guarantee exam pt 2

"Small Group Employer" means

any person, firm, corporation, partnership, or association that is actively engaged in business that has no more than 50 eligible employees.

Which of the following is NOT correct concerning taxation of disability income benefits?

If paid by the individual, the premiums are tax deductible.

Which of the following is NOT a Medicaid qualifier?

Insurability

Major Medical Expense Policy

It provides coverage either on an inpatient or outpatient basis on a reimbursement basis. provides catastrophic medical coverage beyond basic benefits on a usual, customary and reasonable basis.

Florida laws regulating Medicare Supplement insurance conform with

the NAIC model with regard to the federal standard Medigap forms. State laws are introduced for enforcement purposes, as states cannot enforce and prosecute federal laws, only state laws.

A Medicare supplement policy must have a free-look period of at least

30 days.

An employee is insured by a group major medical plan that is provided through her employer. The employer contributes 75% of the premium and the employee contributes the remaining 25%. If the insured received a benefit from this policy in the amount of $1,000, how much of this benefit would be taxed as income?

$0

What is the purpose of the gatekeeper in an HMO?

Controlling costs

Which of the following is NOT mandatory under the Uniform Provisions Law as applied to accident and health policies?

Probationary Period

An agent tells an insured that if he replaces his current insurance policy with a newer one, his dividends will be higher and his premiums will be slightly lower. The policy, however, would not offer either one of these things. What type of misrepresentation is being committed?

Twisting

In Florida, an HMO can offer only

HMO contracts approved by the Department and cannot engage in any other type of activity, including insurance. However, an insurance company or service corporation can own or sponsor an HMO.

Which of the following best describes a Major Medical Expense Policy?

it provides catastrophic medical coverage beyond basic benefits on a usual, customary and reasonable basis.

If the agent delivers a policy, the premium

must be collected at or before that point.

Premium payments on personally owned disability income policies are

non-deductible by the individual. However, disability income benefits are received income tax free by the individual.

What Florida law governs group health insurance provisions provided by insurers and HMOs to small employers?

Florida Employee Health Care Access Act

An insured's cancelable health insurance policy is being cancelled. One day before the policy is scheduled to end, he is involved in a major accident and is hospitalized for a week. Which of the following best describes the coverage that he would receive?

Full benefits, as if the policy were still completely in effect

Which of the following statements about HMOs in Florida is FALSE?

HMOs can engage in selling insurance contracts.

An agent delivers a life policy. He explains a policy change was made and asks the applicant to sign a statement acknowledging the changes were explained. The agent says the premium has not been paid and must be paid before the policy goes into effect. He collects a Statement of Good Health, relinquishes the policy, and leaves. What did he do wrong?

He left the policy with the insured without collecting the premium.

In health insurance, what is coinsurance?

A percentage of the cost of service that the insured and the insurer share

A Major Medical Expense policy would exclude coverage for all of the follow treatments EXCEPT

Drug addiction. Treatment for drug and alcohol addiction is provided on a limited basis.

Which statement best describes agreement as it relates to insurance contracts?

One party accepts the exact terms of the other party's offer.

A corporation has 41 members. Which classification would the employer receive?

Small group

Why does Florida have state laws regulating Medicare Supplement Insurance?

States cannot enforce and prosecute federal laws

Agreement in insurance contracts

includes both an offer and its acceptance.

Group medical and dental expense benefits are received

income tax free by the employee.

"Twisting"

is a misrepresentation that persuades an insured/owner, to his or her detriment, to cancel, lapse, or switch policies from one to another.

Medicaid Qualifiers

residency income level age