Practice test results health and accident

In all individual and small employer health benefit plans, how long is the grace period for persons receiving the federal advance payment tax credit?

3 months

What is the maximum age for qualifying for a catastrophic event?

30

Which of the following is NOT required to be covered by sickness and accident insurance policies issued in the state of Colorado?

A mom's broken arm

What needs to happen before a carrier can offer health benefit plans to a small employers in this state?

A notice of intent must be filed with the Commissioner

Presumptive Disability

A provision that is found in most disability income policies which specifies the conditions that will automatically qualify the insured for full disability benefits.

Which of the following statements is NOT correct concerning the COBRA act of 1985?

It requires all employers, regardless of the number or age of employees, to provide extended group health coverage.

The classification "small employer" means any person actively engaged in business that during the preceding calendar year employed

No more than 50 eligible employees

When can Long-term care policies be purchased?

On an individual or group basis, or as an endorsement to a life insurance policy

Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?

Parts A and B of Medicare

The period of time immediately following a disability during which benefits are not payable is the

Elimination period

Long-term care coverage may be available as any of the following options EXCEPT

Endorsement to a health policy

long-term care insurance policies

For extended nursing home care, which is not a Medicare benefit

An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?

Full benefits

An insured's long-term care policy is scheduled to pay a fixed amount of coverage $120 per day. The long-term care facility only charged $100 per day. How much will the insurance company pay?

$120 a day

An insurer who frequently misses deadlines to respond to inquiries from the Division of Insurance may be fined, for each violation as much as,

$5,000

While a claim is pending, an insurance company may require

An independent examination as often as reasonably required

Representations are written or oral statements made by the applicant that are

Considered true to the best of the applicant's knowledge

What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?

Diagnostic and preventive care

Seminar or self-study programs address which of the following topic would not qualify long-term care continuing education?

Income tax shelters

When can a Long-Term Care policy deny a claim for losses incurred because of a pre-existing condition?

Within 6 months of the effective date of coverage

Elimination Period

amount of time that lapses after a disabling event before the insurance company begins to pay benefits

How often will the Commissioner examine domestic insurers in this state?

every 5 years

Medigap insurance

insurance provided by private insurance companies to cover medical expenses that are not covered by Medicare

All of the following statements about Medicare supplement insurance policies are correct EXCEPT

they cover the cost of extended nursing home care

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?

3 days

When can a long term care facility have controlled substances on hand? And what are the terms and conditions?

In emergency kits! -as long as the source (pharmacy or physician) has a DEA registration -limited access to emergency kits and limited quantity in the kits -maintain complete records of the controlled substances in the kit -the controlled substances are administered by authorized personnel only

All of the following are differences between individual and group health insurance EXCEPT

Individual insurance does not require medical examinations, while group insurance does require medical examinations.

Before a carrier can offer health benefit plans to small employers, what must be filed?

Notice of Intent

According to the Colorado fraud statutes, every licensed insurance company doing business in Colorado is required to do all of the following EXCEPT

Pay a fee to the state of Colorado to protect the insurer against fraud

A guaranteed renewable health insurance policy allows the

Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class.

Certain conditions, such as dismemberment or total and permanent blindness, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe?

Presumptive disability

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 and extent of loss in a hand-written letter to the insurer. Which of the following would be true?

The insured was in compliance with the policy requirements regarding claims.

Hardship Exemption

When an individual has certain life situations, such as foreclosure of or eviction from the person's home or incurring substantial debt due to high medical expenses, that prevent him or her from being able to afford health insurance, a hardship exemption may be acquired