Insurance- Missed practice exam questions
After a hearing, civil penalties imposed by the Commissioner for each unfair method of competition may NOT exceed
$1,000
If the Commissioner believes an individual is involved in unfair trade practices and delivers to that individual a notice of hearing, the hearing may be no sooner than
10 days after receipt of notice
The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over the last
24 months
Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?1
3 days
How soon after the receipt of a properly completed claim form and proof of loss must a health insurance company accept and pay or deny a claim?
30 days
How long is an open enrollment period for Medicare Supplement Policies
6 months
If a premium is required to provide coverage for a newborn child, within how many days from the birth of the child must an insured pay the premium and notify the insurer?
60 days
Which of the following individuals engaged in the business of insurance would NOT be required to be licensed?
A person who secures information for enrolling individual into a group insurance
Which of the following would be required to obtain a producer's license in this state?
A trustee of an employee trust plan that is compensated indirectly by the company issuing the contract
The Life and Health Guaranty Association maintains all of the following accounts EXCEPT
An unallocated life insurance account
What is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application?
As long as the policy is in force
Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?
Attending physician
Contract of Adhesion
Contracts that are prepared by one party and submitted to the other party on a take it or leave it basis
Other than for a qualified life event, when can a change be made in benefits for a Flexible Spending Account (FSA)?
During the open enrollment period
The "stop-loss" feature on a major medical policy is intended to
Establish a maximum amount of out of pocket expenses that the insured will have to pay for medical expenses in a calendar year
Which one of the following is an eligibility requirement for Social Security disability income benefits?
Fully insured status
An insured has an individual disability income policy with a 30 day elimination period. He becomes disabled on June 1st for 15 days. When will he collect on his disability income payments?
He won't collect shit
Which of the following riders would NOT increase the premium for a policyowner?
Impairment rider
The Long-term Care Partnership Program creates a partnership between the state government and which of the following?
Medicaid recipients
An insured pays her Major Medical Insurance premium annually on March 1. Last March she forgot to mail her premium to the company. On March 19, she had an accident and broke her leg. The insurance company would
Pay the claim
Which of the following applies to partial disability benefits?
Payment is limited to a certain period of time.
Regarding the ACA health care tax credit, which is true
Persons receiving Medicaid are not eligible
Which of the following provisions is mandatory for health insurance policies?
Physical examination and autopsy
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.
Which health insurance provision describes the insured's right to cancel coverage?
Renewal provision
An insured has endured multiple surgeries and hospitalizations for an illness during the summer months. Her insurer no longer bills her for medical expenses. What term best describes the condition she has met?
Stop-loss limit
Which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses?
Stop-loss limit
An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?
The PPO will pay reduced benefits.
Whose responsibility is it to ensure that the application for health insurance is complete and accurate?
The agents
Under the ACA, health insurance can no longer be underwritten based on which of the following factors?
The applicants health condition
How do employer contributions to a Health Savings Account affect the insured's taxes?
The employer contributions are not included in the individual insured's taxable income.
When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?
The insurer is considered to be notified since the notification to agent equals notification to the insurer.
Which of the following definitions would make it easier to qualify for total disability benefits?
The more liberal "own occupation"`
Insuring Clause
The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the
When an insurer issues an individual health insurance policy that is guaranteed renewable, the insurer agrees
To renew the policy until the insured has reached age 65.
What is the purpose of benefit schedules
To state what and how much is covered in each plan
A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as
Usual, Customary, and Reasonable
If an insured is not entirely satisfied with a policy issued, the insured may return the policy to the insurance company and receive a refund of the entire premium paid, at which of the following times?
Within 10 days of when the policy was DELIVERED
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
Group health insurance is characterized by all of the following EXCEPT
a)A master contract. b)Lower administrative costs. c)Conversion privilege. d)Adverse selection. ANSWER IS D
All of the following could be considered rebates if offered to an insured in the sale of insurance EXCEPT
a)An offer to share in commissions generated by the sale. b)Dividends from a mutual insurer. c)An offer of employment. d)Stocks, securities, or bonds. ANSWER IS B
Which of the following is NOT true regarding Basic Surgical Expense coverage?
