Question 1

The goals of HIPAA include all of the following except:

Accepted Answer

Sell personal information to third parties

Answer

Securing the privacy of the individual healthcare information

Answer

Reducing the costs associated with the administration of health care

Question 2

True or False, we are permitted to provide brokers with member specific information upon request

Accepted Answer

false

Answer

true

Question 3

True or False, when sending an email internally or externally it’s permitted to include PHI in the subject line of an email.

Accepted Answer

false

Answer

true

Question 4

True or False, all of the following are considered “security” best practices

· Use a Password Protected Screen Saver.

· Log off and shut down your PC at the end of the day.

· Secure sensitive files when leaving the work area.

· Store confidential information in a secure area

· You should always lock your workstation when not in use

Accepted Answer

true

Answer

false

Question 5

What should you do with documents that contain PHI?

Accepted Answer

Secure sensitive papers and software under lock and key. If working onsite, shred all paper documents containing protected health or confidential information on-site or place them in on-site locked recycle bins.

Answer

Throw them out in any company garbage bin

Answer

Bring them home and throw them out

Question 6

How do you get to the Sales/Account Service Library?

Accepted Answer

From the LifeTimes Online page, under Employee Resources, select Fingertips, under Divisional Pages, select Marketing & Sales, under Our Departments select Account Services/Sales Library

Answer

Save it as a favorite

Answer

From the LifeTimes Online page, under Employee Resources, select Marketing & Sales, under Our Departments select Account Services/Sales Library

Question 7

What document contains commonly used acronyms by the health plan?

Accepted Answer

Health Plan Acronyms

Answer

Glossary and Terms

Answer

Fingertips

Answer

Data Bases

Question 8

True or False Sales and Account Service can find resources in all of the following libraries, Customer Care Library, Membership Library, Marketing Operations Library

Accepted Answer

true

Answer

false

Question 9

What is the difference between an individual aggregate and family aggregate in relation to a deductible or the out of pocketmax?

Accepted Answer

Individual Aggregation- Each covered family member only needs to satisfy his or her individual deductible, not the entire family deductible, prior to receiving plan benefits.

Family Aggregation- For family coverage, the entire family’s annual deductible must be met by one or any combination of covered members before a copay or coinsurance is applied for any family member.

Answer

Family Aggregation-Each covered family member only needs to satisfy his or her individual deductible, not the entire family deductible, prior to receiving plan benefits.

Individual Aggregation- For family coverage, the entire family’s annual deductible must be met by one or any combination of covered members before a copay or coinsurance is applied for any family member.

Question 10

What does “Network” refer to?

Accepted Answer

A group of providers and hospitals that have agreed to accept payment in exchange for serving members.

Answer

The group of doctors you can see

Answer

The area in which your plan is covered in

Question 11

What are the 4 different metal levels for community rated products?

Accepted Answer

Platinum, Gold, Silver and Bronze

Answer

Platinum, Silver, Gold and Bronze

Answer

Gold, Platinum, Bronze, Silver

Answer

Platinum, Gold, Bronze and Silver

Question 12

What does AGIF stand for?

Accepted Answer

Annual Group Information Form

Question 13

True or False Brokers are able to obtain new group paperwork, renewal paperwork, annual group information form from ExcellusBCBS.com and Univerahealthcare.com

Accepted Answer

true

Answer

false

Question 14

All of the following are required on an AGIF Except?

Accepted Answer

Phone Number, Email Address, Employee Names

Answer

total number of full-time employees & full time equivalents

Answer

address, ownership structure

Answer

Group name, group number, group EIN/TIN

Question 15

What is considered a large group?

Accepted Answer

100 + employees

Answer

150+ employees

Answer

50+ employees

Answer

200+ employees

Question 16

All of the following information can be found in the Group Administrator Guide except for?

Accepted Answer

Broker Commission Schedule

Answer

Membership Enrollment Options

Answer

Enrollment Opportunities

Answer

How to Contact Us

Question 17

Broker Tools and Resources can be found on all of the following except?

Accepted Answer

Lifetime Learning Corner

Answer

ExceullsBCBS.com, Blue on Demand

Answer

Univerahealthcare.com, Univera on Demand

Question 18

Referring to Facets- Within the group application, how do you get to the receipt history?

Accepted Answer

Transfer to the billing entity, transfer to the receipt history

Answer

Transfer, to the subgroup, transfer to the billing entity, transfer to the receipt history

Answer

Double click on the Billing/Cap Info application

Answer

Transfer to the receipt history

Question 19

True or False- within the Subscriber/Family Application on the member screen you can confirm whether dependents are active?

Accepted Answer

true

Answer

false

Question 20

Within the Subscriber/Family Application where can you find the group number and subgroup information?

