Chapter 8

How is the life and health insurance guaranty association funded A. From agents of member companies B. From member companies C. From the federal government D.From the state government

B. From member companies

And insurer must maintain grievance records for _____ A. Two years B. Five years C. Three years D. 10 years

C. 3 years

Life and Health Insurance Guaranty Association Becomes involved in an insurance company affairs when the company A. Denies a claim B. Withdraws as an association member C. Becomes insolvent D. Enters a lawsuit against a claimant

C. Becomes insolvent

A fraternal benefit society has each of the following characteristics except A. Incorporated B. Exists for the benefit of its members C. Exists for profit D. Without capital stock

C. Exisits for profit

Which of the following must be included with a continuation of coverage of a group hospital surgical and major medical policy. A. Vision care B. Wellness program C.hospital expenses D. Chiropractic coverage

C. Hospital expenses

Which of the following is not regulated by the insurance information and privacy protection act A.agents B.limited represenitives C. Insurance regulators D. Insurance companies

C. Insurance regulators

An accident and health policy holder has___ days to return the policy and receive a full refunded amount on premiums A.21 B. 14 C. 7 D. 10

D.10

In eligible employee has a maximum of____ days After their first day of employment to be added to group health coverage A. 90 B. 30 C. 60 D. 10

A. 90

If the commissioner of insurance is no longer able to complete the term of office who is required to fill this vacancy A. Attorney general B. Governer C. State legislature D.voters

B. Governer

A certificate of authority permit an A. Insurance producer to solicit insurance for foreign company B. Insurance company to transact business C.Insurance producer to sell blank insurance D. Insurance company to conduct business in multiple jurisdictions

B. Insurance company to transact business

Immunity for releasing documents to the commissioner during a fraud investigation means that the person A. May have their license revoked B. May be subject to civil liability or slander C. Is not allowed to market insurance products D. Is not subject to civil liability or slander

B. May be subject to civil liability or slander

A terminated employee must have been covered for at least ______ months Under a group health insurance policy immediately prior to termination in order to be eligible for continuation of coverage A. 1 B. 6 C. 3 D. 12

C. 3

Which of these actions is NOT considered an act of rebating A. Offering employment to an individual in exchange for writing a large insurance contract B.Offering anything of value not specified in the policy C. Sharing commissions with other licensed and appointed agents D.Sharing commissions with a client in exchange for their business

C. Sharing commissions with other licensed and appointed agents

Who does an insurance broker in North Carolina represent A. Commissioner B. Insurer C. Governor D. Insured

D. Insured

The commissioner of insurance is empowered to A. Enforce state laws relating to insurance B. Set rates for all insurance coverages C. Write policy forms for mandatory insurance coverage D. Pass state laws relating to insurance

A. Enforce state laws relating to insurance

Chemical dependency treatment under a group health policy must include over the life of the contract A minimum benefit of A. No limit B. 16,000 C. 10000 D.22000

B. 16,000

If a health insurance claim is not promptly paid legal action may be taken against the insurer after A. 90 days from the date proof of loss is furnished B. 60 days from the date proof of loss is furnished C. Three years from the date proof of loss is furnished D.30 days from the date proof of loss is furnished

B. 60 days from the date proof of loss is furnished

An agent inducing and insured to lapse forfeit or surrender insurance through misrepresentation is committing the legal act of A. Boycotting B. Subrogating C. Twisting D. Rebating

C. Twisting

A health insurance policy applicant untientionally fails to list a previous visit to a neurologist. If the policy is issued and the insurer later decides to contest the policy it must do so A.Within three years of paying a claim B. Within three years from the date of issue C.Within two years from the date of issue D.Within two years from proof. Of loss being submitted

C. Within two years from the date of issue

A group health policy is approved premium rate is guaranteed by the insurer for an initial period of at least ____ months A. 18 B. 36 C. 3 D. 12

D. 12

An insurance applicant Was recently denied insurance coverage. The applicant isRequesting access from the insured to recorded personal information regarding this decision. Under the information and privacy protection act the insurer must make the information available within_____ business days A. 10 B. 15 C. 45 D. 30

D. 30

Essential benefits without annual and lifetime limits Are required on any health policy purchased A. Through mutual insurers B. Through Medicare C. Through the federal marketplace D. Through commercial providers

C. Through the federal marketplace

The life And health insurance guaranty Association is funded by authorize insurance in the state where the rules of this organization is to A. Assist in the prevention of insurer insolvencies B. Provide legal counsel for admitted insurer's C. Set rates from the insurer D. Assist in underwriting large policies

A. Assist in the prevention of insurer insolvencies

The commissioner of insurance has notified and in sure that an individual health policy form does not comply with North Carolina laws . The insurer may... a. Not Issue the form in connection with any new application B. Continue to issue the form as is C. Reapply the form as a foreign insurer D. Appeal the decision and issue the form

A. Not issue the form in Connection with any new applications

The purpose of the insurance guaranty fund is to A. Ensure that claims filed against insolvent insurance companies will be paid B. Approve disability policy forms C.Ensure that premium rates are uniform throughout the state D.Protect the public from fraudulent insurance company marketing practices

A.Ensure that claims filed against involving insurance companies will be paid