Accident and Health Insurance Questions From Pohs Textbook

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zacariasripollcid
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Accident and Health Insurance Questions From Pohs Textbook
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2013-02-19 05:37:51
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Health Insurance Questions
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This are the questions from posh institute textbook
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  1. This type of risk involves only a chance of loss.
    A. speculative
    B. Market
    C. Pure
    D. investment
    C. pure
    (this multiple choice question has been scrambled)
  2. What kind of risk is insurable?

    A. speculative
    B. investment
    C. pure
    D. life
    C. Pure
    (this multiple choice question has been scrambled)
  3. The tendency of persons with above average risk to acquire insurance at a greater extent than those with average or below average risk is defined as:

    A. Self insurance
    B. insurance
    C. Reinsurance
    D. Adverse selection
    D. adverse selection
    (this multiple choice question has been scrambled)
  4. insurance is a method of risk_________?

    A. retention
    B. sharing
    C. avoidance
    D. transfer
    D. transfer
    (this multiple choice question has been scrambled)
  5. if you retain risk, you are:

    A. currently insured
    B. uninsured
    C. self-insured
    D. fully insured
    C. self-insured
    (this multiple choice question has been scrambled)
  6. this law is the basis for statistical  prediction of loss upon which rates for insurance are calculated 

    A. adverse selection
    B. law of large numbers
    C. risk pooling
    D. law of probabilities
    B. law of large numbers
    (this multiple choice question has been scrambled)
  7. mutual companies are owned by their

    A. policyholders
    B. shareholders 
    C. investors 
    D. officers
    A. policyholders
    (this multiple choice question has been scrambled)
  8. this is a method of distributing insurance products to the public by using salaried employees rather than commissioned agents...

    A. branch office system
    B. brokerage system
    C. agency system
    D. direct writers 
    D. direct writers
    (this multiple choice question has been scrambled)
  9. a policy that pays dividends is known as a ______ policy.

    A. dividend
    B. stock
    C. participating
    D. non participating
    C. participating
    (this multiple choice question has been scrambled)
  10. an insurance company that is licensed in the state in which it operates is called a/an _______ insurer

    A. domestic
    B. admitted
    C. foreign
    D. legal
    B. admitted
    (this multiple choice question has been scrambled)
  11. a(n) _______  insurer is one that is incorporated and domiciled outside the United States

    A. alien
    B. foreign
    C. domestic
    D. overseas
    A. alien
    (this multiple choice question has been scrambled)
  12. these producers typically represent only one insurance company.

    A. independent agents
    B. captive agents
    C. brokers
    D. solicitors
    B. captive agents
    (this multiple choice question has been scrambled)
  13. these insurers are organized for the benefit of a society's members and their families.

    A. risk retention groups
    B. reciprocals
    C. llyd's associations
    D. fraternal benefit societies
    D. fraternal benefit societies
    (this multiple choice question has been scrambled)
  14. which of the following is not a rating company used by the insurance industry?

    A. SIPC
    B. moody's
    C. A. M. Best
    D. fitch rating service
    A. SIPC
    (this multiple choice question has been scrambled)
  15. an applicant for life insurance cannot generally bargain for terms, rates, or benefits because the nature of the contract is.

    A. an aleatory contract
    B. adhesive
    C. unilateral
    D. a personal contract
    B. adhesive
    (this multiple choice question has been scrambled)
  16. which of the following terms means that an insurance contract is dependent on chance or uncertain outcome?

    A. adhesion
    B. aleatory 
    C. unilateral 
    D. value
    B. aleatory
    (this multiple choice question has been scrambled)
  17. statements which are guaranteed to be true are 

    A. oaths
    B. warranties
    C. affirmations
    D. representations
    B. warranties
    (this multiple choice question has been scrambled)
  18. statements which are deemed to be untrue are _________

    A. misrepresentations
    B. fibs
    C. untruths
    D. lies
    A. misrepresentations
    (this multiple choice question has been scrambled)
  19. offer and acceptance, legal purpose, competent parties and ________ are all essential requirements of a legal contract

    A. consideration
    B. a judge
    C. witnesses
    D. a lawyer 
    A. consideration
    (this multiple choice question has been scrambled)
  20. the authority granted to a producer by contract to enable him or her to act as an agent is called

    A. implied authority
    B. legal authority
    C. express authority
    D. apparent authority
    C. express authority
    (this multiple choice question has been scrambled)
  21. contracts wherein only one party is mandated to perform are called ________ contracts.

