Simulate Health Insurance Exam
A noncontributory group disability income plan a 30-day elimination period and offers benefits of $2,000 a month. If an employee is unable to work for 7 months due to a covered disability, the employee will receive
$12,000, all of which is taxable
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
The Commissioner may issue a temporary license for an intermediary for a period of up to
12 months
To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been covered under the previous group plan?
18 months
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?
20
Within how many days of the original hearing and final issuance of an order (regarding an order issued by the Commissioner) may an aggrieved person request a re-hearing?
20
What is the elimination period for Social Security disability benefits?
5 months
According to the rule of readability of insurance policies in this state, what is a required minimum score on the Flesch reading ease test for Medicare supplement policies?
50
The benefits for individual disability plans are based on
A flat amount
Which of the following individuals will be eligible for coverage on the Health Insurance Marketplace?
A permanent resident lawfully present in the US
In which Medicare supplemental policies are the core benefits found?
All plans
Which of the following would be a good candidate for a short-term medical insurance?
An overall healthy individual who doesn't need coverage for pre-existing conditions
Which of the following is NOT applied toward the deductible under a nonscheduled plan?
Annual dental exam
Which of the following must an insurer obtain in order to transact insurance within a given state?
Certificate of authority
According to the provisions of the Patient Protection and Affordable Care Act, all of the following are required preventive care services EXCEPT
Cervical cancer exams for all women starting at age 40
Combination plans are comprised for two types of plan features: basic and
Comprehensive
After a year of receiving disability income benefits, the insured notices that her monthly benefit has increased slightly. What rider does the policy most likely have that would cause this?
Cost of Living Adjustment Rider (COLA)
Which type of dental treatment involves the dental pulp within the teeth?
Endodontics
Group policies providing inpatient hospital coverage may provide coverage for the treatment of mental disorders for expenses for how many days?
First 30 days
Which of the following statements is CORRECT concerning the relationship between Medicare and HMOs?
HMOs may pay for services not covered by Medicare
Which of the following types of LTC is NOT provided in an institutional setting?
Home health care
An insurer devises an intimidation strategy in order to corner a large portion of the insurance market. Which of the following best describes this practice?
Illegal
What is franchise insurance?
It is health coverage for small groups whose numbers are too small to qualify for true group insurance
Which of the following is true regarding a term health policy?
It is nonrenewable
Every insurer marketing Long-Term Care insurance must establish marketing procedures to ensure all of the following EXCEPT
LTC policies are marketed effectively to prospective insureds
Medicare Part A services do NOT include which of the following?
Outpatient Hospital Treatment
Which of the following describes taxation of individual disability income insurance premiums and benefits?
Premiums are not tax deductible, and benefits are not taxable
Which of the following is monitored by ERISA?
Stock profit-sharing plans
Which of the following is a licensee able to place insurance with unauthorized insurers?
Surplus lines agent
Which of the following would be a qualifying event as it relates to COBRA?
Termination of employment due to downsizing
If an insurer decides to stop providing all group health insurance coverage. It must send notice of the discontinuance to all of the following EXCEPT the
The NAIC
If a licensee wants to transact insurance under a different name than that listed on his or her producer's license, which of the following must occur?
The change must be reported to the Department
Which of the following is a characteristic of a Reciprocal Insurance Exchange?
The chief administrator of the insurer is called an "attorney-in-fact"
When Oscar completes his health insurance application, he intentionally omits the fact that he had a heart attack eight months prior to the application date. He has another heart attack three years after the policy's effective date. Which of the following is true?
The cost related to his heart attack can be denied
Who guarantees a conventional fully-insured group plan?
The insurer
Who is the beneficiary in a credit disability income policy?
The lending insitution
Examination requirements may be waived for nonresident agents if
Their state imposes requirements that are similar to Wisconsin's requirements
Which of the following is NOT a goal of risk retention?
To minimize the insured's level of liability in the event of loss
In forming an insurance contract, when does acceptance usually occur?
When an insurer's underwriter approves coverage
When must the "Wisconsin Guide for Health Insurance for People with Medicare" pamphlet be issued?
With every policy solicitation
Federal law makes it illegal for any individual convicted of a crime involving dishonesty or breach of trust to work in the business of insurance affecting interstate commerce
Without receiving written consent from an insurance regulatory authority
