Health Practice Exam

What premium mode would be lowest overall premium?

annual

A health care plan that is a hybrid of health maintenance organziations and preferred provider organizations that provide subscribers with freedom of choice of health care providers other than health maintance organizations are called.. a-gatekeeper plans b-point-of-service plan c-comprehensive care plans d-managed care plans

b

A waiver of premium provision may be included with which kind of health insurance policy? a-dread disease b-disability income c-basic medical d-hospital indemnity

b

An applicant for a disability insurance policy has a heart condition of which they are unaware and therefore they answer "no" to the question pertaining to heart problems. Their answer is considered to be a: a-fraudulent answer b-representation c-warranty d-concealment

b

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy? a) 7 days b) 10 days c) 31 days d) 60 days

b

Which of the following is NOT covered under a long-term care policy? a-home health care b-acute care in a hospital c-adult day care d-hospice care

b

A major medical expense polic would exclude coverage for all of the treatments except a-dental care b-cosmetic surgery c-drug addiction d-eye refractions

c

A temporary license may be issued by the Commissioner for a period not to exceed how many days? a-90 b-120 c-180 d-365

c

A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT a-limb b-life c-income d-eyesight

c

In addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health? a-obtaining MIB reports on each enrollee b-by imposing case mangement provisions c-by requiring that the insurance be incidental to the group d-by having each enrollee undergo a paramedical examination

c

On an accidental death and dismemberment policy, the death benefit payable is known as the a-capital sum b-policy limit c-principal sum d-face amount

c

The Medical Information Bureau (MIB) was created to protect a) Insureds from unreasonable underwriting requirements by the insurance companies. b) Medical examiners that perform insurance physical examinations. c) Insurance companies from adverse selection by high risk persons. d) Insurance departments from lawsuits by policyowners.

c

Rebating is an unfair trade practice and is regulated by law. All of the following would be considered to be rebating EXCEPT A) An agent offers to share his commission with a policyholder B) An agent offers tickets to a baseball game as an inducement to buy insurance C) An agent uses misrepresentation to convince a person to cancel an existing policy and take a new policy from him D) An agent offers the use of his lake house to person as an inducement to buy

C

Under the Accidental Death and Dismemberment (AD&D) coverage, what type of benefit will be paid to the beneficiary in the event of the insured's accidental death? a) Double the amount of the death benefit b) Refund of premiums c) Principal sum d) Capital sum

c

In order to comply with Fair Credit Reporting Act, at which times must a producer notify an applicant that a credit report may be requested: A-at the time of application B-when the applicant's credit is checked c-when the policy is delivered D-at the initial interview

a

_________ sums are percentages of principal sums

capital

The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insured have? A-accident only B-restrictive C-accidental death D-comprehensive

A

When can an insured initiate legal action against the insurer? A-60 days after submitting proof of loss B-no later than 1 year from the loss C-at any time after the loss D-within 20 days after the loss

A

A guaranteed renewable disability insurance policy A-Cannot be cancelled by insured before age 65 B-Is renewable at the insured's option to a specified age C-Is renewable at the option of the insurer to a specified age of the insured D-Is guaranteed to have a level premium for the life of the policy

B

A Limited Insurance Representative is an individual, other than an insurance producer, who may solicit or negotiate contracts for certain types of insurance which includes all of the following EXCEPT a) Mortgage guaranty insurance. b) Automobile physical damage insurance. c) Crop hail insurance. d) Portable electronics insurance.