    A. bilateral
    B. legal 
    C. unilateral
    D. performance
    C. unilateral
    (this multiple choice question has been scrambled)
  22. ________ is the term that describes the intentional giving up of a knowing right.

    A. estoppel
    B. recall 
    C. gifting
    D. waiver
    D. waiver
    (this multiple choice question has been scrambled)
  23. the primary source of insurance regulation is the :

    A. national association of insurance commissioners 
    B. securities and exchange commission
    C. federal government
    D. state government
    D. state goverment
    (this multiple choice question has been scrambled)
  24. what did the McCarran-Ferguson Act of 1945 do?
    it reaffirmed the primary role of states in regulating the insurance industry
  25. what is the primary role of the NAIC?

    a. to act as a forum for the development of uniform policy when uniformity is appropriate 

    b. to enforce insurance laws in each state
    c. to renew, approve or deny insurer rate or premium  requests.
    A. to act as a forum for the development of uniform policy when uniformity is appropiated
  26. an agent is a representative of:

    A. the general agency system
    B. the policy owner
    C. an insured
    D. the insurance company
    D. the insurance company
    (this multiple choice question has been scrambled)
  27. a health insurance policy that pays a specified amount for covered surgical expenses is called:

    A. reimbursement basis
    B. traditional basis
    C. service basis
    D. schedule basis
    D. schedule basis
    (this multiple choice question has been scrambled)
  28. principal types of losses covered by accident and health insurance include all of the following except:

    A. medicaid
    B. hospital and medical expenses
    C. long term care expenses
    D. loss of income from disability
    A. medicaid
    (this multiple choice question has been scrambled)
  29. all of the following policies are defined as limited policies except:

    A. HMO
    B. vision care
    C. dental insurance
    D. hospital indemnity
    A. HMO
    (this multiple choice question has been scrambled)
  30. the amount paid by and AD&D policy for the accidental dismemberment of a finger is called:

    A. specified sum
    B. accident sum
    C. principal sum
    D. capital sum
    D. capital sum
    (this multiple choice question has been scrambled)
  31. a policy that only pays for losses that occur due to disease specified in the policy is called:

    A. accident only
    B. vision care
    C. hospital indemnity
    D. specified disease 
    D. specified disease
    (this multiple choice question has been scrambled)
  32. an insurance underwriter's primary job is to:

    A. decline policies applied for
    B. protect the insurer from adverse selection
    C. make sure the application is accurate
    D. check that all required signatures on the application have been obtained
    B. protect the insurer from adverse selection
    (this multiple choice question has been scrambled)
  33. all of the following are producer's responsibilities at the time a policy is delivered EXCEPT:

    A. explain any ratings or declines
    B. explain the coverage of the policy
    C. obtain a signed statement of continued good health when necessary
    D. provide copies of medical records obtained by the insurer
    D. provide copies of medical records obtained by the insurer
    (this multiple choice question has been scrambled)
  34. the effective date of an accident and health policy is: 

    A. the date specified in the policy
    B. the date the policy is delivered to the agent
    C. the date insurer received the application
    D. the application date
    A. the date specified in the policy
    (this multiple choice question has been scrambled)
  35. which of the following are considerations in replacing an accident and health polity?

    a. underwriting
    b. limitations and exclusions of the new policy
    c. pre-existing conditions
    d. all of the above
    d. all of the above
  36. a producer's responsibilities include all of the following, EXCEPT:

    A. making sure recommendations for coverage are suitable 
    B. guaranteeing a policy is issued 
    C. knowing the details for how the policies work
    B. guaranteeing a policy is issued
    (this multiple choice question has been scrambled)
  37. an insurer must furnish claim forms to an insured within how many days of receiving a notice of claim?

