California Life & Health: Group Health, PPACA, Senior Health Products & California Rules Common to L&H
5 free practice questions from the 67 in this chapter of StudyWren Insurance. Pick an answer and check it to see the explanation. Part of the free California Life & Health practice exam.
Group Health, PPACA, Senior Health Products & California Rules Common to L&HCA-LH-07-453
A licensed agent is conducting a marketing event for Medicare Advantage plans. During the presentation, the agent mentions that the plan is 'endorsed by Medicare.' According to CMS marketing compliance rules, what is the status of this statement?
Choose an answer first.
Correct
The answer is D: This is prohibited, because Medicare does not endorse private plans.
CMS prohibits plans and agents from claiming that a plan is recommended or endorsed by CMS, Medicare, the Secretary or HHS (42 CFR 422.2262(a)(1)(ix)). Medicare does not endorse any private plan, so the statement is a violation however it is qualified.
The answer is D: This is prohibited, because Medicare does not endorse private plans.
CMS prohibits plans and agents from claiming that a plan is recommended or endorsed by CMS, Medicare, the Secretary or HHS (42 CFR 422.2262(a)(1)(ix)). Medicare does not endorse any private plan, so the statement is a violation however it is qualified.
Group Health, PPACA, Senior Health Products & California Rules Common to L&HCA-LH-07-459
A Medicare beneficiary is enrolled in a stand-alone Prescription Drug Plan (PDP). They decide to enroll in a Medicare Advantage Prescription Drug (MAPD) plan. What happens to their previous PDP enrollment?
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Correct
The answer is B: The PDP enrollment is automatically terminated upon enrollment in the MAPD plan.
Enrolling in a Medicare Advantage plan that includes prescription drug coverage (MAPD) automatically terminates enrollment in a stand-alone Medicare Part D plan.
Why not ?
Reviewed in our October 2026 California fact-check.
The answer is B: The PDP enrollment is automatically terminated upon enrollment in the MAPD plan.
Enrolling in a Medicare Advantage plan that includes prescription drug coverage (MAPD) automatically terminates enrollment in a stand-alone Medicare Part D plan.
Reviewed in our October 2026 California fact-check.
Group Health, PPACA, Senior Health Products & California Rules Common to L&HCA-LH-07-479
Under the PPACA, what is the 'Medical Loss Ratio' (MLR) requirement for individual health insurance plans?
Choose an answer first.
Correct
The answer is B: 80%
The PPACA requires individual and small group plans to spend at least 80% of premium dollars on clinical services and quality improvement. Large group plans must spend 85%.
Why not ?
Reviewed in our October 2026 California fact-check.
The PPACA requires individual and small group plans to spend at least 80% of premium dollars on clinical services and quality improvement. Large group plans must spend 85%.
Reviewed in our October 2026 California fact-check.
Group Health, PPACA, Senior Health Products & California Rules Common to L&HCA-LH-07-488
An agent at a third-party marketing organization (TPMO) that sells for some, but not all, of the Medicare Advantage organizations in the area is running a marketing event for Medicare Advantage plans. The TPMO disclaimer must be included in the marketing materials. What is the purpose of this disclaimer?
Choose an answer first.
Correct
The answer is D: To tell the beneficiary the TPMO does not offer every plan in the area.
The TPMO disclaimer tells beneficiaries that the organization does not offer every plan available in their area and points them to Medicare.gov or 1-800-MEDICARE for all of their options (42 CFR 422.2267(e)(41)). It must appear in marketing materials, on websites and in electronic communications, and be stated on sales calls.
The answer is D: To tell the beneficiary the TPMO does not offer every plan in the area.
The TPMO disclaimer tells beneficiaries that the organization does not offer every plan available in their area and points them to Medicare.gov or 1-800-MEDICARE for all of their options (42 CFR 422.2267(e)(41)). It must appear in marketing materials, on websites and in electronic communications, and be stated on sales calls.
Group Health, PPACA, Senior Health Products & California Rules Common to L&HCA-LH-07-502
An agent is marketing a Medicare Advantage plan and wants to use the term 'Medicare-approved' in their advertisement. What is the requirement?
Choose an answer first.
Correct
The answer is B: It may describe benefits or services, but may not claim Medicare endorses the plan.
CMS marketing rules let Medicare Advantage organizations and agents use the term 'Medicare-approved' to describe benefits or services, and to say they are approved to participate in Medicare. They may not claim that CMS, Medicare, the Secretary or HHS recommends or endorses the plan (42 CFR 422.2262). No Social Security approval, certification period or outright ban applies, and the rules do not require a 'not endorsed by Medicare' disclaimer.
The answer is B: It may describe benefits or services, but may not claim Medicare endorses the plan.
CMS marketing rules let Medicare Advantage organizations and agents use the term 'Medicare-approved' to describe benefits or services, and to say they are approved to participate in Medicare. They may not claim that CMS, Medicare, the Secretary or HHS recommends or endorses the plan (42 CFR 422.2262). No Social Security approval, certification period or outright ban applies, and the rules do not require a 'not endorsed by Medicare' disclaimer.