b

A dentist is off work for 4 months due to a disability. His dental assistant's salary would be covered by: A) Key Employee Disability B) Business Overhead Insurance C) Partnership Disability D) Disability Income

b

Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by her insurer. what is the name of this agreement? a-statement of loss coverage b-consideration clause c-insuring clause d-coverage provisions

c

Tom purchase a health insurance policy with a renewability clause that staets the policy is Guaranteed Renewable. This means that as long as Tom pays the required premiums, the policy will continue until tom... a-reaches 100 b-becomes disabled c-reaches 65 d-dies

c

Upon payment of a loss, the insured is obligated to surrender to the insurer the right to sue a negligent third party. This is called a-insurable interest b-entirety c-subrogation d-indemnity

c

Which of the following actions does NOT constitute false advertising? a-misrepresenting the dividends of a policy b-using names that disguise the true nature of a polciy c-requiring applications more quickly than whats reasonable d-misrepresenting the terms of a policy

c

Which of the following activities is NOT performed by an insurance producer? a) Countersigning policies b) Soliciting policies c) Issuing the policy d) Collecting premiums

c

Which of the following best describes the type of care provided by HMOS? a-major medical b- fee for service c-preventive d-elective

c

Which of the following is consideration on the part of an insurer? a-paying the premium b-underwriting c-paying a claim d-decreasing premium amounts

c

A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim? A-Claim is denied if his policy contains the Illegal Occupation provision B-50% of claim will be paid C-If the man isn't convicted, he will get 75% of his claim paid D-The claim is paid in full

A

Medicaid provides all of the following benefits EXCEPT: A-family planning services B-Income assistance for work-related injury C-Home health care services D-Eyeglasses

B

Under the mandatory uniform provision Legal Actions, an insured is prevented from bringing a suit against the insurer to recover on a health policy prior to a- 90 DAYS AFTER WRITTEN PROOF OF LOSS HAS BEEN SUBMITTED B- 60 DAYS AFTER WRITTEN PROOF OF LOSS HAS BEEN SUBMITTED. C-ONE YEAR AFTER OCCURENCE OF DISABILITY D-30 DAYS AFTER THE LOSS

B

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 A-Relative-value schedule B-benefit schedule C-Gatekeepers D-Usual,customary, and reasonable

D

An insurance company is domiciled in Montana and transacts insurance in Wyoming. Which term best describes the insurer's classification in Wyoming? A-Alien B-Domestic C-Unauthorized D-Foreign

D

An insurer devises an intimidation strategy in order to corner a large portion of the insurance market. Which of the following best describes this practice? A-A legal advertising strategy B-Unfair discrimination C-Defamation D-Illegal

D

Which is NOT a characteristic of group health insurance? A-Dependents of insureds can be covered under group health plans B-Group coverage may be converted to individual coverage if the group contract is ended C- The actual policy is called the "master contract" D- A policy is issued to each insured individual

D

Which of the following reports will provide the underwriter with the information about an insurance applicant's credit? A-inspection report B-agent's report C-any federal report D-Consumer report

D

Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be best for Ray? a) 50/50 b) 75/25 c) 80/20 d) 90/10

a

What does the application of 'Contract of Adhesion' mean? A-Since the insured doesn't participate in preparing the contract, any ambiguities would be resolved in favor of the insured B-The holder of the contract has the ultimate power of promise c-insurer may go to another for representation d-it makes sure that the insured doesnt get more than the value of the loss

a

Which of the following is NOT correct concerning taxation of disability income benefits? a-if paid by the individual, the premiums are tax deductible b-if the employer paid the premiums, income benefits are taxable to the insured as ordinary income c-if the insured paid the premiums, any disability income benefits are tax free d-if the benefits are for a permanent loss, they are not subject to income taxation no matter who paid the premium

a

Which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policyowner? a) Payment of Claims b) Change of beneficiary c) Entire Contract Clause d) Proof of Loss

a

Who chooses a primary care physician in an HMO? a) The individual member b) HMO subscribers do not have a primary care physician c) The insurer d) A referral physician

a

An insured has an individual disability income policy with a 30 day elimination period. He becomes disabled on june 1st for 15 days. when will he collect on his disability income payments? a-he wont collect anything b-he will collect 15 days of payment after 30 days c-he will begin collect on the 15th day d-hew ill begin collecting on june 1st

a (he never fulfilled the elimination period)