    A. 20
    B. 15
    C. 60
    D. one year
    B. 15
    (this multiple choice question has been scrambled)
  38. all of the following are uniform mandatory provisions, EXCEPT:

    A. reinstatement
    B. the entire contract provision
    C. change of occupation
    D. change of beneficiary
    C. change of occupation
    (this multiple choice question has been scrambled)
  39. the police provision that provides an insured a specified amount of time to pay the premium after being billed is called:

    A. notice of claim provision
    B. grace period
    C. payment of claims provision
    D. free look provision
    B. grace period
    (this multiple choice question has been scrambled)
  40. all of the following are uniform optional provisions, EXCEPT:

    A. other insurance with this insurer
    B. change of occupation
    C. illegal occupation
    D. change of beneficiary
    D.  change of beneficiary 
    (this multiple choice question has been scrambled)
  41. the reinstatement provision states that a policy is automatically reinstated if the insurer does not issue a decision after: 

    A. 60 days
    B. 45 days
    C. 15 days 
    D. one year
    B. 45 days
    (this multiple choice question has been scrambled)
  42. the insuring clause of a policy describes:

    A. the change of beneficiary rules
    B. the time limit on certain defenses
    C. the cancellation provisions of a policy
    D. the conditions necessary for benefits to be paid
    D. the conditions necessary for benefits to be paid
    (this multiple choice question has been scrambled)
  43. a policy in which an insurer cannot cancel coverage or change the premium is called:

    A. conditionally renewable
    B. optionally renewable 
    C. noncancellable
    D. guaranteed renewable
    C. noncancellable
    (this multiple choice question has been scrambled)
  44. this provision describes who will receive payment for claims made if the insured dies:

    A. time payment of claims provision
    B. time limit on certain defenses provision
    C. payment of claims provision 
    D. change of beneficiary provision
    C. payment of claims provision
    (this multiple choice question has been scrambled)
  45. the provision that allow an insured a period of time to study a policy that was just delivered is called:

    A. consideration clause
    B. right to examine ( free look) 
    C. conformity with state statutes 
    D. grace period
    B. right to examine ( free look )
    (this multiple choice question has been scrambled)
  46. an insured can bring legal action against an insurer after how many days form the filing of a proof of loss? 

    A. 90 days
    B. 60 days
    C. 45 days
    D. 120 days
    B. 60 days
    (this multiple choice question has been scrambled)
  47. the most restrictive definition of total disability is:

    A. any occupation
    B. any occupation for which the insured is qualified by education or training
    C. own occupation
    D. limited own occupation
    A. any occupation
    (this multiple choice question has been scrambled)
  48. a disability policy provision that allows a person to receive disability benefits for the entire benefit period, even if that person can earn an income is:

    A. recurrent disability 
    B. presumptive disability 
    C. limited own occupation
    D. residual disability
    B. presumptive disabiity
    (this multiple choice question has been scrambled)
  49. the time frame selected by an insured during which otherwise payable disability income benefits would not be paid is called:

    A. elimination period
    B. probationary period
    C. benefit period
    D. claims period
    A. elimination period
    (this multiple choice question has been scrambled)
  50. a person that would like to receive benefit payments for a partial disability would purchase this rider

    A. residual disability rider
    B. rehabilitation rider
    C. automatic monthly benefit rider
    D. waiver of premium rider
    A. residual disability rider
    (this multiple choice question has been scrambled)
  51. a rider that allows an insured to increase his disability income coverage periodically without regard to changes in the insured's health is called:

    A. social insurance supplement rider
    B. future increase option rider
    C. cost of living adjustment rider
    D. medical reimbursement rider
    B. future increase option rider
    (this multiple choice question has been scrambled)
  52. the unique aspects of underwriting a disability policy is include all of the following, EXCEPT: 

    A. beneficiary designations
    B. occupation
    C. benefit limits
    D. earned income
    A. beneficiary designations
    (this multiple choice question has been scrambled)
  53. all of the following are necessary for an individual to receive full disability benefits, EXCEPT:

    A. completion of the benefit period
    B. be totally disabled as defined in the policy
    C. be under the supervision of a physician 
    D. completion of the elimination period
    A. completion of the benefit period
    (this multiple choice question has been scrambled)
  54. features of group disability insurance include:

    A. guaranteed conversion to an individual policy
    B. unlimited choices of benefit options
    C. no individual underwriting
    D. enrollment at any time for full time employees
    C. no individual underwriting
    (this multiple choice question has been scrambled)
  55. a disability income policy that promises to pay a sole proprietor a monthly benefit to cover the fixed expenses of running his business is called:

    A. business continuation insurance
    B. own occupation insurance 
    C. key person disability income insurance
    D. business overhead expense insurance 
    D. business overhead expense insurance
    (this multiple choice question has been scrambled)
  56. a policy designed to fund the purchase of a departing partner's share of business is called:

    A. key person disability insurance
    B. short term disability insurance
    C. partnership insurance
    D. disability buy/sell insurance 
    D. disability buy/sell insurance
    (this multiple choice question has been scrambled)
  57. the shorter the elimination period

    A. the shorter the benefit period
    B. the lower the premium 
    C. the longer the benefit period
    D. the higher the premium
    D. the higher the premium
    (this multiple choice question has been scrambled)
  58. group disability income benefits may be reduced by:

    A. workers compensation benefits and social security disability income benefits
    B. social security disability income benefits only
    C. individual disability income benefits only
    D. workers compensation benefits only
    A. workers compensation benefits and social security disability income benefits 
    (this multiple choice question has been scrambled)
  59. a medical plan that provides low maximum limits of coverage is called:

    A. basic medical
    B. HMO/POS
    C. HMO
    D. PPO
    A. basic medical 
    (this multiple choice question has been scrambled)
  60. major medical plan characteristics include all of the following, except:

    A. limited access to providers
    B. use of coinsurance
    C. high limits of coverage
    D. use of deductibles
    A. limited access to providers
    (this multiple choice question has been scrambled)
  61. which of the following plans would be considered managed care?

    a. HMO
    b. PPO
    c. HMO/POS
    d. all of the above
    d. all of the above
  62. a medical plan that combines basic medical expense coverage and major medical expense coverage in one policy is called:

    A. preferred provider organization
    B. supplemental major medical
    C. comprehensive major medical
    D. major medical
    B. supplemental major medical
    (this multiple choice question has been scrambled)
  63. common limitations of major medical insurance include all of the following, EXCEPT:

    A. custodial care
    B. home health care
    C. mental and nervous disorder treatments
    d skilled nursing facility care
    A. custodial care
    (this multiple choice question has been scrambled)
  64. the expenses that must be paid by an insured before major medical insurance pays is called:

    A. deductible
    B. coinsurance
    C. co-pay 
    D. stop loss limit
    A. deductible
    (this multiple choice question has been scrambled)
  65. a closed panel HMO is one that:

    A. reviews medical cases in private meetings
    B. agrees to accept any provider that agrees to its terms
    C. limit the number of providers it will place under contract
    D. will not accept any new insureds
    C. limits the numbers of providers it will place under contract
    (this multiple choice question has been scrambled)
  66. all of the following are characteristics of HMOs, except:

    A. they require referrals to see specialists
    B. they pay for preventive care
    C. they only pay for medical necessary treatment for illness or injury
    D. they limit the choices of medical providers
    C. they only pay for medical necessary treatment for illness or injury
    (this multiple choice question has been scrambled)
  67. the point of service part of an HMO/POS contract :

    a. requires referrals to access care
    b. requires the insured to use a network provider
    c. requires the insured to pay the provider a small co-pay amount
    d. none of the above
    d. none of the above
  68. managed care plans use the following practices to control costs:

    a. prospective review
    b. utilization review
    c. concurrent review
    d. all of the above
    d. all of the above
  69. a concurrent review is used by insurers to:

    A. adjust ongoing care to appropriate levels
    B. make sure providers have completed their continuing education and are current in their practices
    C. pre-approve a treatment for an insured
    D. review treatments after they are completed to identify any unnecessary care
    A. adjust ongoing care to appropriate leves
    (this multiple choice question has been scrambled)
  70. The federal law that allows employees covered under a group plan to be guaranteed coverage under another group plan if the employee change jobs is called:

    A. Tefra
    B. Hipaa
    C. Erisa
    D. Tamra
    B. Hipaa
    (this multiple choice question has been scrambled)
  71. A waiver for pre-existing conditions is now limited to : 

    A. 12 months
    B. 18 months
    C. There are no more waivers for pre-existing conditions
    D. 6 months
    A. 12 months
    (this multiple choice question has been scrambled)
  72. A special type of saving account established under HIPAA  to encourage the use of high deductible medical plans is called:

    A. HSA
    B. MSA
    C. FSA
    D. IRA
    B. MSA
    (this multiple choice question has been scrambled)
  73. HSAs can be used to pay for the following medical expenses:

    A. hospital expenses not paid for by insurance
    B. premiums for long term care insurance
    C. premiums for COBRA
    D. all of the above
    D. all of the above
  74. a plan that allows either the employer or the employee to make a tax deductible contribution to a special account is called:

    A. FSA
    B. IRA
    C. MSA
    D. HSA
    D. HSA
    (this multiple choice question has been scrambled)
  75. which of the following is NOT  considered a natural group?

    A. members of a labor union
    B. employees of the same company
    C. students at a university
    D. members of a block association
    D. members of a block association
    (this multiple choice question has been scrambled)
  76. once an employee completes the probationary period, the employee can enroll in the company's group benefit plan without underwriting:

    A. during the open enrollment period
    B. up to one year after the probationary period ends
    C. any time after the probationary period ends
    D. 6 months after the probationary period ends
    A. during the open enrollment period
    (this multiple choice question has been scrambled)
  77. all of the following are group characteristics, EXCEPT:

    A. coordination of benefits
    B. experience rating
    C. predetermined options
    D. individual policies for all enrollees
    D. individual policies for all enrollees
    (this multiple choice question has been scrambled)
  78. if a group plan sponsor sets up a contributory plan, what percentage of eligible employees are required to participate?

    A. 75%
    B. 100%
    C. 60%
    D. 50%
    A. 75%
    (this multiple choice question has been scrambled)
  79. a federal law created to protect employee pensions is called:

    A. ERISA
    B. OBRA
    C. TEFRA
    D. COBRA
    A. ERISA
    (this multiple choice question has been scrambled)
  80. the federal law that mandates that Medicare be secondary to group medical insurance for groups with more than 20 employees is called;

    A. TEFRA
    B. OBRA
    C. ERISA
    D. COBRA
    A. TEFRA
    (this multiple choice question has been scrambled)
  81. a condition that would be suitable for a self-funded medical plan is:

    A. an employer has less than 20 employees
    B. an employer has operations is several states
    C. an employer with hazardous employment
    D. an employer has employees with a large number os medical claims
    B. an employer has operations in several states
    (this multiple choice question has been scrambled)
  82. under ADEA, it is illegal for employers to:

    A. discriminate against employees age 40 or younger
    B. discriminate against employees with disabilities
    C. discriminate against employees that are pregnant
    D. discriminate against employees age 40 or older
    D. discriminate against employees age 40 or older
    (this multiple choice question has been scrambled)
  83. an employee can be disqualified for COBRA benefits if:

    A. the employee becomes disabled
    B. the employee does not pay premiums in a timely manner
    C. the employee is reduced to working part-time
    D. the employee gets divorced
    B. the employer does not pay premiums in a timely manner
    (this multiple choice question has been scrambled)
  84. an arrangement designed to limit an employer's exposure if employee medical claims become very high is called:

    A. reserve reduction arrangement
    B. premium delay arrangement
    C. retrospective rating arrangement
    D. stop loss coverage
    D. stop loss coverage
    (this multiple choice question has been scrambled)
  85. an individual that loses group coverage can convert to an individual medical insurance plan without evidence of insurability within:

    A. 31 days
    B. 60 days
    C. 90 days
    D. 30 days
    A. 31 days
    (this multiple choice question has been scrambled)
  86. in order for an illness to qualify for worker's compensation, it must:

    A. cause temporary partial disability only
    B. be foreseeable
    C. occur while not working
    D. be due to conditions peculiar to the job
    D. be due to conditions peculiar to the job
    (this multiple choice question has been scrambled)
  87. the four basic benefits of worker's compensation include all of the following, EXCEPT:

    A. Death benefits for surviving dependents
    B. disability income benefits of 50% of disabled employee's salary
    C. unlimited medical coverage for the job related illness or injury
    D. rehabilitation
    B. disability income benefits of 50% of the disabled employee's salary
    (this multiple choice question has been scrambled)
  88. to qualify for social security disability income benefits, a person must be:

    A. currently insured
    B. medicaid  insured
    C. fully insured
    D. medicare insured
    C. fully insured
    (this multiple choice question has been scrambled)
  89. medicare part A covers all of the following, EXCEPT:

    A. custodial care
    B. hospice care
    C. care in a skilled nursing facility
    D. hospitalization
    A. custodial care
    (this multiple choice question has been scrambled)
  90. a person can qualify for medicare part A:

    A. by being on SSDI for 12 months
    B. by being financially needy
    C. by suffering from end stage renal disease
    D. at age 62
    C. by suffering from end stage renal disease
    (this multiple choice question has been scrambled)
  91. medicare part A pays for the first 60 days in hospital:

    A. after the insured pays the Part B deductible
    B. on a first dollar basis
    C. after the insured pays a calendar year deductible
    D. after the insured pays the Part A deductible 
    D. after the insured pays the Part A deductible
    (this multiple choice question has been scrambled)
  92. medicare is financed by:

    A. payroll taxes paid equally by the employers and the employee
    B. The Social Security Admisnistration
    C. employee paid payroll taxes only
    D. employers paid payroll taxes only
    A. payroll taxes paid equally by the employer and the employee
    (this multiple choice question has been scrambled)
  93. the federal law that allows employees covered under a group plan to be guaranteed coverage under another group plan if the employee changes job is called:

    A. TEFRA
    B. TAMRA
    C. ERISA
    D. HIPAA
    D. HIPAA
    (this multiple choice question has been scrambled)
  94. a waiver for pre-existing conditions is not limited to :

    A. 12 moths
    B. there are no more waivers for pre-existing conditions
    C. 6 months
    D. 18 months
    A. 12 months
    (this multiple choice question has been scrambled)
  95. a special type of savings account established under HIPAA to encourage the use of high deductible plans is called:

    A. FSA
    B. HSA
    C. IRA
    D. MSA (medical savings account)
    D. MSA
    (this multiple choice question has been scrambled)
  96. HSAs can be used to pay for the following medical expenses:

    A. hospital expenses not paid for by insurance
    B. premiums for long term care insurance
    C. premiums for COBRA
    D. all of the above
    D. all of the above
  97. a plan that allows either the employer or the employee to make a tax deductible contribution to a special account is called:

    A. IRA
    B. FSA
    C. MSA
    D. HSA
    D. HSA
    (this multiple choice question has been scrambled)
  98. which of the following is NOT considered a natural group?

    A. employees of the same company
    B. members of a labor union
    C. members of a block association
    D. students at a university
    C. members of a block association
    (this multiple choice question has been scrambled)
  99. once a employee completes the probationary period, the employee can enroll in the company's group benefit plan without underwriting:

    A. any time after the probationary period ends
    B. during the open enrollment period
    C. up to one year after the probationary period ends
    D. 6 months after the probationary period ends
    B. during the open enrollment period
    (this multiple choice question has been scrambled)
  100. all of the following are group characteristics, EXCEPT:

    A. predetermined options
    B. experience rating
    C. coordination of benefits
    D. individual policies for all enrollees
    D. individual policies for all enrollees
    (this multiple choice question has been scrambled)
  101. if a group plan sponsor sets up a contributory plan, what percentage of eligible employees are required to participate?

