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The given statement states that Mr. Jones is on the phone with Mrs. Jones and he has plans in the cart, but he is not completing his applications today. It also mentions that you still have to secure the call for Mr. Jones. Therefore, the correct answer is True, indicating that you need to secure the call for Mr. Jones despite his current situation.

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  • 46. 

    What is the correct location of the checking account number and routing number on the customer’s check? 

    • A.

      Checking account numbers are at the bottom left. Routing numbers are to the right.

    • B.

      Routing numbers are on the bottom left. Checking account numbers are to the right.

    • C.

      It changes, depending on the type of bank (Bank vs. Credit Union)

    Correct Answer
    B. Routing numbers are on the bottom left. Checking account numbers are to the right.
    Explanation
    The correct location of the checking account number and routing number on the customer's check is that the routing numbers are on the bottom left, while the checking account numbers are to the right.

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  • 47. 

    The only payment method accepted for AARP membership completed online is Debit/Credit Card? 

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The explanation for the given correct answer is that AARP only accepts Debit/Credit Card as the payment method for membership completed online. This means that if someone wants to become a member of AARP through their website or online platform, they can only use a Debit/Credit Card to make the payment. Other payment methods like cash, check, or online wallets are not accepted for online membership completion.

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  • 48. 

     If a call is disconnected, you should choose which disposition option?

    • A.

      Was not able to complete applications

    • B.

      Not buying from OneExchange

    • C.

      They just hung up

    • D.

      Call Interrupted–Wait for Customer Call Back

    Correct Answer
    D. Call Interrupted–Wait for Customer Call Back
    Explanation
    If a call is disconnected, the appropriate disposition option to choose would be "Call Interrupted–Wait for Customer Call Back". This option indicates that the call was interrupted and the agent should wait for the customer to call back. It is the most suitable option in this situation as it allows the agent to be available for the customer's return call and continue the conversation or provide assistance as needed.

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  • 49. 

    If a customer wants to pay for their AARP membership with a check you should…

    • A.

      Tell them to call AARP directly, then call us back

    • B.

      Tell them, “That’s not the way it works!”

    • C.

      Tell them, “We cannot accept checks.”

    • D.

      Do a 3-way call with AARP and the customer.

    Correct Answer
    D. Do a 3-way call with AARP and the customer.
    Explanation
    The correct answer is to do a 3-way call with AARP and the customer. This option allows for clear communication between the customer, the company, and AARP to ensure that the payment can be processed correctly. By involving all parties in the call, any questions or concerns can be addressed and resolved in real-time, providing a satisfactory solution for the customer.

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  • 50. 

    True or False: If a customer gives you their AARP membership number, you DO NOT have to look it up.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement "If a customer gives you their AARP membership number, you DO NOT have to look it up" is false. If a customer provides their AARP membership number, it is essential to look it up in order to verify their membership and provide any applicable benefits or discounts associated with it. Failing to look up the membership number may result in the customer not receiving the benefits they are entitled to.

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Quiz Review Timeline +

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

  • Current Version
  • Jul 27, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 15, 2014
    Quiz Created by
    Bthorup
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