ch 29 review

All of the following statements about the Outline of Coverage for health insurance policies are correct EXCEPT

principal benefits also shown on the policy need not be included

All of the following statements about health insurance application are correct EXCEPT

the agent can correct and sign an application form for the client

Which of the following is considered a "cost containment" measure of health policies?

Coordination of benefits

All of the following statements regarding group health insurance are correct EXCEPT

Coordination of benefits is required between group policies and Medicare supplements

Which of the following statements is correct about coverage for a handicapped family member who reaches adulthood?

Coverage continues if the member is chiefly dependent on the policyholder

Group health insurance policies are required to provide all of the following EXCEPT

Coverage for dental expenses

All of the following provisions are required by the Florida Employee Health Care Access Act EXCEPT

Coverage must always be renewed by carriers

All of the provisions are required by Florida law for group health insurance policies EXCEPT

Coverage must continue until age 25 for a handicapped child that is a family member

A health maintenance organization provides which of the following?

Preventive health care for its members

At what point in time can a policyholder file suit against a health insurance company for failure to pay a claim?

60 days after filing proof of loss

All of the following are correct about the required provisions of a health insurance policy EXCEPT

A reinstated policy provides immediate coverage for an illness

Which of the following is NOT provided in a proof-of-loss form?

A statement from the attending physician

All of the following statements regarding maternity benefits are correct EXCEPT

All health insurance policies must provide maternity benefits

A health insurance company can refuse coverage solely for which of the following reasons?

Applicant's past medical history

All of the following are eligible for group health insurance EXCEPT

Employees of members under an association plan

The notice to the insurance company of a health insurance claim must include all of the following EXCEPT

Estimated amount of claim

Which of the following statements is correct about a group health insurance policy?

It can provide coverage for handicapped children

Which of the following applies to the 10-day free-look privilege in a health insurance contract?

It permits the insured to reject the policy within 10 days of policy delivery and receive a full refund.

All of the following provisions are mandatory in health insurance policies EXCEPT

Misstatement of age

Which of the following practitioners is NOT defined as a "physician" under Florida law?

Sports therapist performing services in a health club

Individual and group health insurance policies and HMO contracts can be canceled for all of the following reasons EXCEPT

The insured develops a serious illness

In which of the following situations is a group health insurance policy NOT required to provide coverage?

Treatment for an occupational illness or injury