Dri 10.5

In the event a policy lapses due to nonpayment of premium, within how many days would the policy be automatically reinstated once the outstanding premium is paid?

45 days

An insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay?

$5,000

If a health insurance carrier withdraws from the small employer market, how soon may they reenter that market if they later choose to do so?

5 years

After an insurance company examination, the Commissioner or the examiner appointed by the Commissioner must file a written report of the examination within

60 days.

The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have?

Accident-only

While a claim is pending, an insurance company may require

An independent examination as often as reasonably required.

How is the Minnesota Comprehensive Health Association funded?

By its members -authorized insurers

Any payment to a producer from an insurer that is contingent on the sale of an insurance policy or contract is called a

Commission.

All of the following could be considered rebates if offered to an insured in the sale of insurance EXCEPT

Dividends from a mutual insurer.

Which of the following is considered a qualifying event under COBRA?

Divorce

Which of the following provisions states what must be included for an insurance contract to be considered complete?

Entire contract

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the

Entire contract clause.

he provision that states that both the printed contract and a copy of the application form the contract between the policyowner and the insurer is called the

Entire contract.

Which of the following types of LTC is NOT provided in an institutional setting?

Home health care

Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?

Indemnity

What is an outcome of the Consolidated Omnibus Reconciliation Act?

Individuals who leave their jobs may temporarily keep their existing health coverage.

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the

Insuring clause.

The type of dental plan which is incorporated into a major medical expense plan is a/an

Integrated dental plan.

A guaranteed renewable disability insurance policy

Is renewable at the insured's option to a specified age.

The primary eligibility requirement for Medicaid benefits is based upon

Need.

An applicant for a health insurance policy returns a completed application to her agent, along with a check for the first premium. She receives a conditional receipt two weeks later. Which of the following has the insurer done by this point?

Neither approved the application nor issued the policy

An insured purchased a noncancellable health insurance policy 1 year ago. Which of the following circumstances would NOT be a reason for the insurance company to cancel the policy?

The insured is in an accident and incurs a large claim.

A guaranteed renewable health insurance policy allows the

Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class.

Insurers may change which of the following on a guaranteed renewable health insurance policy?

Rates by class

When determining the suitability of a life insurance policy or annuity contract, the agent must consider all of the following, EXCEPT

The commissions payable on such policy or contract.

Which statement accurately describes group disability income insurance?

The extent of benefits is determined by the insured's income.

Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In November, he has a small claim which is less than his deductible. Which of the following is true?

The insured may carry over the amount of this year's expenses to next year, which will help satisfy next year's deductible.

When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?

The insurer is considered to be notified since the notification to agent equals notification to the insurer.

Which of the following is NOT a feature of a noncancellable policy?

The insurer may terminate the contract only at renewal for certain conditions.

All health insurance plans that reimburse inpatient hospital and medical expenses must provide health service benefits for the treatment of emotionally handicapped children on

The same basis as hospital and medical benefits.

An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?

Time of Payment of Claims