Health exam

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To be eligible for group insurance for its members, an association group must have at least how many members?

100 people

Under the notice of claim provision, insureds are required to provide insurers with notice of a loss within

20 days

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?

3 days

Producers are required to report to the Commissioner any administrative actions taken against them within how many days?

30 days

In the event an employee covered under a group health insurance policy dies, how long may a spouse receive coverage through COBRA?

36 months

A health insurance policy that has lapsed due to nonpayment of premium may be reinstated if the outstanding premium is paid. How long after that will coverage be reinstated?

45 days

Which of the following types of health insurance options will generally cover any sickness or accidents?

Comprehensive policy

What is the main difference between coinsurance and copayments?

Copayment is a set dollar amount.

A waiver of premium provision may be included with which kind of health insurance policy?

Disability Income

Which of the following would NOT be considered an Activity of Daily Living (ADL) for insurance purposes?

Driving , cooking , and seeing

The Commissioner of Insurance may examine books and records of any of the following EXCEPT

General agents and managing agents authorized to transact insurance in the state.

If a physician does not accept assignment, the maximum amount the physician can charge a Medicare beneficiary for a covered service is known as the

Nonparticipating fee.

The Medical Information Bureau (MIB) helps insurers compare medical information they have collected on a potential insured with the information received from

Other insurers.

Which of the following provisions is mandatory for health insurance policies?

Physical examination and autopsy

Which of the following is NOT covered under Medicare Part B?

Prescription drug coverage

Insurers may change which of the following on a guaranteed renewable health insurance policy?

Rates by class

Any inducement offered to the insured in the sale of an insurance policy that is not specified in the policy is an unlawful practice known as

Rebating

When an insurer combines two periods of disability into one, the insured must have suffered a

Recurrent Disability

The insuring clause of a disability policy usually states all of the following EXCEPT

The method of premium payment

Regarding Medicare SELECT policies, what are restricted network provisions?

They condition the payment of benefits.

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?

Within 90 days or as soon as reasonably possible, but not to exceed 1 year

The guaranteed purchase option is also referred to as the

future increase option

Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within

90 days of a loss

Which of the following is FALSE regarding requirements for the outline of coverage provided to applicants for long-term care policies?

It may contain material of advertising nature.

Which of the following does NOT describe hospice care?

It provides care to people with life expectancies of 1 to 2 years


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