Commercial Knowledge Assessment

Is CMS verifying SSN in real time since October 2024?

• Yes

• No

Is an Enhanced Direct Enrollment (EDE) entity able to generate eligibility results in policies that belong to a different Agent of Record (AOR)?

• Yes

• No

Is it compliant to put an ad on social media that says if you buy a Florida Blue or Ambetter Plan, you can earn a Visa gift card with up to $500?

• 
  It depends on the social network where the ad is published.

• Yes

• No

• Only in authorized states.

What's the danger of having a duplicated policy when searching for a client in the Marketplace?

• There's no harm as long as there's only one policy active.

• More than one agent could have access to clients personally Identifiable Information (PII), and there's a risk of having multiple policies at once.

• The risk is for the agent; if they are receiving multiple commissions, there will be chargebacks.

• The agent's license will be revoked.

An agent searches for a policy with a client's information and finds multiple policies. What's the best practice?

• The agent should have a three-way call with the marketplace and the client to change AOR.

• The agent should request the Marketplace remove the duplicate policies and leave only the active policy to avoid risks.

• As long as the agent wasn't responsible for duplicating the applications, there's no bad practice.

• The agent should start a new application and avoid existing applications.

Can clients submit their own applications without help or interference from a Marketplace representative? (Select all that apply)

• Yes, through a valid DE or EDE agent pathway.

• Yes, through a valid DE or EDE Client pathway.

• Yes, through healthcare.gov by creating an account.

• • Yes, through a call with a marketplace representative.

If a client has an existing Marketplace application and wants to renew with a new agent for PY2025 through their client application, will their Marketplace application require documentation to prove identity and allow the new agent to avoid three-way calls?

• It will request a valid identification document to verify identity, and the application could be finished without a three-way call.

• It won't request identification documents or require a three-way call.

• It won't require identity verification but will require a three-way call.

• It will require verification of the client's identity but won't require a three-way call.

Is it compliant to request clients' Marketplace credentials to log in, change AOR, and avoid a three-way call?

• Yes

• No

If an agent creates an email address for their clients to submit Marketplace applications and avoid three-way calls, what will happen?

• The marketplace won't notice, so nothing will happen.

• The marketplace will see it as a pattern that all clients are choosing the agent through the client pathway and will audit and investigate.

• The marketplace will cancel the agent's license for two years immediately.

• The Marketplace will remove client applications, end their eligibility to enroll in a QHP, remove agent access to commissions or bonuses, and any commission will be charged back by the carrier.

An agent is currently appointed with Affordable Care Act (ACA) carriers under a different Field Marketing Organization (FMO) but wants to work with Claro. As of October 2024, what is the best approach to onboard this agent?

• Ask the agent for the release from the previous upline.

• Ask the agent to find a free NPN to get appointed or to use the MBO.

• Tell the agent to request the contracts in the ARC.

• Offer a competitive compensation package and highlight Claro's unique benefits.