Long-term care insurance policies must cover which of the following? a) Injuries caused by an act of war b) Alzheimer's disease c) All mental disorders d) Treatment of alcoholism

b

Under the mandatory uniform provision Notice of Claim written notice of a claim must be submitted to the insurer within what time parameters? a-within 10 days b-within 20 days c-within 30 days d-within 60 days

b

Which of the following best describes a Major Medical Expense Policy? a-It provides coverage to an insured who is confied to a hospital with a daily benefit amount and a specified benefit period b-it provides catastrophic medical coverage beyond basic benefits on a usual, customary, and reasonable basis c-it provides surgical coverage to an insured with a schedule indicating charges for each procedure d-it provides coverage for in-hospital doctor visits that are of a nonsurgical nature

b

Which of the following statements is INCORRECT regarding the definition of total disability? a-inability to perform duties of ones own occupation b-inability to perform partial duties of any occpation for which a person is suited by reason of education, training or experience c-defined differently under certain disability income policies d-inability to perform any occupation for which a person is reasonably suited by reason of education, training or experience

b

An underwriter must review an applicant with an extensive medical history. Which document would give the underwriter a better understanding of how the insured was treated for various illnesses? A. MIB Report B. Policy Application C-medical exam D-attending physician's statement

d

Before a customer's agent delivers his policy, the insurer makes a last-minute change to the policy. The agent informs the customer of this change, and he accepts it. What must the agent do now? a) Nothing. After the explanation, the agent is not legally bound to do anything else. b) The agent must notify the beneficiary of the change in policy. c) If the change would affect the premium, the agent must have the customer sign a statement acknowledging the change. d) The agent should ask the customer to sign a statement acknowledging that he is aware of the change.

d

If an insurer is going to terminate the appointment of an insurance producer, within how many days following termination must the insurer notify the Commissioner of the termination? a) 45 days b) 60 days c) 15 days d) 30 days

d

In a relative value system of determining coverage for a given procedure, what term describes the total amount payable per point? a) Relative value b) Translation factor c) Practical value d) Conversion factor

d

Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to a) Creditors. b) Beneficiary of the death benefit. c) The spouse of the insured. d) The insured.

d

As a condition for renewal of their licenses, how many hours of continuing education are required for all resident and nonresident insurance producers? a-24 b-12 c-10 d-20

a

2. Theodore received a $15,000 cash benefit from his $50,000 accidental death and dismemberment policy for the accidental loss of one eye. The amount he received could be identified as the policy's A. principal sum B. secondary sum C. capital sum D. contingent amount

c

L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay? A-$900 (deductible + 20% of the bill after the deductible [20% of $2,000]) B-$2500 (the entire bill) C-$1000 (deductible + 20% of the entire bill) D- $500 (amount of deductible)

A

Any of the following would be considered an unfair trade practice, EXCEPT A-Attempting to settle a claim for less than the amount to which a reasonable person would have believed he was entitled by reference to written or printed advertising material used in the sale B-Attempting to settle a claim by the use of arbitration C-an insurer failing to affirm or deny coverage within a reasonable time after proof of loss statements have been recieved by the company D-attempting to settle a claim on the basis of an application which was altered without notice to, or knowledge and consent of the insured

B

As it pertains to group health insurance, COBRA stipulates that A. group coverage must be extended for terminated employees up to a certain period of time at the employer's expense B. group coverage must be extended for terminated employees up to a certain period of time at the former employee's expense C. retiring employees must be allowed to convert their group coverage to individual policies D. terminated employees must be allowed to convert their group coverage to individual policies

B

Concerning group Medical & Dental insurance, which of the following statements is incorrect? A. Premiums paid by the employer are deductible as a business expense B. Employee benefits are tax deductible the year in which they were received C. Benefits received by the employee are free from federal income tax D. Employee paid premiums may be deducted if certain conditions are met

B

Which of the following terms describes making false statements about the financial condition of any insurer that are intended to injure any person engaged in the business of insurance? A-Slandering B-Defamation C-Undercutting D-Twisting

B

Insurers may change which of the following on a guaranteed renewable health insurance policy? a-individual rates b-no changes are permitted c-rates by class d-coverage

