health exam

a deductible is

a specified dollar amount that the insured must pay first before the insurance company will pay the policy benefits

under the mandatory uniform provision notice of claim the first notice of injury or sickness covered under an accident or health policy must contain

a statement that is sufficiently clear to identify the insured and the nature of the claim

which of the following statements is not true regarding health insurance policy provisions

all additional provisions written by insurers are cataloged by the respective states

occasional visits from which of the following medical professionals will not be covered under ltc's home health Care

attending physician

which of the following are not true regarding workers compensation

benefits are offered by the insurer

HMOs that contract with outside physicians to provide health care service to their subscribers compensate those providers on a

capitation basis

agents in this state are required to promptly report all of the following to the department EXCEPT

change in marital status

if an agent advises a policy owner to replace an insurance policy but only does so for the purpose of making commissions, the agent has committed an act of

churning

the proposed insured makes the premium payment on a new insurance policy. if the insured should die, the insurer will pay the death benefit to the beneficiary if the policy is approved. this is an example of what kind of contract

conditional

because an insurance policy is a legal contract it must conform to the state laws governing contracts which require all of the following elements except

conditions

maternity benefits include all of the following except

coverage without cost sharing

if an insurer appoints a customer representative appointment needs to be filed with each of the following entities

department

a major medical expenses policy would exclude coverage for all of the following treatments except

drug addiction

an insurance company has published a brochure that inaccurately portrays the advantages of a particular insurance policy. what is this an example of

false advertising

circulating deceptive sales material to the public is what type of unfair trade practice

false advertising

the guaranteed purchase option is also referred to as

future increase option

all of the following are features of catastrophic plans except

high premiums

which of the following statements about hmos in Florida is false

hmos can engage in selling insurance contracts

which of the following entities must approve all Medicare supplement advertisements

insurance commissioner or director

which of the following entities has the authority to make changes to an insurance policy

insurers executive officer

What happens to the copy of the application for health insurance once the policy is issued

it becomes part of the entire contact

the corridor deductible derives its name from fact that it is applied between basic coverage and

major medical coverage

medicare part a services does not include which of the following

private duty nursing

what is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered

probationary period

in reference to the standard Medicare supplement benefits plans, what does the term standard mean

providers will have the same coverage options and conditions for each plan

insurers offering small employer health insurance are prohibited from

providing varying coverage to employees in different geographic locations

which of the following optional provisions allows insurers to limit benefits to an insureds average income over the last 2 years

relation of earnings to insurance

an insured wants to name her husband as the beneficiary of her health policy. she also wishes to retain all of the rights of ownership. the insured should have her husband named as what type of beneficiary

revocable

which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses

stop-loss limit

which of the following does not have to be disclosed in a long-term care policy

the aggregate amount of premiums due

insurable interest can best be described by which of the following

the applicant must experience a financial loss due to accident or sickness that befalls the insured

the benefits for the group disability plans are based on

the percentage of the worker's income

if an applicant submits the initial premium with an application, which action constitutes acceptance

the underwriters approve the application

an insured notifies the insurance company that he has become disabled. what provisions states that claims must be paid immediately upon written proof of loss

time of payment of claims

when an insurer issues an individual insurance policy is guaranteed renewable, the insurer agrees

to renew the policy until the insured has reached age 65

under what circumstances can an agent's appointment be transferred to another person

under no circumstances

Florida law requires that both individual and group insurance policies provide coverage for a newborn child of a covered family member, other than the insured, for a period of

18 months

the time limit of certain defenses provision prohibits insurers from denying a claim due to misrepresentation, as long as the policy has been in force for at least

2 years

under the mandatory uniform of provision notice of claims, written notice of a claim must be submitted to the insurer within what time parameters

20 days

how long does the law require agents to maintain records of transactions pertaining to premium payments

3 years

how long must an insurer retain an advertisement for it's long-term care policies

3 years

an agent has been convicted of a crime punishable by one year imprisonment. within how many days must the agent notify the department of insurance

30 days

what is the statute of limitations on lawsuits for health insurance policies

5 years

in order to maintain coverage under cobra, how soon from termination of employment must an employee must exercise extension of benefits

60 days

what is the maximum age that a disabled insured worker may receive social security benefits

65

individual health policies, proof of loss must be provided from the insured to the insurer within how many days of a loss

90 days

under the mandatory uniform provision proof of loss, the claimant must submit proof of loss within what time period after the loss

90 days

when must the Medicare supplement buyer's guide be presented

At the time of application

who examines the books and records of insurance companies in Florida

Chief Financial Officer

which of the following is not a characteristic or a service of an HMO plan

Contracting with insurance companies

in a disability policy, the probationary period refers to the time

During which illness-related disabilities are excluded from coverage.

the federal fair credit reporting act

Regulates consumer reports

why does Florida have state laws regulating Medicare supplement insurance

States cannot enforce and prosecute federal laws

Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy?

Submit the description in their own words on a plain sheet of paper

which of the following entities is considered the principal

The insurer issuing a policy

what is the purpose of a benefit schedule

To state what and how much is covered in the plan