Missed Questions Accident and Health State Exam Simulator

Health insurance will typically cover which of the following perils?

Injury due to accident

A doctor who accepts Medicare Assignment agrees to which of the following?

Doctor cannot charge more than Medicare's scheduled coverage

What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?

Dread disease policy

Benefits for a Medicare Supplement policy

Must not duplicate Medicare benefits

What is the tax liability for employer contributions in Health Savings Accounts (HSA's)?

No tax payment needed

Disability Income plans which requre that the insurer can NEVER change or alther premium rate are usually considered

Noncancellable

All Health Benefit Plans issued after January 1, 2014 must provide

Preventative health services

What is the purpose of the Medical Information Bureau(MIB)

TO help underwriters evaluate risk

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must

be the same and the premium cannot exceed 102%

Preferred risk policies with reduced premiums are issued by insurance companies because the insured has

better than avg mortality or morbidity experience

Medicare provides coverage for each of the following EXCEPT - hospital room and board - doctor and surgeon services -prescription drugs - custodial care

custodial care

Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)

deductible

A pharmacy benefits covers prescription drugs derived from a list called a(n)

drug formulary

Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the

employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan

Key Person Disability Insurance pays benefits to the

employer

A field underwriter's main task is to

ensure an applicant's medical info is accurate and complete

The waiting period for a disability insurance policy

excludes payments for a short-term illness or injury

A payment system for health care in which the provider is paid for each service given is called

fee-for-service

An indemnity plan

provides the insured a specific dollar amount for services

Karen is a producer who has obtained personal information about a client without having a legitimate reason to do so. Under the McCarran-Ferguson Act, what is the minimum penalty for this?

$10,000

The typical long-term care policy is designed to provide a minimum of ____ year(s) of coverage 1 3 5 7

1

Which of the following is NOT taken into consideration when determining eligibility for Medicare benefits

Income

Sole proprietors are permitted tax deductions for health costs paid from theri earnings in the amount of

100% of costs

After a disability policy has been in force for ___ year(s), it is considered incontestable. - 1 -2 -3 -4

2

Long-term care insurance and Medicare Supplement plans have a free-look period of ______ days

30

Prior to a disciplinary hearing the director is required to give at least ____ days notice

30 days

As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer.30%40%50%60%

50%

What percentage of a participants income are group long term disability benefit amounts typically limited to

60%

Proof of loss on a health insurance claim must be submitted to an insurer within _____ days after the insured's date of loss

90 days

Which of the following is an example of the insured's consideration?

A paid premium

The term which describes the fact that both parties of a contract may not receive the same value is referred to as

Aleatory

The waiver of premium does NOT include which provision

All future premiums are waived if the insured recovers from the disability

The deeds and actions of a producer indicate what kind of authority

Apparent

Implied authority is defined as

Authority that is not specifically given to an agent in the agency contract, but that an agent can reasonably assume to carry out his.her duties

A disability policyowner is injured and becomes totally disabled. The benefits pay for 2 years, starting from the date of the injury. What is this time period called?

Benefit period

XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?

Benefits are fully taxable

Which of the following would be considered an underwriting duty of an agent

Completing all applications and collecting initial premiums

Which of these is NOT a qualifying event for MEdicare

Falling below the federal poverty level

Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance?

Hospital Indemnity

The authority granted to a licensed producer is provided via the - producers apparent authority - written contract -Law of Agency - Principal Capacity

Law of Agency

How do insurers predict the increase of individual risks?

Law of large numbers

Which contract element is insurable interest a component of?

Legal Purpose

The election of COBRA for continuation of health coverage will

Maintain the same coverage and increase premium

Which type of plan would be most appropriate for an individual on Medicare and is concerned that Medicare will not pay for charges exceeding the approved amount?

Medicare supplement Plan F

Which of the following is a legal entity created for the sole purpose of providing affordable group health coverage to its participants

Multiple Employer Welfare Arrangement (MEWA)

Insurance policy that is renewable only at the option of the insurance company. Policy is considered to be

Optionally renewable

Typically, Long-Term Disability benefits are coordinated with which benefit plan?

Social Security

What is the elimination period of an individual disability policy?

Time period a disabled person must wait before benefits are paid

A medical provider that accepts Medicare Assignment must

accept payment based upon a defined Medicare schedule as a payment in full

An underwriter's primary responsibility to an insurer is to protect against

adverse selection

MEdical expense would cover

an injury occurring at the insured's residence

The power given to an individual producer that is not specifically addressed in his/her contract is considered what type of authority?

implied authority

An accident and health policy that provides reimbursement benefits makes them payable to the

insured

A dread disease policy is considered to be a type of

limited health insurance policy

The reinstatement provision in a health insurance policy is

mandatory

Group health plans may deny participation based upon the

member' part time employment status

Which of the following is NOT an example of utilization review

on going inspection of accident prone individuals

A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n)

optional renewability clause

States that have "no loss no gain" laws require a replacing policy to

pay for ongoing claims under the policy it replaces

The date when you receive coverage is when

premium paid and when the effective date is

In an insurance contract, the applicant's "consideration" is the

statements made in the application and the premium

Distributions from a Health Savings Account (HSA) for qualified medical expenses are

tax free

The MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes

the entire insurance contract between parties

MAjor Medical expense plans provide coverage for each of the following EXCEPT

work related injuries