Tennessee Health Insurance
What percentage of individually-owned disability income benefits is taxable?
0%
Candidates for either a Property license or a causalty license must complete how many hours of prelicensing education?
20
According to the PPACA rules, what percentage of health care costs will be covered under a bronze plan?
60%
Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within a) 90 days of a loss. b) 20 days of a loss. c) 30 days of a loss. d) 60 days of a loss.
90 days of a loss
Which of the following does the Insuring Clause NOT specify?
A list of available doctors
An insurance producer is defined as
A person licensed to sell insurance
The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have?
Accident-only
A 63-year-old man is planning to be employed until age 68.When will he be eligible for Medicare?
Age 65, regardless of his employment status
Alexander has a policy with his ex-wife as its beneficiary. What provision allows him to change the beneficiary to his new wife?
Change of beneficiary
An insurance producer license may be renewed if the producer has paid the applicable fees, submitted the renewal form to the Commissioner, and
Completed all continuing education requirements
In a relative value system of determining coverage for a given procedure, what term describes the total amount payable per point?
Conversion factor Note:In order to determine the amount payable for a given procedure, the assigned points (relative value) of 200 are multiplied by a conversion factor. This conversion factor represents the total amount payable per point. For example, if the conversion factor is $10 and the point value is 200, the policy would pay $2,000 for the procedure (200 x 10).
Which of the following is considered a qualifying event under COBRA? Divorce Marriage Relocation Promotion
Divorce
The insurance policy, together with the policy application and any added riders form what is known as
Entire contract
Which of the following best describes the Aleatory nature of an insurance contract?
Exchange of unequal values
Items stipulated in the contract that the insurer will not provide coverage for are found in the________________.
Exclusions
Am insurance company has published a brochure that inaccurately portrays the advantages of a particular insurance policy. What is this an example of?
False advertising Note:False advertising is the illegal practice of advertising or circulating materials that are untrue, deceptive, or misleading.
Which provision allows the policyholder a period of time, while coverage is in force, to examine a health insurance policy and determine whether or not to keep it?
Free Look Period
Which of the following statements is correct? A) HMOs may pay for services not covered by Medicare B) HMOs do not pay for services covered by Medicare C) Medicare Advantage is Medicare provided by an approved Health Maintenance Organization only D) All HMOs and PPOs charge premiums beyond what is paid by Medicare
HMOs may pay for services not covered by Medicare
Which of the following is INCORRECT concerning Medicaid? a) It provides medical assistance to low-income people who cannot otherwise provide for themselves. b) It pays for hospital care, outpatient care, and laboratory and X-ray services. c) The federal government provides about 56 cents for every Medicaid dollar spent. d) It is solely a federally administered program.
It is solely a federally administered program.
If a producer was licensed at the time he sold an insurance policy but no longer holds a valid license, what happens to the commission earned for the sale?
It will be paid to the producer since he was licensed at the time of the sale.
Which of the following statements pertaining to Medicare Part A is correct?
Medicare Part A is automatically provided when an individual qualifies for Social Security benefits at age 65.
And insurance pays her major medical insurance premium annually on March 1. Last March she forgot to mail her premium to the insurance company. On March 19, she had an accident and broke her leg. They insurance company would?
Pay the claim
Which of the following provisions is mandatory for health insurance policies?
Physical examination and autopsy.
All of the following are TRUE regarding key person disability income insurance EXCEPT
Premiums are tax deductible as a business expense. In key person disability insurance, the contract is owned by the business, the premium is paid by the business, and the business is the beneficiary. The key person is the insured, and the business must have the key person's consent to be insured in writing.
An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of
Rebating
Which of the following would basic medical expense coverage NOT cover?
Surgeon's Services
In insurance an offer is usually made when
The completed application is submitted
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to
The insured.
Hospital indemnity/hospital confinement indemnity policy will provide payment based on
The number of days confined in a hospital
In terms of parties to a contract, which of the following does NOT describe a competent party?
The person must have at least completed secondary education
Which of the following statements regarding the Change of Beneficiaries Provision is false?
The policyowner has the right to change beneficiaries in any case.
How does a member of an HMO see a specialist?
The primary care physician refers the member.
A policyowner has a health insurance policy with his wife listed as the primary beneficiary. He would like to change the primary beneficiary to his sister. Which of the following is true?
Unless the policy designated the current beneficiary as irrevocable, the policyowner can make the change at any time.
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?
Within 90 days or as soon as reasonably possible, but not to exceed 1 year Note: The "proof of loss" provision states the claimant must submit a proof of loss within 90 days; however, if it is not possible to comply, the time parameter is extended to 1 year. The one-year limit does not apply if the claimant is not legally competent to comply with this provision
The mode of premium payment
is defined as the frequency and the amount of the premium payment