a)Contracts include a surgical schedule. b)It is commonly written in conjunction with Hospital Expense policies. c)Coverage is unlimited. d)There is no deductible. ANSWER IS C
Social Security disability definition includes all of the following EXCEPT
a)Disability resulting from a medically determinable mental impairment. b)A physical impairment expected to result in death. c)Disability expected to last for at least 6 months. d)The inability to engage in any gainful work. ANSWER IS C
Underwriting a group health insurance plan that is paid for by the employer requires all of the following EXCEPT
a)Individual members of the group may select the level of benefits for their own coverage. b)The plan is based on other than individual selection. c)All eligible employees must be covered. d)Coverage for plan participants is uniform. ANSWER IS A
Which of the following is NOT a feature of a noncancellable policy?
a)The guarantee to renew coverage usually applies until the insured reaches certain age. b)The insured has the right to renew the policy for the life of the contract. c)The insurer may terminate the contract only at renewal for certain conditions. d)The premiums cannot be increased beyond the amount stated in the policy. ANSWER IS C
All of the following are true of the Key Person disability income policy EXCEPT
a)The income may be used to find a replacement for the key employee. b)Benefits are considered taxable income to the business. c)Premiums are not deductible to the business. d)It is typically written to protect the company in the event a key employee becomes disabled and is unable to work. ANSWER IS B
To send important documents to the insured through electronic mail services, all of the following must be met EXCEPT
a)The insurer must let the insured know he or she may choose to not elect the delivery method. b)The insured must be made aware that choosing another method may affect the validity of the document. c)The insured must first consent to the delivery method. d)The insurer must relay all software requirements needed to open the documents. ANSWER IS B
Which of the following is NOT a requirement for a partnership qualified LTC policy?
a)The policy must abide by Social Security and federal regulations. b)The applicant must meet residence requirements for Iowa at the time of issuance. c)The policy must provide for inflation protection if the applicant is less than 61 years of age. d)The policy must have been issued before January 1, 2010. ANSER IS D
Which of the following would NOT be considered a limited coverage policy?
a. Accident only policy b. Travel policy c. Major medical expense policy d. Special risk policy ANSWER IS C
All of the following would be classified as "limited insurance coverage" EXCEPT
a. Accidental death and dismemberment policy b. Supplement social security coverage c. Travel insurance policy d. Dread disease policy ANSWER iS B
Which of the following is used to define any person, firm, or corporation appointed by an insurer that posseses the authority to transact insurance?
a. Broker b. Agent c. Actuary d. Producer ANSWER IS D
Which of the following statements is NOT true regarding health insurance policy provisions
a. Insurers may add provisions that are not in conflict with uniform standards b. All additional provisions written by insurers are cataloged by their respective states c. All individual polices contain Universal Mandatory Provisions d. Insurers may only offer optional provisions that are allowed by the state where the policy is delivered ANSWER IS B
A long term care policy, certificate or rider may provide coverage to an insured on any of the following bases EXCEPT
a. Prepaid b. Expense-incurred c. Deferred d. Indemnity ANSWER IS C
Which of the following is NOT mandatory under the Uniform Provisions Law as applied to accident and health policies?
a. Probationary period b. Time limit on certain defenses c. Physical examination and autopsy d. Entire contract ANSWER IS A
All of the following are characteristics of a group health insurance plans EXCEPT
a. The benefits under a group plan are more extensive than those under individual plans b. The parties that hold the group health insurance contract are the employees and the employer c. The cost of insuring an individual is less than what would charged for comparable benefits under an individual plan d. Employers may require the employees to contribute to the premium payments ANSWER IS B
In comparison to a policy that uses the accidental means definition, a policy that uses the accidental bodily injury definition would provide a coverage that is
broader in general
In a basic expense policy, after the limits of the basic policy are exhausted, the insured must pay what kind of deductible?
corridor
A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as
critical illness
In which of the following locations would skilled care most likely be provided?
institutional setting
A life insurance policy has a legal purpose if both of which of the following elements exist
insurable interest and consent
In a group health plan, a probationary period is
intended for people who join the group after the effective date
Which of the following is NOT a mandatory coverage in health insurance policies in Iowa?
maternity benefits
An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits?
no benefit
All of the following are types of care that is provided under LTC's home health care EXCEPT occasional visits by which of the following?
pediatric nurses
The Fair Credit Reporting Act
protects consumers against the circulation of inaccurate or obsolete personal or financial information
Which of the following is true about the requirements regarding HIV exams?
the applicant must give prior informed written consent
Under the physical examination and autopsy provision, how many times can the insurer have the insured examined at its own expense, while the claim is pending?
unlimited
GUARANTEE EXAM MISSES
yeeyee