Health Insurance thingy
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
After an insurance company examination, the Commissioner or the examiner appointed by the Commissioner must file a written report of the examination within
50 days
A health plan policy cannot be issued or delivered in Minnesota until which of the following has been filed with the Commissioner?
Both risk classification and premium rates
When delivering a policy, which of the following is an agent's responsibility?
Collect payment at the time of delivery
What are the 2 types of Flexible Spending Accounts
Health Care Accounts and Depends Care Accounts
In the event of loss, after a notice of claim is submitted to the insurer, who is responsible for providing claims forms and to which party?
Insurer to insured
How soon after a notice of hearing is made may the hearing be conducted?
No less than 20 days
On a participating insurance policy issued by a mutual insurance company, dividends paid to the policyholders are
Not taxable since the IRS treats them as a return of a portion of the premium paid.
In a Commerical General Liability policy, which of the following forms covers losses that occur, the start of is discovered during the policy period, regardless of when the date is actually reported by the insured?
Occurrence
Can an individual who belongs to a POS plan use an out-of-network physician?
Yes, and they may use an preferred physician, even if not part of the HMO
Once an individual is licensed as an insurance producer for life or accident and health insurance, how many hours of training must he or she initially complete to sell long-term care insurance?
8
How is emergency care covered for a member of an HMO
A member of an HMO can receive care in or out of the HMO's service area, but care is preferred in the service area.
All the following are correct about the required provisions of a health insurance policy EXCEPT
A reinstated policy immediate coverage for an illness
All the following individuals may qualify for Medicare health insurance benefits EXCEPT
A retired person age 50
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
While a claim is pending, an insurance company may require..
An independent examination as often as reasonably required
What document describes an insured's medical history, including diagnoses and treatment?
Attending Physician's Statement
Contracts that are prepared by on party and submitted to the other party on a take-it-or-leave-it basis are classified as
Contracts of adhesion
Which of the following is a specified dollar amount that the insured must pay before the policy benefits begin?
Deductible
This arrangement specifies who will purchase a disabled partner's interest in the event he or she becomes disabled?
Disability buy-off
Which of the following individuals related to an insured will be eligible for coverage under the insured's group health insurance policy?
Disabled dependents
The provisions in a health insurance policy that ensures that the insurer cannot refer to any documents that is not contained in the contract is the
Entire contract clause
A women's health insurance policy dictates which doctors she is allowed to see her health providers share an assumed risk for their patients and encourage preventive care. What best describes the health system that the woman is using?
Managed care
A corporation that contracts for health services for subscribers in exchange for the periodic payment by or on behalf of the subscribers, and that does not bill the subscriber directly, but bills the service plan, is classified as a
Nonprofit health service plan corporation
An insured purchased a disability income policy with a 10 year benefit period. The policy started a 20-day probationary period for illness. If the insured is hospitalized with an illness 2 weeks after the policy was issued, how much will the policy pay?
Nothing, illness is not covered during the first 20 days of the contract
Which of the following applies to partial disability benefits?
Payment is limited to a certain period of time
Who might receive dividends from a mutual insurer ?
Policyholders
Which of the following must be received by the insurer before a claim will be paid?
Proof of loss
All of the following are true regarding rebates EXCEPT
Rebated are allowed if it is in the best interest of the client
What type of care is Respite Care
Relief for a major care giver
The law that protects consumers against the circulation of inaccurate or obsolete information is known as
The Fair Credit Reporting Act
If an insurer becomes insolvent, which entity would pay benefits to policyholders
The Guaranty Association
An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?
The PPO will pay reduced benefits
Which statement is NOT true regarding underwriting group health insurance?
The group is assessed individually for insurability.
Which of the following statements is true about business owners policies (BOPs)?
BOPs may be customized by adding optional coverage
In life insurance, producers are permitted to share or split commissions, provided that
Both are properly licensed for the line of insurance
A husband and wife are insured under the group health insurance plans at their own places of employment, and as dependents under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid?
The benefits will be coordinated
An insured submitted a notice of claim to the insurer, but never received claims forms. He later submits proof of loss, and explains the nature of the extent of loss in a hand-written letter to the insurer. Which of the following is true?
The insured was in compliance with the policy requirement regarding claims
Which of the following is NOT a feature of a noncancellable policy?
The insurer may terminate the contract only at renewal for certain conditions
The insuring clause of a disability policy usually states all of the following except?
The method of premium payment
An insured makes regular contributions to his Health Savings Account. How are those contributions treated in regards to taxation?
They are tax deductible
Todd has been informed that he has a hernia which requires repair. When Todd researches the cost, he learns that his insurance plan will cover 200 points worth of surgical expenses. Each point represents $10, which means that $2000 of his surgery will be covered by his insurance plan. What system is Todd's insurance company using?
They are tax deductible
Which provision states that the insurance company must pay Medical Expense claims immediately ?
Time of Payment of Claims
What is the purpose of a certificate of insurance?
To provide individual insured with evidence of insurance.
