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Step 5 Review

Answer the following questions about Step 5 based on the information you have just reviewed.

1. When the annuity issuer indicates a death benefit is not available for an annuity you:

1. Send a copy of the DHS-5037 to DHS Special Recovery Unit (SRU). Try again.
2. Submit a request to HealthQuest for guidance. Try again.
3. Do nothing. One of the three conditions for the requirement is not met. Correct!
4. Determine a period of ineligibility. Try again.

2. When the annuity issuer indicates the person is not cooperating in designating DHS as the PRB, you:

1. Send a copy of the DHS-5037 to DHS SRU. Try again.
2. Submit a request to HealthQuest for guidance. Try again.
3. Do nothing. One of the three conditions for the requirement is not met. Try again.
4. Determine a period of ineligibility. The person has until the end of the processing period to cooperate. Correct!

3. When the annuity issuer provides a valid reason indicating it is not possible to name DHS as the PRB, you then:

1. Send a copy of the DHS-5037 to DHS SRU. Try again.
2. Submit a request to HealthQuest for guidance. Try again.
3. Do nothing. One of the three conditions for the requirement is not met. Correct!
4. Determine a period of ineligibility. Try again.

4. When the annuity issuer indicates DHS has been named as the PRB, you then:

1. Send a copy of the DHS-5037 to DHS SRU. Correct!
2. Submit a request to HealthQuest for guidance. Try again.
3. Do nothing. One of the three conditions for the requirement is not met. Try again.
4. Determine a period of ineligibility. Try again.

Page 10

Designating DHS as the PRB - Designation Process

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