Aetna Individual Core Certification
What reports are available on Aetna's Producer World?
A) Your Medicare book of business
B) Month/YTD/Prior year commission report
C) Licensing reports
D) A and B
E) All of the above
E) All of the above
You will need to successfully complete which requirements to have "ready-to-sell" status with Aetna Medicare?
A) The Aetna Individual Medicare certification process for the products you intend to sell
B) Have an active contract through the Medicare Producer Contracting site
C) Be licensed and appointed in accordance with state law in states where you intend to sell
D) Pass a background investigation
E) All of the above
E) All of the above
Any voluntary disenrollment occurring within three months of the membership effective date is considered a rapid disenrollment, and will result in a chargeback of the full commission paid.
True or False
True
To report compliance or fraud, waste, and abuse concerns to Aetna you should:
A) Make an anonymous call to Ethics Line
B) Visit Ethics Line on the web
C) Fax the information
D) Email Medicare Compliance
E) A, B and D
E) A, B and D
Agent Oversight routinely monitors agent performance against CMS and internal standards. We monitor:
A) Cancellation and rapid disenrollment rates
B) Enrollment application turnaround time
C) Scope of Appointment forms
D) Third party secret shopper surveillance program of formal and informal marketing/sales events
E) Complaints and marketing incidents
F) Marketing/sales seminar reporting, cancellations and updates
G) All of the above
G) All of the above
Our agent oversight team will implement corrective action when there are CMS infractions and prohibited tactics. Disciplinary or corrective action may include:
A) Focused training or monitoring sessions
B) Verbal or written warnings
C) Full re-training and re-testing
D) Placement on an agent "watch list"
E) Suspension or probationary period
F) Contract termination, with or without cause
G) All of the above
G) All of the above
Failure to respond within the required timeframe to Aetna or CMS requests for information may result in suspension or termination of an agent, broker or producer's ability to market, sell and receive commissions.
True or False
True
You can receive commission for any sale that results from an unreported marketing/sales event.
True or False
False
A prohibited marketing event is:
A) Conducting health screenings that give the impression of "cherry picking"
B) Requiring beneficiaries to provide contact information as a prerequisite for attending an event
C) Asking a beneficiary for a referral
D) Using superlative language such as "the best", "one of the best" or "rated number 1" unless substantiated by data provided by CMS
E) Claiming you are recommended or endorsed by CMS
F) All of the above
F) All of the above
How long are you required to maintain Scope of Appointment documentation?
A) 2 years
B) 5 years
C) 10 years
D) Forever
C) 10 years
If a beneficiary requests to discuss other products not originally documented on the SOA, you must document a second SOA for the additional product type, and then the appointment may continue.
True or False
True
When obtaining a Scope of Appointment, you may NOT:
A) Discuss plan options not agreed to by the beneficiary
B) Ask for referrals
C) Market non-health care products such as annuities or life insurance
D) All of the above
D) All of the above
The Permission-to-Contact form is used by Aetna sales representatives and external agents to contact beneficiaries, and must be completed prior to conducting an outbound call to a Medicare prospect.
True or False
True
The Permission-to-Contact form is required when a prospect calls in to RSVP for a meeting.
True or False
False
You may not contact your own clients by telephone and plans may not contact current members by telephone at any time to discuss plan business.
True or False
False
Producers may only use the CMS and Aetna-approved marketing materials that have been created by our marketing team, approved by us and filed with CMS by us when discussing Aetna or Coventry Individual Medicare plans.
True or False
True
Every time you meet with beneficiaries to discuss MA/MAPD products use appropriate CMS-approved consumer sales presentations from beginning to end, read the presentation notes or talking points; and when you use the MA/MAPD sales video it should be used in conjunction with the approved sales presentation.
True or False
True
To order enrollment kits for Aetna Medicare products, you access Aetna-branded kits through a single point of entry, and use you NPN to log in.
True or False
True
Annual Election Period is from:
A) Oct 1 - Dec 7
B) Oct 15 - Dec 15
C) Oct 15 - Dec 7
D) Oct 1 - Dec 15
C) Oct 15 - Dec 7
A signed Medicare enrollment must reach us within two calendar days of when you receive it from the beneficiary.
True or False
True
Aetna Medicare plan applications can be submitted by mail, e-mail, over the phone or through the online Ascend virtual sales office app.
True or False
True
It's not necessary to verify that the consumer has Medicare Parts A and B at the time of enrollment
True or False
False
You are prohibited from soliciting referral clients through cold calling, door-to-door visits or other actions prohibited under state or federal law.
True or False
True
Following enrollment, the client will hear from us within about 14 days of their acceptance into the plan.
True or False
True
You must direct all requests to cancel, withdraw, or terminate enrollment applications to the same location where the application was originally sent or call the Member Services number on the member ID card.
True or False
True
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