    A. 100%
    B. 75%
    C. 50%
    D. 60%
    B. 75%
    (this multiple choice question has been scrambled)
  102. a federal law created to protect employee pensions is called:

    A. TEFRA
    B. OBRA
    C. ERISA
    D. COBRA
    C. ERISA
    (this multiple choice question has been scrambled)
  103. the federal that mandates that Medicare be secondary to group medical insurance for groups with more than 20 employees is called;

    A. TEFRA
    B. COBRA
    C. ERISA
    D. OBRA
    A. TEFRA
    (this multiple choice question has been scrambled)
  104. a condition that would be suitable for a self-funded medical plan is :

    A. en employer has less than 20 employees
    B. an employer has operations in several states
    C. an employer with hazardous employment conditions
    D. an employer has employees with a larger number of medical claims
    B. an employer has operations in several states
    (this multiple choice question has been scrambled)
  105. under ADEA, it is illegal for employers to:

    A. discriminate against employees with disabilities
    B. discriminate against employees that are pregnant
    C. discriminate against employees age 40 and younger
    D. discriminate against employees age 40 or older
    D. discriminate against employees age 40 or older
    (this multiple choice question has been scrambled)
  106. an employee can be disqualified for COBRA benefits if:

    A. the employee is reduced to working part-time
    B. the employees gets divorced
    C. the employee does not pay premiums in a timely manner
    D. the employee becomes disabled
    C. the employee does not pay premiums in a timely manner
    (this multiple choice question has been scrambled)
  107. an arrangement designed to limit an employer's exposure if employee medical claims become very high is called:

    A. premium delay arrangement
    B. stop loss coverage 
    C. reserve reduction arrangement
    D. retrospective rating arrangement
    B. stop loss coverage
    (this multiple choice question has been scrambled)
  108. an individual that loses group coverage can convert to an individual insurance plan without evidence of insurability within:

    A. 31 days
    B. 30 days
    C. 60 days
    D. 90 days
    A. 31 days
    (this multiple choice question has been scrambled)
  109. in order for an illness to qualify for worker's compensation, it must be:

    A. cause temporary partial disability only
    B. be foreseeable
    C. be due to conditions peculiar to the job
    D. occur white not working
    C. be due to conditions peculiar to the job
    (this multiple choice question has been scrambled)
  110. the four basic benefits of Worker's compensation include all of the following, EXCEPT:

    A. death benefits for surviving dependents
    B. rehabilitation
    C. disability income benefits of 50% of the disabled
    D. unlimited medical coverage for the job related illness or injury
    C. disability income benefits of 50% of the disabled employee's salary
    (this multiple choice question has been scrambled)
  111. to qualify for social security disability income benefits, a person must be:

    A. medicare insured
    B. currently insured
    C. fully insured
    D. medicaid insured
    C. fully insured
    (this multiple choice question has been scrambled)
  112. medicare part A covers all of the following, EXCEPT:

    A. hospitalization
    B. hospice care
    C. custodial care
    D. care in skilled nursing facility
    C. custodial care
    (this multiple choice question has been scrambled)
  113. a person can qualify for Medicare part A:

    A. by suffering from end stage renal disease
    B. by being financially needy
    C. at age 62
    D. by being on SSDI for 12 months
    A. by suffering from end stage renal disease
    (this multiple choice question has been scrambled)
  114. medicare part A pays for the first 60 days in a hospital:

    A. on a first dollar basis
    B. after the insured pays a calendar year deductible
    C. after the insured pays the part A deductible
    D. after the insured pays the part B deductible
    C. after the insured pays the Part A deductible
    (this multiple choice question has been scrambled)
  115. medicare is financed by :

    A. employer paid payroll taxes only
    B. payroll taxes paid equally by the employer and the employee
    C. employee paid payroll taxes only
    D. the social security administration
    B. the payroll taxes paid equally by the employer and the employee
    (this multiple choice question has been scrambled)
  116. skilled nursing facility care is paid for by Medicare:

    A. in full under Part A
    B. in full under part B
    C. in full after a 20  day waiting period
    D. in full for the first 20 days
    D. in full for the first 20 days
    (this multiple choice question has been scrambled)
  117. the medicare part B deductible is:

    A. per illness
    B. per calendar year
    C. per benefit period
    D. per family
    B. per calendar year
    (this multiple choice question has been scrambled)
  118. all of the following are exclusions under medicare part A and part B, EXCEPT:

    A. acupuncture
    B. self-administered drugs
    C. flu shots
    D. custodial care
    C. flu shots
    (this multiple choice question has been scrambled)
  119. a medicare plan that requires the insured to utilize a provider in an HMO is called:

    A. medicare part D
    B. medicare part B
    C. medicare part C (medicare advantage)
    D. medicare part A
    C. medicare part C
    (this multiple choice question has been scrambled)
  120. under federal law, how many standardized medicare supplement plans are there?

    A. 8
    B. 15
    C. 12
    D. 10
    C. 12
    (this multiple choice question has been scrambled)
  121. enrollment for medicare part B is handled by:

    A. workers compensation board
    B. the social security administration
    C. government contracted intermediaries
    D. CMS
    B. the social security administration
    (this multiple choice question has been scrambled)
  122. medicare part B covers all of the following, EXCEPT:

    A. durable medical equipment
    B. skilled nursing facility
    C. occupational therapy
    D. physicians services
    B. skilled nursing facility
    (this multiple choice question has been scrambled)
  123. according to the 2000 census, the fastest growing segment of our population is the cohort ages:

    A. 1-15
    B. 30-45
    C. 65 and above
    D. 46-64
    C. 65 and above
  124. the average cost for a stay in a private room in a nursing home, nationally, in 2005 was:

    A. over $400 per day
    B. approximately $100 per day
    C. over $500 per day
    D. over $200 per day
    D. over $200 per day
    (this multiple choice question has been scrambled)
  125. which type of care is the most provided long-term care in the US?

    A. custodial care
    B. hospital care
    C. skilled care
    D. intermediate care
    A. custodial care
    (this multiple choice question has been scrambled)
  126. a LTCI policy that is tax qualified is one that:

    A. meets the standards of health insurance set forth by the IRS under HIPAA
    B. allows full deduction of all premiums
    C. can require prior hospitalization as a prerequisite for receiving policy benefits
    D. can have cash value
    A. meets the standards of health insurance set forth by the IRS and HIPAA
    (this multiple choice question has been scrambled)
  127. all of the following are activities of daily living (ADLs), EXCEPT:

    A. taking medication
    B. transferring
    C. bathing
    D. dressing
    A. taking medications
    (this multiple choice question has been scrambled)
  128. LTCI  policies my pay for long term care in all of the following settings, EXCEPT:

    A. adult day care
    B. hospice
    C. VA Hospital
    D. home health care
    C. VA hospital
    (this multiple choice question has been scrambled)
  129. a benefit in tax qualified LTCI policies that provides short term care to give temporary relief to an unpaid care giver is called:

    A. home care
    B. custodial care
    C. respite care
    D. intermediate care
    C. respite care
    (this multiple choice question has been scrambled)
  130. Tom and Mary, ages 54 and 52, want to purchase a long term care insurance policy with the strongest inflation protection. They should purchase which inflation option?

    A. periodic inflation
    B. GPO
    C. 5% simple
    D. 5% compound
    D. 5% compound
    (this multiple choice question has been scrambled)
  131. a period selected by the applicant made up of the number of dates of service that would otherwise be covered by the policy if it were not for this period is called:

    A. the elimination period
    B. the benefit period
    C. the probationary period
    D. the waiver period
    A. the elimination period
    (this multiple choice question has been scrambled)
  132. an employer with 500 employees wants to offer LTCI

    A. modified issue
    B. fully underwritten issue
    C. periodic issue
    D. guaranteed issue
    C. periodic issue
    (this multiple choice question has been scrambled)
  133. a federal law that requires states to recover funds spent by medicaid on long term is called:

    A. ERISA
    B. OBRA 93
    C. TEFRA
    D. HIPPA
    B. OBRA 93
    (this multiple choice question has been scrambled)

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