C

Another term used to describe "no deductible" is A-comprehensive B-total coverage C-immediate cooperative D-first-dollar basis

D

What is the best way to change an application? A-Erase the previous answer and replace it with the new answer B-White-out the previous answer C-Draw a line through the incorrect answer and insert the correct one D- Start over with a fresh application

D

With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance? A-promise to renew the policy at the end of the policy period b-providing warranties on the application c-notice of policy cancellation d-payment of premium

D

How soon following the occurrence of a covered loss, or after the insurer becomes liable for periodic payments for income benefits, must an insured submit written proof of such loss to the insurance company? a. within 20 days b. Within 90 days or as soon as reasonably possible but not to exceed one year. c. as soon as possible d. within 60 days

b

An insurance company has published a brochure that inaccurately portrays the advantages of a particular insurance policy. What is this an example of? A-False Advertising B-Unfair Claims C-Twisting D-Defamation

A

Which of the following is considered a qualifiying event under COBRA? A-Divorce B-Marriage C-Relocation D-Promotion

A

An insurance producer is defined as A-a corporation, association, or other legal entity B- an individual or business entity C- A person licensed to sell insurance D-The National Association of Insurance Commissioners

C

Which of the following persons is required to hold a producer license? A-A person who takes messages related to claims B-A person who administers employee benefits C-A person who negotiates insurance contracts D-A person who creates insurance advertisements

C

Which of the following best describes a rebate? a-a producer selling insurance primarily to himself, his family and his friends b-producer returning part of her commission to her client, as an inducement to buy c-a producer mispresenting policy provisions or coverages at issue d-a producer requiring an insured to buy insurance from her as a condtion to loan

b

Which of the following policies is required to provide coverage for the treatment of alcohol and drug dependency? a) Individual conversion b) Group health c) Specified disease d) Medicare

b

All of the following are changes to health insurance plans introduced by the PPACA except: a-coverage for pre-existing conditions b-requirement for preventive care without deductibles or copays c-full cost coverage for all medical expenses d-limiting age for dependent children

c

An insured had a heart attack while jogging, but is expected to return to work in about 6 weeks. The insured's Disability Income policy will a-not pay b-pay a lump sum benefit c-replace a percentage of his lost income d-cover injuries only

c

Concerning Medicare Part B, which statement is INCORRECT? a) It offers limited prescription drug coverage. b) It provides partial coverage for medical expenses not fully covered by Part A. c) It is fully funded by Social Security taxes (FICA). d) It is known as medical insurance.

c

If a resident insurance producer moves from Tennessee to another state, he/she must file a change of address and provide certification from the new resident state within how many days of the change of legal residence? a) 10 days b) 20 days c) 30 days d) 60 days

c

Individual long-term care insurance policyholders have the right to return the policy within __ days of its delivery and to have the premium refunded if, after examination of the policy, the policyholder is not satisfied for any reason. a) 10 b) 20 c) 30 d) 60

c

What is the purpose of the impairment rider in health insurance policy? a-cover impairments that otherwise couldn't be covered b-provide disability coverage c-identify pre-existing conditions d-exclude coverage for a specific impairment

d

When the insured purchased his health policy he was a window washer. He has since changed occupations and now manages a library. If the insurer is notified of the insured's change of occupation, the insurer should a) Increase the benefit. b) Return any unearned premium. c) Consider decreasing the premium. d) Adjust the benefit in accordance with the decreased risk.

d

Which of the following used to be called Medicare + Choice Plans? a-medical insurance b-medicare supplement plans c-original medicare plan d-medicare advantage plans

d

An insured is hospitalized with a back injury. Upon checking his disability income policy, he learns that he will not be eligible for benefits for at least 30 days. This indicates that his policy is written with a 30-day A-elimination period B-Blackout period C-Probationary Period D-Waiver of Benefits period

A

In which of the following situations would Social Security Disability benefits NOT cease? A) The individual's son gets a part-time job to help support the family B) The individual reaches age 65 C) The individual dies D) The individual has undergone therapy and is no longer disable

A

Alexander has a policy with his ex-wife as its beneficiary. What provision allows him to change the beneficiary to his new wife? A-payment of claims B-change of beneficiary C-Absolute assignment D-Entire contract

B

In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met? A) The insured must cover daily copayments B) The insured must have first been hospitalized for 3 consecutive days. C) The insured must have a Medicare supplement insurance policy D) There is no benefit provided under Medicare Part A for skilled nursing care

B

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained inthe contract is the A) Legal action against us clause. B) Entire contract clause. C) Time limit on certain defenses clause. D) Incontestability clause.

