Health exam
A producer enrolls in a continuing education (CE) course that is taught by his immediate supervisor. The course is worth a total of 10 credit hours. How many hours will the producer be able to count towards his total of 24 required CE hours?
0 hours
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?
10 days
What is the minimum fine applied to a producer who violates any Colorado law relating to the regulation of long-term care insurance?
10,000
If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?
12 credits
Insurers must provide health insurance claim forms within how many days?
15
The Division of Insurance has requested information regarding an insurer's underwriting policies via e-mail. How many days does the insurer have to respond to this request?
20 days
COBRA applies to employers with at least
20 employees.
What is the maximum civil penalty per violation if an unauthorized entity violates the Commissioner's cease and desist order?
25,000
How many hours of continuing education must cover ethics?
3
What is the maximum age for qualifying for a catastrophic plan?
30
All licensed producers are required to inform the Commissioner in writing of any change of address within how many days of the change?
30 days
An insurer must process a clean electronically submitted health claim within
30 days
If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?
5 days
Once the person meets the stringent requirements for disability benefits under Social Security, how long is the waiting period before any benefits will be paid?
5 months
For how many years must a producer keep supporting documentation of his or her continuing education completion?
5 years following license continuation
An insurer who frequently misses deadlines to respond to inquiries from the Division of Insurance may be fined, for each violation, as much as
5,000
A person was found guilty of an unfair trade practice of defamation. What is the maximum monetary penalty the person may have to pay?
500
In accident and health policies issued in this state, an insured must submit proof of loss within how many days?
90 days
A hospital indemnity policy will pay
A benefit for each day the insured is in a hospital.
How is emergency care covered for a member of an HMO?
A member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area.
Which is NOT a characteristic of group health insurance?
A policy is issued to each insured individual.
Which of the following is not covered under a long-term care policy?
Acute care in a hospital
Which of the following would NOT be a violation of state insurance regulations?
Agent C uses her license to write only business other than controlled.
If an insurance company wishes to order a consumer report on an applicant to assist in the underwriting process, and if a notice of insurance information practices has been provided, the report may contain all of the following information EXCEPT the applicant's.
Ancestry.
All insurance companies doing business in the state of Colorado must file a financial statement with the Commissioner
Annually, on or before March 1.
When must an insurer offer a long-term care insurance policyholder the option of purchasing inflation protection?
At the time of purchase
Which of the following provides coverage on a first-dollar basis?
Basic expense
Which of the following statements regarding Business Overhead Expense policies is NOT true?
Benefits are usually limited to six months.
What type of policy allows the insurance company to cancel a policy at any time?
Cancellable
The gatekeeper of an HMO helps
Control specialist costs.
What is the main difference between coinsurance and copayments?
Copayment is a set dollar amount.
An insurer may adopt standards and criteria for eligibility to be applied to home health services programs and hospice care programs consistent with standards established by the
Department of Public Health and Environment.
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?
Diagnostic and preventive care
Long-term care coverage may be available as any of the following options EXCEPT
Endorsement to a health policy.
Which of the following best describes the aleatory nature of an insurance contract?
Exchange of unequal values
The benefits available to newborn children must include coverage for injury or sickness, and all medically necessary care and treatment for how many days of the newborn's life?
First 31 days
An insured becomes disabled at age 22 and can no longer work. She meets the definition of total disability under Social Security. What other requirement must the insured have met to receive Social Security disability benefits?
Have accumulated 6 work credits in the past 3 years
When would a producer be able to transact insurance through an unauthorized insurer?
If surplus lines insurance
In long-term care (LTC) policies, as the benefit period lengthens, the premium
Increases.
Who makes up the Medical Information Bureau?
Insurers
An insurance producer must renew his or her license by which of the following dates?
Last day of the producer's birth month every 2 years
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 benefits
An insured is covered by a disability income policy that contains an accidental means clause. The insured exits a bus by jumping down the steps and breaks an ankle. What coverage will apply?
No coverage will apply, since the injury could have been foreseen.
If your health care plan has characteristics of an HMO and PPO, what type of plan do you have?
POS
Which of the following factors would be an underwriting consideration for a small employer carrier?
Percentage of participation by the employees
A Medicare supplement policy may exclude coverage based on
Pre-existing conditions
Regarding the taxation of Bussiness Overhead policies,
Premiums are deductible and benefits are taxed.
A Medicare SELECT policy does all of the following EXCEPT
Prohibit payment for regularly covered services if provided by non-network providers.
Which health insurance provision describes the insured's right to cancel coverage?
Renewal provision
Which of the following scenarios would be an example of coercion on the part of a lender?
Requiring the debtor to acquire a policy from a specific producer
Which of the following is NOT covered under Basic Hospital Expense Coverage?
Surgeons' fees
Which of the following protects consumers against the circulation of inaccurate or obsolete personal or financial information?
The Fair Credit Reporting Act
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.
Insurable interest can be best described by which of the following?
The applicant must experience a financial loss due to an accident or sickness that befalls the insured.
A husband and wife are insured under group health insurance plans at their own places of employment, and as dependents under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid?
The benefits will be coordinated.
Which of the following is NOT a feature of a guaranteed renewable provision?
The insurer can increase the policy premium on an individual basis.
Which of the following is NOT a feature of a noncancellable policy?
The insurer may terminate the contract only at renewal for certain conditions.
Which of the following will vary the length of the grace period in health insurance policies?
The mode of the premium payment
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
Time of Payment of Claims
Which provision states that the insurance company must pay Medical Expense claims immediately?
Time of Payment of Claims
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.
Which of the following is a statement that is guaranteed to be true, and if untrue, may breach an insurance contract?
Warranty
Which of the following is NOT a factor in determining qualifications for Social Security disability benefits?
Worker's occupation
The Commissioner has all of the following duties EXCEPT
Writing insurance laws.
When twin brothers applied for life insurance from Company A, the company found that while neither of them smoked and both had a very similar lifestyle, one of the twins was in a much stronger financial position than the other. Because of this, the company charged him a higher rate for his insurance. This practice is considered
discrimination
How often are insurance producers required to renew their license?
eveery 2 years
An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of
rebating
The regulation of the insurance industry primarily rests with
the state
