Health Exam

How long does the free-look period last for an individual disability policy? a) 10 days b) 15 days c) 20 days d) 30 days

10 days

Policies with monthly premiums must provide for a grace period of at least

10 days

If reasonably possible, a notice of proof of loss claim must be provided to the insurer within what period of time after the time required by the policy?

12 months

An insured was involved in an accident and could not perform her current job for 3 years. If the insured could reasonably perform another job utilizing similar skills after 1 month, for how long would she be receiving benefits under an "own occupation" disability plan?

2 years

Any person who violates an insurance statute or rule of Wisconsin can be imprisoned for up to how many years?

3

If the Commissioner issues an order without having conducted a hearing, the person aggrieved by the order may demand a hearing within how many days after the order was mailed?

30

What is the maximum period of coverage for most short-term care policies?

36 months

Which of the following are the authorities that an agent can hold?

Express and implied

The limits of a health reimbursement account are set by

the employer

A policy may be issued for a term longer than one year or for an indefinite term as long as there is a clause in the policy providing for cancellation by giving how much notice prior to the anniversary date?

60 days

Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?

Attending physician

Contracts that are prepared by one party and submitted to the other party on a take-it-or-leave-it basis are classified as

Contracts of adhesion.

Which of the following statements is true regarding coverage for prescription contraceptives in disability insurance policies issued in this state? a) Insurers may restrict benefits for contraceptives. b) It must be added by endorsement. c) It is a mandatory coverage. d) Deductibles for this coverage can be higher than for other prescription drugs.

It is a mandatory coverage

Which of the following is any person who has authority to bind, or manages all or part of the assumed reinsurance business of a reinsurer and acts as an agent for the reinsurer?

Reinsurance manager

A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim,

The insurance through his company is primary.

Regarding the return of premium option for LTC policies, what happens to the premium if the policy lapses?

The insurer will return a percentage of the premiums paid.

When employees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance and deductibles?

They carry over from the old plan to the new plan.

Which of the following does NOT qualify as a long-term care policy? a) A disability policy that provides hospital coverage only b) A long-term care policy that provides institutional and community-based benefits c) A nursing home policy that provides institutional benefits d) A home health care policy that provides community-based benefits

a) A disability policy that provides hospital coverage only

Which of the following health care plans would most likely provide the insured/subscriber with comprehensive health care coverage? a) Medical-surgical expense plan b) Basic medical expense plan c) Health Maintenance Organization plan d) Group dental insurance plan

a) Medical-surgical expense plan

Which of the following statements is most correct concerning the changing of an irrevocable beneficiary? a) They can be changed only with the written consent of that beneficiary. b) They may be changed at any time. c) They can never be changed. d) They may be changed only on the anniversary date of the policy.

a) They can be changed only with the written consent of that beneficiary.

In order to minimize adverse selection, employer group dental plans may require employees who enroll after they were initially eligible to participate to do all of the following EXCEPT a)Increase benefits for a period of one year. b) Submit evidence of insurability. c) Satisfy a longer probationary period. d) Reduce benefits for a period such as one year.

a)Increase benefits for a period of one year.

All of the following are true regarding coverage for diabetes EXCEPT

all policies must cover diabetes

Which of the following applies to partial disability benefits? a) Benefits are reduced once an insured is no longer under a doctor's care. b) Payment is limited to a certain period of time. c) An insured is entitled to a principal sum benefit for the partial loss of a limb. d) Payment is based on termination of employment.

b) Payment is limited to a certain period of time.

An association could buy group insurance for its members if it meets all of the following requirements EXCEPT a) Holds annual meetings. b) Is contributory. c) Has at least 50 members. d) Has a constitution and by-laws.

c) Has at least 50 members. must have at least 100

An insured has Medicare Part D coverage. He has reached his initial benefit limit and must now pay 50% of his prescription drug costs. What is the term for this gap in coverage?

donut hole