B

Under which of the following employer provided plans are the benefits taxable to an employee in proportion to the amount of premium paid by the employer? A-Basic Medical Expense B-Disability Income C-Major Medical D-Dental Expense

B

A husband and wife are insured under group health insurance plans at their places of employment. Because their employers pay for their plans, each is covered as a dependent under their spouse's coverage. If the husband is hospitalized, how are medical expenses likely paid? A) The husband can collect from each plan B) The husband will have to select a plan from which he wants to collect benefits C) The benefits will be coordinated. D) Neither plan would pay.

C

A woman's health insurance policy dictates which doctors she is allowed to see. Her health providers share an assumed risk for their patients and encourage preventative care. What best describes the health system that the woman is using? A) Major medical B) Group health C) Managed Care D) Comprehensive health

C

According to the rights of renewability rider for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy EXCEPT a) Claims incurred before cancellation must be honored. b) An insurance company may cancel the policy at any time. c) Unearned premiums are retained by the insurance company. d) The insurer must provide the insured a written notice of the cancellation.

C

All of the following could be considered rebates if offered to an insured in the sale of insurance except: A-stock, securities, or bonds B-An offer to share in commissions generated by the sale C-Dividends from a mutual insurer D-An offer of employment

C

All of the following long-term care coverages would allow an insured to receive care at home EXCEPT: A-respite care B-home health care C-Skilled Care D-Custodial Care in insured's house

C

An insured loses her left arm in an accident that is covered by her Accidental Death and Dismemberment policy. WHat kind of benefit will she most likely receive from this policy? A-Capital amount in monthly installments B-Principal amount in monthly installments C-Capital amount in a lump sum D-Principal amount in a lump sum

C

The type of dental plan which is incorporated into a major medical expense plan is a/an A-stand-alone dental plan B-Blanket dental plan C-Integrated dental plan D-supplemental dental plan

C

When would a misrepresentation of the insurance application be considered fraud? A. when the application is incomplete B. any misrepresentation is considered fraud C. if it is intentional and material D. never; statements made by the applicant are only representations

C

an insured is covered under a medicare policy, that provides a list of network healthcare providers that he must use in order to receive coverage. in exchange for the inconvenience, he is offered a lower premium, which type of "medicare" policy does he own ? A-Medicare supplement B-Medicare Advantage C-Medicare SELECT D-Medicare Part A

C

what is the maximum period of time during which an insurer may contest fraudulent and misstatements made in the health insurance application? A-90 days after the effective policy date B-6 months after the effective policy date C-1 year after the effective policy date D-as long as the policy is in force

D

Which of the following Disability Income policies has the highest premium: A- 30 day waiting period / 5 year benefit period B- 30 day waiting period / 10 year benefit period C- 15 day waiting period / 5 year benefit period D- 15 day waiting period / 10 year benefit period

D (the shorter the waiting period, the higher the premium. the longer the benefit period, the higher the premium)

#17. Which of the following is NOT mandatory under the Uniform Provisions Law as applied to accident and health policies? a) Change of Occupation b) Time Limit on Certain Defenses c) Physical Examination and Autopsy d) Entire Contract

a

An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the a) Consideration Clause. b) Insuring Clause. c) Pre-existing Conditions Clause. d) Eligibility Clause.

