Section 15 questions

How long is the free look period with a Medicare supplement policy?

30 days

An accident and health policy whose premiums are paid on a quarterly basis must contain a grace period of at least:

31 days

Under what circumstances can a claim associated with a preexisting condition be denied, assuming the policy's contestable period has expired?

The condition has been specifically excluded from the policy, by name or description.

All of the following are required provisions in health insurance policies EXCEPT:

change of occupation

All of the following statements are required uniform provisions in an individual health insurance policy EXCEPT:

change of occupation

The time of payment of claims provision in an accident and health insurance policy requires that:

claims will be paid immediately after the insurer receives written proof of the loss.

Lisa is in the hospital awaiting surgery. The doctors meet in the morning to discuss the best way to proceed as a routine procedure in their PPO. This is an example of:

concurrent review

Beth's health insurance policy contains a provision that allows her to renew coverage up to age 65. However, the policy also states that should Beth lose her job, the insurance company will cancel the policy, regardless of Beth's age. In terms of renewability, what type of policy does Beth have?

conditionally renewable

Medical cost management is designed to:

control health claims expense

All of the following are considered to be viable medical plan cost-saving options EXCEPT:

emergency room preadmission testing

What accident and health insurance renewability clause means the insurer cannot unilaterally change any provision while the policy is in force but can change premium rates by class?

guaranteed renewable

Which kind of health insurance policy ensures renewability up to a specific age of the insured, although the insurer reserves the right to change the premium rate on a class basis?

guaranteed renewable

A broad statement that generally appears on the first page of a health insurance policy and specifies conditions under which benefits will be paid is known as the:

insuring clause

At what point after the effective date of an accident and health insurance policy does it become incontestable?

2 years

Which of the following statements about reinstated health insurance policies is CORRECT?

They only cover sicknesses that begin more than 10 days after the policy is reinstated.

Exclusions for preexisting conditions help to avoid:

adverse selection against an insurer

An insurer may change the wording of a uniform policy provision in its health insurance policies only if the:

modified provision is not less favorable to the insured or beneficiaries

Which of the following types of health insurance policies prevents the insurer from changing the premium rate or modifying the coverage in any way?

noncancelable

Which renewability provision allows an insurer to not renew a health insurance policy on a given date as specified in the policy?

optionally renewable

All of the following provisions in an individual health insurance policy are optional EXCEPT:

proof of loss

With an optionally renewable policy, the insurance company reserves the right to:

terminate coverage at any policy anniversary date or premium due date

Assured Insurance Company issues a health insurance policy it describes as noncancellable. This means that:

the insured can continue the policy by paying premiums until at least age 65.

Insured losses are covered immediately after a health policy is reinstated when:

the losses result from accidental injuries

According to the entire contract provision, the entire contract includes all of the following EXCEPT

the premium payment