A sales agent employed by the Sponsor's First-Tier or Downstream entity, submitted an application for processing and requested to things. 1. to back-date enrollment date by one month, and 2. to waive all monthly premiums for the beneficiary. What should you do?
A. Refuse to change the date or waive the premiums, but decide not to mention the request to a supervisors or the compliance department
B. Make the requested changes because the sales agent determines the beneficiary's start date and monthly premiums
C. Tell the sales agent you will take care of it, but then process the application properly (without the requested revisions) - you will not file a report because you don't want the sales agent to retaliate against you
D. Process the application properly (without the requested revisions), inform your supervision and the compliance officer about the sales agent's request
E. Contact law enforcement and the Centers for Medicare & Medicaid Services (CMS) to report the sales agent's behaviour

Question

13-01-2020
Biology

contestada

A sales agent employed by the Sponsor's First-Tier or Downstream entity, submitted an application for processing and requested to things. 1. to back-date enrollment date by one month, and 2. to waive all monthly premiums for the beneficiary. What should you do?
A. Refuse to change the date or waive the premiums, but decide not to mention the request to a supervisors or the compliance department
B. Make the requested changes because the sales agent determines the beneficiary's start date and monthly premiums
C. Tell the sales agent you will take care of it, but then process the application properly (without the requested revisions) - you will not file a report because you don't want the sales agent to retaliate against you
D. Process the application properly (without the requested revisions), inform your supervision and the compliance officer about the sales agent's request
E. Contact law enforcement and the Centers for Medicare & Medicaid Services (CMS) to report the sales agent's behaviour

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Answer:

D. Process the application properly (without the requested revisions), inform your supervision and the compliance officer about the sales agent's request

Explanation:

Before anything else, I would go through the content in the application submitted by the sales agent employed by the Sponsor's First-Tier or Downstream entity in details without the solicited revisions, this will be with the intent of communicating the knowledge to my supervisior and the compliance officer on the sales agent's offer to enable us take the right course of decision.