a

An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary? A-revocable B-primary C-contingent D-irrevocable

a

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply? A-5 days B-7 days C-10 days D-3 days

a

In insurance, an offer is usually made when A. the application is submitted B. the insurer approves the application and receives the initial premium C. the agent hands the policy to the policyholder D. an agent explains a policy to a potential applicant

a

The Time of Payment of Claims Provision requires that an insurance company pay Disability Income benefits no less frequently than: AMonthly BSemiannually CQuarterly D Annually

a

Under the Physical Exam and Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending? a. unlimited b. 1 examination per week of the claim processing period c. none at all d. 2 examinations per week of the claim processeing period

a

What are the three basic coverages for medical expense insurance? A-hospital, surgical, medical B-basic, major, overhead C-medical, dental, vision D-reimbursement, preventive, service

a

What document describes an insured's medical history, including diagnoses and treatments? A-attending physician's statement B-physician's review C-Individual medical summary D-Comprehensive medical history

a

Which of the following statements is NOT correct concerning the COBRA Act of 1985? a) It requires all employers, regardless of the number or age of employees, to provide extended group health coverage. b) It covers terminated employees and/or their dependents for up to 36 months after a qualifying event. c) It applies only to employers with 20 or more employees that maintain group health insurance plans for employees. d) COBRA stands for Consolidated Omnibus Budget Reconciliation Act

a

Which of the following statements regarding Business Overhead Expense policies is NOT true? a) Benefits are usually limited to six months. b) Premiums paid for BOE are tax-deductible. c) Any benefits received are taxable to the business. d) Leased equipment expenses are covered by the plan.

a

Which of the following statements regarding the Change of Beneficiaries Provision is false? A) The policyowner has the right to change beneficiaries in any case B) A policyown can change beneficiaries without the consent of the former revocable beneficiary C) The policyowner cannot change beneficiaries if he/she has chose to have an irrevocable beneficiary, unless the policyowner has the permission of the irrevocable beneficiary D) All policies that allow a death benefit must at least provide the option of a change of beneficiary provision.

a

Which of the following would be required to complete the producer licensing requirements? a-customer service representtaive who discusses policies b-agency supervisor whose actions don;t include selling insurance c-a person whose activities are limited to insurance advertising d-an officer of an insurer who doesn't recieve commissions

a

A disability income policy is written with a 10-month benefit period, a 30-day elimination period and a 30-day probationary period. If the insured becomes disabled due to sickness 9 days after the effective date, the policy will pay benefits for a maximum of: A) 21 days B) 10 months C) No coverage applies D) 270 days

b

According to the Time Limit on Certain Defenses provision, statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been in force for a minimum of how many years? a-1 year b-2 years c-3 years d-5 years

b

An agent is in the process of replacing the insured's current health insurance policy with a new one. Which of the following would be a proper action? A. the old policy must be cancelled before the new one can be issued B. the old policy should stay in force until the new policy is issued C. there should be at least a 10-day gap between the policies D. policies must overlap to cover pre-existing conditions

b

An insured was diagnosed 2 years ago with kidney cancer. she was treated with surgeries and chemotherapy and is in remission. she also has a 30 year smoking history. she is now healthy enough to work and has started a full time job. Which describes the health insurance that she will likely recieve? a-she would be accepted under an insurance policy, provided that a rider excluding cancer related conditions is attached b-She would be covered under her employer's group health insurance plan, without higher premiums c-she would be covered under her employers group health insurance plan, but she would pay higher premiums d-she would be denied coverage due to the risk posed by her prior medical history

b

Ed is covered under a health plan provided by his employer. he was told that his insurance would pay the majority of the covered expenses if he would chooce to see a provider in his plan's list. If ed chose to be treated by a provider who wasn't on the list, his portion of the bill would be greater. Ed is covered under a/an a-limited health plan b-preferred provider plan c-coordinated plan d-HMO group plan

b

In a group health policy, a probationary period is intended for people a) Who want lower premiums. b) Who joined the group after the effective date. c) Who had a pre-existing condition at the time they joined the group. d) Who have additional coverage through a spouse.

