4 10 Health Insurance Exam
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#7. What are the 2 types of Flexible
a) Health care accounts and Health reimbursement accounts
b) Medical savings accounts and Dependent care accounts
c) Medical savings accounts and Health reimbursement accounts
D) HEALTH CARE ACCOUNTS AND DEPENDENT CARE ACCOUNTS
There are 2 types of Flexible Spending Accounts: a Health Care Account
for out-of-pocket health care expenses, and
- a Dependent Care Account to help pay for dependent care
- expenses which make it possible for an employee and his or her spouse, if
- applicable, to work.
Which of the following would be an
example of a limited accident and health insurance policy?
A DREAD DISEASE POLICY
An automobile liability policy
A Medicare policy
A long-term care policy
- Limited risk policies cover
- specific illness or accidents.
#20. If a consumer requests additional
information concerning an Investigative Consumer Report, how long does the
insurer or reporting agency have to comply?
a) 7 days
b) 10 days
c) 3 days
D) 5 DAYS
- Consumers must be advised that
- they have a right to request additional information concerning Investigative
- Consumer Reports, and the insurer or reporting agency has 5 days to provide
- the consumer with the additional information.
#23. Which renewability provision
allows an insurer to terminate a policy for any reason, and to increase the
premiums for any class of insureds?
a) Conditionally renewable
c) Guaranteed renewable
D) OPTIONALLY RENEWABLE
- The renewability provision in an optionally renewable policy gives the insurer the
- option to terminate the policy for any reason on the date specified in the
- contract (usually a renewal date). Furthermore, this provision allows the
- insurer to increase the premium for any class of optionally renewable insureds.
#24. Which of the following entities
can legally bind coverage?
a) Federal Insurance Board
d) The insured
Only insurers, not agents, can bind coverage.
#31. Concerning Medicare Part B, which
statement is INCORRECT?
a) An individual must reject Medicare
Part B or they will be enrolled in it automatically.
b) Medicare Part B provides partial
coverage and benefits for medical expenses not covered completely by Part A.
C) MEDICARE PART B
IS FULLY FUNDED BY SOCIAL SECURITY TAXES (FICA).
d) If a person initially declines
Part B, he or she must wait until the next general enrollment period (Jan. 1 through Mar. 31) to enroll.
Medicare Part B has an annual deductible and co-payment by the enrollee.
#35. While a claim is pending, an
insurance company may require
a) The insured to be examined only
b) An independent examination only
once every 45 days.
C) AN INDEPENDENT
EXAMINATION AS OFTEN AS REASONABLY REQUIRED.
d) The insured to be examined only
within the first 30 days.
- While a claim is pending, an
- insurance company may require an independent exam as often as reasonably
Which of the following definitions
would make it easier to qualify for total disability benefits?
The more liberal "any occupation"
The more strict "own occupation"
THE MORE LIBERAL "OWN OCCUPATION"
The more strict "any occupation"
- Total disability is defined differently under some disability income policies. The more liberal "own
- occupation" definition of disability makes it easier to qualify for benefits.
#38. A guaranteed renewable health insurance policy allows the
a) Policyholder to renew the policy
to a stated age and guarantees the premium for the same period.
b) Policy to be renewed at time of
expiration, but the policy can be canceled for cause during the policy term.
c) Insurer to renew the policy to a specified age.
d) POLICYHOLDER TO
RENEW THE POLICY TO A STATED AGE, WITH THE COMPANY HAVING THE RIGHT TO INCREASE PREMIUMS ON THE ENTIRE CLASS.
Coverage is guaranteed, but rates can be adjusted for the entire class.
#40. Sally purchases an individual
health insurance policy on September 1. On September 7 her doctor informs her
that she is four months pregnant. Her coverage will most likely pay
a) ALL EXPENSES EXCEPT THOSE RELATED TO THE PREGNANCY.
b) Only expenses related to the
d) All expenses.
- The pregnancy would not be considered a pre-existing condition if part of a group policy because of HIPAA, but since she has purchased an individual policy, all expenses would
- be covered except those relating to the pregnancy.
#51. Under the uniform required
provisions, proof of loss under a health insurance policy normally should be filed within
a) 30 days of a loss.
b) 60 days of a loss.
c) 90 DAYS OF A LOSS.
d) 20 days of a loss.
- Under the Uniform Required
- Provisions, proof of loss under a health insurance policy normally should be
- filed within 90 days of a loss.
#52. Which of the following provisions
would prevent an insurance company from paying a reimbursement claim to
someone other than the policyowner?
a) Entire Contract Clause
b) Proof of Loss
c) PAYMENT OF CLAIMS
d) Change of beneficiary
- The Payment of Claims provision
- states that the claims must be paid to the policyowner, unless a death
- proceed needs to be paid to a beneficiary.
#53. Long term care coverage may be
sold in all of the various ways EXCEPT
a) Individual long term care.
b) Endorsement to life policy.
c) ENDORSEMENT TO HEALTH POLICY.
d) Group long term care.
Long-term care insurance policies may be purchased on an individual or group basis, or as an endorsement to a life insurance policy.
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