Accepted Answer

Sub Group

Answer

Class

Answer

Employment

Answer

Rate Date

Question 21

What information can be found in Billing 360?

Accepted Answer

The date and amount of the groups last invoice

Answer

The groups tolerance percent

Answer

The premium statement print ID

Answer

The groups grace period

Question 22

True of False- the ANSI Indicator is Under the Subgroup application, attachments

Accepted Answer

true

Answer

false

Question 23

True or False the Style ID is The Style ID or LBS COBRA Point is the (Community Rated) LBS COBRA Administration indicator. If there a date in the Date 1field and no date in the Date 2 field, this indicates the group has LBS COBRA Administration.

Accepted Answer

true

Answer

false

Question 24

What is the Wild Card in Facets?

Accepted Answer

%

Answer

:

Answer

#

Answer

@

Question 25

All of the following is found in Facets except for which of the following?

Accepted Answer

Customer Number

Answer

Total Number or Eligible Employees

Answer

Broker Number

Answer

EIN/TIN Number

Question 26

Within the Subscriber/ Family Application Where can you find the group number and Subgroup information?

Accepted Answer

Subgroup

Answer

Class

Answer

Employment

Answer

Rate Data

Question 27

Groups can be canceled in the middle of the month?

Accepted Answer

false

Answer

true

Question 28

Member Searches can be done with all of the following criteria except?

Accepted Answer

Customer Number

Answer

Name, Address

Answer

Last Name, Date of Birth

Answer

SSN

Question 29

What the wild card in Siebel?

Accepted Answer

*

Answer

&

Answer

#

Answer

@

Question 30

True or False- Siebel Is?

· Contact management tool

· Contains all active groups and prospects (65,000records)

· Group demographics

· All information and documents connected to the group

Accepted Answer

true

Answer

false

Question 31

For the best performance which browser should Siebel be accessed through?

Accepted Answer

Google Chrome

Question 32

True or False? To help maintain Siebel performance, close database using the File >> Exit option rather than just ‘X’ out when closing Siebel

Accepted Answer

true

Answer

false

Question 33

Siebel will time out after how many minutes of inactivity?

Accepted Answer

15 Min

Answer

30 Min

Answer

10 Min

Answer

20 Min

Question 34

What does the Siebel home Tab Show?

Accepted Answer

Displays user specific activities and task flows

Answer

Group Names

Answer

Recent records

Question 35

True or False:

All columns in Siebel are

• Sortable – Click once on column header to sort

• Freezable – Double click on column header to freeze column

• Movable – Drag and drop columns to move

• Sizable – Put cursor between columns to adjust size

Accepted Answer

true

Answer

false

Question 36

True or False- A groups sales region is determined by the zip code of the groups physical address?

Accepted Answer

true

Answer

false

Question 37

True or False- The groups Legal Entity name is the legal group name used on tax documents.

Accepted Answer

true

Answer

false

Question 38

What form does the groups eligibility information come from?

Accepted Answer

AGIF

Question 39

Within Siebel where can the group number, product information financial information and renewal month be found?

Accepted Answer

Product - Sub Tab

Answer

Contact information

Answer

Favorites

Question 40

True or false, the following information can be found in the attachments sub tab: enrollment documents, benefit grids/summaries, rate sheets, group agreements.

Accepted Answer

true

Answer

false

Question 41

Where do automated for the iFacets Group tab get submitted?

Accepted Answer

iFacets

Question 42

True or false, Broker information is view only to all teams other than the Broker Administrative team. Broker Administration maintains all broker information

Accepted Answer

true

Answer

false

Question 43

What are the benefits of using Express Scripts?

Accepted Answer

All of the Above

Answer

Cost- Saving Services

Answer

At Home Convenience

Answer

Health and Safety Support

Question 44

True or false, by registering atexpress-scripts.com, members can access their benefits at anytime. They can easily find available lower-cost medication options, order refills, check order status, view plan information, receive medication alerts, and more

Accepted Answer

true

Answer

false

Question 45

What is the acronym for Express Scripts Incorporated?

Accepted Answer

ESI

Question 46

The format field in Cognos should always be changed from HTML to what?

Accepted Answer

Excel format

Question 47

True or false, when pulling a retro membership report for a retro the effective date entered should match the requested date on the retro request.

Accepted Answer

true

Answer

false

Question 48

True or false, if brokers have the required access they can submit enrollment changes externally through “the web”.

Accepted Answer

true

Answer

false

Question 49

Available resources online include all of the following except

Accepted Answer

Large Group Rates

Answer

Annual Group Information Form

Answer

Group Maintenance Guide

Answer

Renewal Group Paperwork

Question 50

True or false – Prior to submitting a retro request to term a subscriber, the subscriber must first be termed in the M&B database within M&B guidelines first?

Accepted Answer

true

Answer

false

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