b

In order to be eligible for a producer's license in the state of tennesee, an applicant must meet all of the qualifiecations EXCEPT a-be a resident of tennessee or satisfy nonresident requirements b-complete 40 hours of prelicenscing education c-be competent, trustworthy, and good business reputation d-be 18 years or older

b

Under the mandatory uniform provision Proof of Loss, the claimant must submit proof of loss within what time period after the loss? a-60 days b-90 days c-two years d-30 days

b

Which of the following meets the insured's personal needs, and is provided by nonmedical personnel? a) Intermediate care b) Custodial Care c) Skilled care d) Assisted living

b

All of the following are excluded from coverage in an individual health insurance policy EXCEPT a-purely cosmetic surgery b-treatment received in a govermnent hospital c-mental illnes d-experitemental procedures

c

Which of the following would be considered false advertising? A-stating that a policy has limitations and exclusions B-failing to include premium in sales materials C-implying that the agent is the insurer D-stating the differences in benefits between whole life insurance and term life insurance

c

A long-term care plan cannot use a more restrictive definition of "pre-existing condition" than a condition which was treated advised within how many months before coverage began? A-12 B-18 C-24 D-6

d

Many health insurance policies are required to provide Chlamydia screenings. At what age does this coverage end? a-30 b-35 c-25 d-29

d

The policy provision that prevents an insurance company from altering its agreement with a policy owner by referring to documents or other items not contained in the policy is called the A-legal action provision b-grace period provision c-reinstatement provision D-entire contract provision

d

What is the purpose of the benefit schedule? a-to include the average charges for procedures b-to provide the dates for the payment of benefits c-to list the insured's copayments and deductibles d-to state what and how much is covered in the plan

d

What type of care is respite care? a-daily medical care, given by medical personnel b-institutional care c-24-hour care d-relief for a major care giver

d

Which is true regarding HMO coverage? A-it's divded based on the average tax bracket of a family b- it's divided by state c- HMOs provide nationwide coverage d- it's divided into geographic territories

d

A husband and wife both incur expenses that are attributed to a single major medical insurance deductible. Which type of policy do they have? A-mutual B-family C-combined D-joint

B

HMOS are known as what type of plans a-service b-health savings c-consumer driven d-reimbursement

a

Which of the following would be required to complete prelicensing education? a-An accredited advisor in insurance who wants to sell property insurance b-a nonresident life insurance producer who is planning to transact property insurance c-a producer previously licensed in another state planning to transact the same line of insurance d-a chartered life underwriter planning to transact life insurance

b

An agent delivers a policy to an applicant, who pays the initial premium but refuses to submit a Statement of Good Health. Which of the following best describes what the applicant has violated? A-adhesion B-contractual agreement c-consideration d-representation

c

Hospice care is intended for a-home health visits from a participating home health agency b-the caregiver c-the terminally ill d-people in need of acute care

c

Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a mjaor medical policy? a-demand full payment immediately for the claim b-speak with a claims adjuster or another represenative from the insurnace company c-submit the description in their own words on a plain sheet of paper d-be reimbursed any copayment or deductible on the claim

c

Which act was introduced to reduce the cost of health care by utilizing preventive care? a-medical freedom act b-HIPAA c-HMO Act of 1973 d-Employee retirement income security act

c

Which of the following is provided by skilled medical personnel to those who need occasional medical assistance or rehabilitative care? a) Home health care b) Skilled care c) Intermediate care d) Custodial care

c

An insured needs ongoing treatment for a diabetic condition. Under the PPACA, which of the following is correct? a) The condition is covered if the insured's plan specifies the condition b) Treatment is subject to pre-existing conditions exclusion c) Treatment is subject to an annual dollar maximum d) The condition must be covered under the insured's plan

d

Which of the following MUST the commissioner do before suspending or revoking the licence of an agency? a-advice the agency of suspension in writing within 30 days b-assess a civil penalty of $100 to $1000 c-inform the NAIC d-hold a hearing to determine if a violation has been comitted

d

Whose responsbility is it to determine if all of the questions on an application have been answered? a-insurer b-applicant c-beneficiary d-agent

d