health Insurance test questions
In addition to the current year, for how many prior years must an insurer maintain claim records?
5 years
The pre-existing condition limitation in a long term care policy cannot restrict coverage for an illness which has been treated or advised more than how many months before the effectives date of coverage?
6
Under the mandatory uniform provision legal actions, an insured is prevented form bringing a suit against he insurer to recover on a healthy policy prior to?
60 days after written proof of loss has been submitted
A Limited Insurance Representative is an individual, other than an insurance producer, who may solicit or negotiates contracts for certain types of insurance which includes all of the following except?
Automobile physical damage insurance
Who is responsible for approving informational booklets intended to educate senior citizens on the advantages and disadvantages of supplementary medicare coverage?
The commissioner
An insured needs ongoing treatment for a diabetic condition. Under the PPACA, which of the following is correct? a) The condition is covered if the insured's plan specifies the condition b) Treatment is subject to pre-existing conditions exclusion c) Treatment is subject to an annual dollar maximum d) The condition must be covered under the insured's plan
The condition must be covered until ehe insured's plan
What is the maximum fine the commissioner may impost on an insurer for a single willful violation of the insurance code?
$25,000
An insurer must notify the consumer in writing that an investigative consumer report has been requested, within how many days of the initial request?
3 days
How long is the free-look period for individual long-term care policies?
30 days
Which of the following is considered a qualifying event under COBRA?
Divorce
What would major medical expense policy would exclude coverage for all of the follow treatments except?
Drug Addiction
The guaranteed purchase option is also referred to as
Future Increase Option
Concerning insurance, the definition of a fiduciary responsibility is
Handling insurer funds in a trust capacity
In order for an alumni association to be eligible to purchase group health insurance for its members, all of these statements must be true EXCEPT when the association
Has been active for five years minimum
What is not excluded from coverage in an individual health insurance policy?
mental illness
Allow of the following long-term coverages would allow an insured to receive care at home EXCEPT
skilled care
Which of the following meets the insured's personal needs, and is provided by nonmusical personal?
Custodial care
What does Medicare Part B not cover?
Long-term care services
When may HIV-related tests results be provided to the MIB?
Only if the individual is not identified
On an accidental death or dismemberment policy, the death benefit payable is known as?
Principal Sum
What is NOT mandatory under the Uniform Provisions Law as applied to accident and health policy?
Probationary period
A guaranteed renewable disability insurance policy
Is renewable at the insureds option to a specified age
HMOs are known as what type of plans? a) Service b) Health savings c) Consumer driven d) Reimbursement
Service
An insured has endured multiple surgeries and hospitalizations for an illness during the summer months. Her insurer no longer bills hers for medical expenses. What term best describes the condition she has met?
Stop-loss Limit
All of the following would be classified as "limited insurance coverage" EXCEPT?
Supplement Social Security Coverage
If a basic medical insurance plans benefits are exhausted, what type of plan will then begin to cover those losses?
Supplementary Major Medical
What is the purpose of the impairment rider in a health insurance policy?
to exclude coverage for a specific impairment
Under the mandatory uniform provision Notice of Claim, written notice of a claim must be submitted to the insurer within what time parameters?
within 20 days
Guaranteed renewable will continue until insured reaches age?
65
What would not qualify as a group for insurance?
An association of 35 ppl
An insurance producer may NOT act as an agent for an insurer until he or she has been
Appointed
Which is NOT a medicaid qualifier?
Insurability
All of the following are correct about the required provisions of a health insurance policy EXCEPT
A reinstated policy provides immediate coverage for an illness
In order to be eligible for a producers license in the state of TN, an applicant must meet all fo the requirements except, ?
Complete 40 hours of relicensing education
Conrad receives $50,000 from a $100,000 Accident Death and Dismemberment Policy as a result of the loss of his left arm from an accident. What has Conrad received?
Conditional Amount
Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by her insurer. What is the name of the agreement?
Insuring Clause
With respect to the entire contract clause with health policies, who has the authority to make changes to an existing policy?
Only an executive officer of the company
Which of the following terms relates to disability income insurance?
Residual benefit
