Chapter 9: Health Insurance Basics

At what age does an individual qualify for Medicare? 60 65 70 72

65

Which of the following losses will be covered by a group medical expense policy? An elective cosmetic surgery A pre-existing condition An injury resulting from active military duty An intentionally self-inflicted injury

A pre-existing condition

To comply with Fair Credit Reporting Act, when must a producer notify an applicant that a credit report may be requested? When the applicant's credit is checked When the policy is delivered At the initial interview At the time of application

At the time of application

Because of the history of cancer in her family, Julie purchased a policy that specifically covers the expense of treating cancer. Her policy would be classified as what type of policy? Dread Disease Policy Family History Cancer Policy Specified Health Policy Term Health Policy

Dread Disease Policy

The main purpose of ERISA is to ensure that Employees are able to extend group health coverage after termination of employment. Uniform policy terms and provisions are established for all insurers in all states. High quality care is available to all insured. Employees receive the pension and other benefits promised by their employers.

Employees receive the pension and other benefits promised by their employers.

A producer misrepresents the details of an insured's new insurance contract that will be replacing the current contract. Which of the following is the producer violating? Errors and omissions liability Implied authority Entire contract Underwriting regulations

Errors and omissions liability

With regard to genetic testing, which of the following is NOT true? Insurers must provide written notice before collecting genetic material. Insurers cannot discriminate against individuals on the basis of genetic testing. Insurers cannot consider genetic susceptibility as a pre-existing condition, and limit or exclude benefits. Insurers cannot use an applicant's DNA for underwriting purposes.

Insurers cannot use an applicant's DNA for underwriting purposes.

An applicant who receives a preferred risk classification qualifies for Lower premiums than a person who receives a standard risk. Dividends payable for lack of claims. Higher premiums than a person who receives a sub-standard risk. Higher premiums than a person who receives a standard risk.

Lower premiums than a person who receives a standard risk.

All of the following are factors that an underwriter could use to select and classify risk EXCEPT Morals. Occupation. Avocation. National origin.

National Origin

A person steps off a street car and trips and breaks his ankle. This type of injury can be described as A recurrent injury. Intentional. Not covered. Sudden and unforeseen.

Sudden and unforeseen.

Which of the following expenses is NOT covered by a health insurance policy? Dental Funeral Hospital Disability

Funeral

Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT Benefits may change. Premiums always stay the same. Due to age or health, the policy may change dramatically. Pre-existing conditions that were previously covered may not be covered under the replacing policy.

Premiums always stay the same.

Which of the following would an accident-only policy NOT cover? Death from a motorcycle accident Amputation of a leg that was burned during a house fire Surgery to repair a wrist damaged by tendonitis. Hospitalization costs due to a boating accident

Surgery to repair a wrist damaged by tendonitis.

An insurer wishes to compare the information given in an insurance application with previous insurance applications by the same applicant but for different companies. What organization can help the insurer accomplish this? The State Department of Insurance Social Security The National Association of Insurance Commissioners The Medical Information Bureau

The Medical Information Bureau

An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy? The capital amount in monthly installments The principal amount in monthly installments The capital amount in a lump sum The principal amount in a lump sum

The capital amount in a lump sum

On a health insurance application, a signature is required from all of the following individuals EXCEPT The spouse of the policyowner. The proposed insured. The policyowner. The agent.

The spouse of the policyowner.

An insured is upset that her new health insurance policy was delivered to her by certified mail and not through her agent. Which of the following is true? The insured should ask for a new policy to be delivered. The policy will not be legal until it is delivered by an agent. There is nothing wrong with this form of policy delivery. The insured should complain to the insurer.

There is nothing wrong with this form of policy delivery.

Are insurance company underwriters allowed to discriminate? Yes, but not unfairly No, higher risks pay higher premium No, discrimination is an unfair practice Yes, but only for gender

Yes, but not unfairly