Chapter: Accident and Health Insurance Basics

C. A summer camp

A group blanket heath policy is best suited for which of the following? A. A manufacturer B. A large family C. A summer camp D. A small employer

A. Comprehensive plan

A health insurance plan covers all accidents and sicknesses that are not specifically excluded from the policy is referred to as a ... A. Comprehensive plan B. General plan C. Service plan D. Broad plan

C. Limited Policy Notice

A policyowner is reading a statement on the first page of his health insurance policy, which says "this is a limited policy." What is the name of this statement? A. Statute of Limitations B. Limited Benefit Statement C. Limited Policy Notice D. Policy Limitation Notice

B. Suspension of License

An agent misrepresents the details of an insured's new insurance contract that will be replacing the current contract. Which of the following will most likely happen? A. Reduction in commissions B. Suspension of License C. Charges of fraud against the agent D. Annulment of the policy

C. First premium has been paid and the application has been approved

Health coverage becomes effective when the... A. Medical examination has been completed and the premium paid B. First premium has been received in the insurance company's home office C. First premium has been paid and the application has been approved D. Producer delivers the policy to the insured

B. The number of days confined in a hospital

Hospital indemnity/hospital confinement indemnity policy will provide payment based on... A. The medical expense incurred B. The number of days confined in a hospital C. The type of illness D. The premiums paid into the policy

C. By their members - authorized insurers

How are state insurance Guaranty Associations funded? A. By NAIC B. By the Government C. By their members - authorized insurers D. By the Department of Insurance

The Guaranty Association

If an insurer becomes insolvent, which of the following would pay benefits to policyholders?

B. Premiums always stay the same

Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT... A. Benefits may change B. Premiums always stay the same C. Due to age or health, the policy may change dramatically D. Pre-existing conditions that were previously covered may not be covered under the replacing policy

War injuries, intentionally self inflicted injuries, elective cosmetic surgery, eligibility for government plans, participating in criminal activity

What are common exclusions from coverage in health insurance policies?

It is health coverage for small groups whose numbers are too small to qualify for true group insurance

What is franchise insurance?

D. It is health coverage for small groups whose numbers are too small to qualify for true group insurance

What is franchise insurance? A. It provides insurance for franchises, such as a restaurant or hotel chain B. It is group insurance C. It is blanket insurance D. It is health coverage for small groups whose numbers are too small to qualify for true group insurance

Underwriting

What process helps minimize the problem of adverse selection?

Accidental bodily injury and sickness

What two major types of losses does health insurance cover?

B. Income lost by the insured's inability to work

Which benefit would a disability plan most likely pay? A. Medical expenses associated with a disability B. Income lost by the insured's inability to work C. Rehabilitation costs D. Copayments

B. Insurance Guaranty Association

Which of the following entities protects policyowners, insureds, and beneficiaries under insurance contracts when insurers fail to perform contractual obligations due to financial impairment? A. Consumer Protection Agency B. Insurance Guaranty Association C. Insurance Consumer Protectorate D. Insurance Solvency Association

C. Funeral

Which of the following expenses is NOT covered by a health insurance policy? A. Disability B. Dental C. Funeral D. Hospital

A. Income

Which of the following factors about the insured determines the amount of disability benefit that the insured will receive? A. Income B. Gender C. Marital Status D. Age

D. Sickness

Which of the following is an example of a peril covered in an accident and health insurance policy? A. Alcoholism B. Smoking C. Death D. Sickness

A. Sickness

Which of the following is an example of a peril covered in an accident and health insurance policy? A. Sickness B. Alcoholism C. Smoking D. Death

B. It could provide for loss of income

Which of the following is true regarding health insurance? A. It only covers expenses related to heath care B . It could provide payments for loss of income C. Disability coverage is excluded D. It provides death benefit coverage

C. The applicants house help

Which of the following will NOT be covered under an individual health insurance policy? A. The applicant B. The applicant's spouse C. The applicant's house help D. The applicant's adopted child

C. Indemnity

Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital? A. Blanket B. Medigap C. Indemnity D. Surgical