Exam practice 1

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?

10 days

in a noncontributory health insurance plan, what percentage of eligible employees must participate in the plan before in the plan before the plan can become effective?

100%

The patient protection and affordable care act mandates the insurers provide coverage for adult children of the insured up the age of

19

At what age does an individual qualify for Medicare?

65

A producer licensed in life and health, as well as property and casualty, must complete a minimum of how many hours in each line of authority for every 2 years?

8 hours

Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within

90 days of a loss

A hospital indemnity policy will pay

A benefit for each day the insured is in a hospital

Before being issued a license, applicants must submit which of the following to the director as part of a background check?

A complete set of fingerprints

Which of the following will be covered a group medical expense policy?

A pre-existing condition

An insured carries health insurance with two different providers and is covered by on an expense incurred basis. He has an appendectomy and files the claims to both insurers. Neither company is notified in advance that the insurer has other coverage. What should each insurer pay?

A proportionate amount

Assuming that any other eligibility requirements have been met, which of the following would NOT qualify for coverage in South Carolina Health Insurance Pool?

A state resident who receives Medicare

Which of the following groups would probably be covered by blanket insurance?

A university's sports team

The Omnibus budget Reconciliation Act of 1990 (obra) requires that coverage for disabled individuals under

Age 65 who are not retired

Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company

Aleatory

an individual producer license must contain all of the following EXCEPT

Any punitive measures taken against the licensee

An insurer that holds a Certificate of Authority in the state in which it transacts business is considered a/an

Authorized insurer

How often are producers in South Carolina required to pay the license renewal fee?

Biennially

Which of the following is owned by corporation to serve that organization's needs to lower rates than would otherwise be available with commercial insurance?

Captive insurer

which of the following would not be used in preventive care?

Chemotherapy

A producer who fails to separate premium from his own personal funds is guilty of

Commingling

any payment to a producer from an insurer that is contingent on the sale of an insurance policy or contract is called a a. charge fee b. service fee c. commission d. regular fee

Commission

An insured is receiving hospice care. His insurer will pay for painkillers but not for an operation to reduce the size of a tumor. What term best fits this arrangement?

Cost-containment

According to the Fair Credit Reporting Act, all of the following would be considered negative information about a consumer EXECPT

Disputes regarding consumer report information

How often must producers complete continuing education hours?

Every 2 years

A producer's license may be revoked or suspended by the director for all of the following EXCEPT

Failure to meet sales quotas set by insurer

An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits?

Full benefits

Health Savings Account (HSA) are designed to

Help individuals save for qualified health expenses

How can LTC benefits be received tax free by an individual?

In any case, benefits are received tax-free

which benefits would a disability plan most likely pay?

Income lost by the insured's inability to work

all of the following actions by a person could be described as a risk avoidance EXCEPT

Investing in the stock market

Which of the following is true about health insurance?

It could provide payments for loss of income.

How is the amount of Social Security disability benefits calculated?

It is based upon the worker's Primary insurance amount (PIA), which is calculated from their Average indexed Monthly Earnings over their highest 35 years.

all of the following statements about Medicare B are correct EXCEPT

It is compulsory

In group insurance, what is the policy called?

Master policy

An insurance company wants to obtain the insurance history of an applicant. Which source releases coded information to insurers regarding information including previous insurance applications?

Medical information Bureau

An insured is covered under Medicare policy that provides that the insured must use to receive coverage. In each limitation, the insured is 0ffered a lower premium. Which type if Medicare policy dies the insured own?

Medicare SELECT

In order to be eligible for group health insurance, all of these are conditions employee must mee EXCEPT

Must have dependents

Which of the following report will provide the underwriter with the information about an insurance applicant's credit?

No benefits

The director has just finished examining a domestic insurer. When is the director next required to examine the same insurer?

No later than 5 years from now

Who provision concerns the insured's duty to provide the insurer with reasonable notice in the event of loss?

Notice of Claim

An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare Part A and Part B. What is the insurance company obligated to do?

Offer the supplement policy on guaranteed issue basis

Medicare Part A services do NOT include which of the following?

Outpatient Hospital Treatment

When an individual is covered under two health insurance policies that have duplicate benefits which could make a claim for benefits because of an injury or illness profitable, it is called?

Over-insurance

Who might receive dividends from a mutual insurer?

Policyholders

a women obtains health coverage through the marketplace on October 1st two weeks later she finds out she is 3 months pregnant. Which of the following is true about coverage pregnancy?

Pregnancy will be covered immediately

Underwriting is a major consideration when an insured wishes to replace her current policy for all the following reasons EXCEPT

Premiums always stay the same

Which of the following do the standard and preferred risk categories share?

Premiums are not elevated

A medical insurance plan in which the health care provider is paid a regular fixed amount of providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called

Prepaid plan

Rose bought three policies from the same insurer. He benefits have exceeded the maximum allowed by the insurer. Which of the following will happen?

Pro rata benefit reduction

Following a career change, an insured is no longer required to perform many physical activities, so he has implemented a program where he walks and jogs for 45 minutes each morning. The insured has also eliminated most fatty foods from his diet. Which method of dealing with risk does this scenario describe?

Reduction

when an employee covered under a health reimbursement account employers, the HRA

Stays with the employer

Which of the following protects consumers against

The Fair Credit Reporting Act

Who determines the eligibility and contribution limits in a HRA?

The employer determines both

Who is responsible for covering the expenses associated with the examination of domestic insurers

The examined insurer

When the policy premium wasn't submitted with the application, what should the agent obtain from the insured upon policy delivery?

The fair credit reporting act

In which of the following cases would an "any occupation" disability income policy pay the benefits?

The insured is unable to perform any jobs in the field related to the insured's education and experience.

An applicant is considered to be high-risk, but not so much that the insurer wants to deny coverage. Which of the following is not True?

The insurer will issue a conditional coverage.

An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered pre-existing condition. which of the following is true?

The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off

How does a member of an HMO see a specialist?

The primary care physician refers the member

Which of the following statements is most correct concerning the changing of an irrevocable?

They can be changed only with the written consent of that beneficiary

Under the Physical Exam and Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending?

Unlimited

A dental plan that provides coverage based upon a specified maximum scheduled amount for each procedure and pays on a 'first dollar' basis with no deductible or coinsurance is a

basic or scheduled plan

Medicaid is sponsored by what kind of sources?

both state and federal

In a group prescription drug plan, the insured typically pays what amount of the drug cost

copayment

Which of the following is correct concerning taxation of long-term care insurance?

excessive benefits may be taxable.

Under workers compensation, which of the following benefits are NOT included?

legal benefits

which of the following is NOT provided by an HMO?

reimbursement

which of the following is the most common time for errors and omission to occur on the part an insurer?

underwriting