Health Exam Simulated Study Guide
What percentage of individually-owned disability income benefits is taxable?
0%
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
Which of the following disability income policies would have the highest premium?
15 day waiting 10 year benefit
A temporary license may be issued by the Commissioner for a period not to exceed how many days?
180
As a condition for renewal of their licenses, how many hours of continuing education are required for all resident and nonresident insurance producers?
24
The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over the last
24 Months
An insured is covered under 2 group health plans - under his own and his spouse's. He had suffered a loss of $2,000. After the insured paid the total of $500 in deductibles and coinsurance, the primary insurer covered $1,500 of medical expenses. What amount, if any, would be paid by the secondary insurer?
500$
Insurance producers licensed in another state who move to Tennessee may apply for a resident license, as long as they do so within how many days of obtaining legal residence?
90 Days
Most policies will pay the accidental death benefits as long as the death is caused by the accident and occurs within
90 Days
Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within
90 days of loss
A hospital indemnity policy will pay
A benefit for each day the insured is in the policy
Which of the following does the Insuring Clause NOT specify?
A list of available doctors
Which of the following best describes the MIB?
A nonprofit organization that maintains underwriting information on applicants for life and health insurance
Which of the following would be required to be licensed as an insurance producer?
A salaried employee or advertises and solicits insurance.
The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have?
Accident Only
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?
Accumulated 6 work credits in 3 years
Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?
Adult Day Care
Long-term care policies MUST cover
Alzheimer's disease
An agent makes a mistake on the application and then corrects his mistake by physically entering the necessary information. Who must then initial that change?
Applicant
An agent is ready to deliver a policy to an applicant but has not yet received payment. Upon delivery, the agent collects the applicant's premium check, answers any questions the applicant may have, and then leaves. What did he forget to do?
Ask her to sign a statement of good health
In a replacement situation, all of the following must be considered EXCEPT
Assets
Any of the following would be considered an Unfair Trade Practice, EXCEPT
Attempting to a settle a claim by use of arbitration
All of the following are requirements to be licensed as an insurance producer in Tennessee EXCEPT
Be at least 21 years of age
A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim?
Claimed is denied if his policy contains the illegal occupation provision
Which of the following includes information regarding a person's credit, character, reputation, and habits?
Consumer Report
The purpose of managed care health insurance plans is to
Control Health insurance Claims Expenses
How often are insurance producers in this state required to fulfill continuing education requirement?
Every 2 years
The requirement that an agent not co-mingle insurance monies with their own funds is known as
Fiduciary Responsibility
An association could buy group insurance for its members if it meets all of the following requirements EXCEPT
Has at least 50 members
What are the 2 types of Flexible Spending Accounts?
Health Care accounts and Dependent Care accounts
Which of the following riders would NOT increase the premium for a policyowner?
Impairment Rider
In which of the following locations would skilled care most likely be provided?
In an institutional Setting
The Medical Information Bureau (MIB) was created to protect
Insurance companies from adverse selections by high risk persons
Which of the following entities has the authority to make changes to an insurance policy?
Insurers Executive Office
In health insurance, if a doctor charges $50 more than what the insurance company considers usual, customary and reasonable, the extra cost
Is not covered
Which of the following is NOT true of a major-medical health insurance policy?
It is designed to pay on a first dollar basis
Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss?
Notice of Claim
Under which of the following organizations are the practicing providers compensated on a fee-for-service basis?
PPO
Which of the following applies to partial disability benefits?
Payment is limited to a certain period of time
Which of the following provisions is mandatory for health insurance policies?
Physical Examinations and Autopsy
Which of the following is correct regarding the taxation of group medical expense premiums and benefits? a)Premiums are tax deductible and benefits are taxed.b)Premiums are tax deductible and benefits are not taxed.c)Premiums are not tax deductible and benefits are taxed.d)Premiums are not tax deductible and benefits are not taxed.
Premiums are taxed and benefits arent
Certain conditions, such as dismemberment or total and permanent blindness, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe?
Presumptive Disability
All of the following are true regarding rebates EXCEP
Rebates are allowed if its in the best interest of the client
All of the following are true regarding rebates EXCEPT
Rebates are allowed if its in the best interest of the client
The Federal Fair Credit Reporting Act
Regulates Consumer Reports
What type of care is Respite care?
Relief for a major care giver
Which of the following would an accident-only policy NOT cover?
Surgery to repair a wrist due to tendonitis
Which of the following is an example of a producer being involved in an unfair trade practice of rebating?
Telling a client that his first premium will be waived if he signs today
Which of the following is an example of a producer being involved in an unfair trade practice of rebating?
Telling his client that his first premium will be waived
Which of the following would provide an underwriter with information concerning an applicant's health history?
The MIB
An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?
The capitol amount in a lump sum
In comparison to consumer reports, which of the following describes a unique characteristic of investigative consumer reports?
The customers assoiciates friends and neighbors reported data
Which statement accurately describes group disability income insurance?
The extent of benefits relies on insured income
Which statement is NOT true regarding underwriting group health insurance?
The group is accessed individually for insurability
Who is personally liable for all contracts of insurance unlawfully made within Tennessee on behalf of an unauthorized insurer?
The individual making the contract on behalf of the unauthorized producer
Who chooses a primary care physician in an HMO?
The individual member
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to
The insured
Which of the following is NOT a feature of a noncancellable policy?
The insurer may terminate the contract only a renewal for certain conditions
The insuring clause of a disability policy usually states all of the following EXCEPT
The method of premium payment
Hospital indemnity/hospital confinement indemnity policy will provide payment based on
The number of day in the hospital
All of the following statements about Medicare supplement insurance policies are correct EXCEPT
They cover the cost of extended nursing homes
In comparison to a policy that uses the accidental means definition, a policy that uses the accidental bodily injury definition would provide a coverage that is
broader in general