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Medicare Part A services do NOT include which of the following?

Outpatient Hospital Treatment

A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT

Part A deductible

Regarding the PPACA health care tax credit, which of the following is true?

Persons receiving Medicaid are not eligible

If an insured decides to reduce the coinsurance amount on her major medical insurance, what can the insured expect

A higher monthly premium

Peril

cause of loss

The presumptive disability provision assumes that the insured is totally disabled upon loss of all of the following except

feeling

Example of a peril

fire

Medicare Part B does NOT cover

inpatient hospital services

In a group policy, all of the following can be the policy owner except

insurance company

HMOs are known as what type of plans?

service

Which policy rider added to a disability income policy may require that a benefit be paid as a capital sum

Accidental Death and Dismemberment

In some cases, in order for an insurer to legally disclose privileged information to appropriate sources, the insured must sign an authorization form. What is the maximum amount of time that can legally pass between the completion of the form and the disclosure of information? a) 1 month b) 6 months c) 1 year d) 2 year

1 year

All of the following could qualify as a group for the purpose of purchasing a group health insurance except

An association of 35 people

All of the following health insurance disability benefits are income tax free except

Employer-paid group disability

All of the following are characteristics of group health insurance plans except

The parties that hold a group health insurance contract are the employees and the employer

If an applicant submits the initial premium with an application, which action constitutes acceptance

The underwriters approve the application

With a conditionally renewable policy, the premiums are more likely to be

increased

Which of the following is a preferred solution for reducing the cost of hospitalization

outpatient services

Which of the following is required to provide a notice of information practices to applicants and policyholders

producer

Premiums collected on behalf of the insurance company by an agent will be held in what capacity?

Fiduciary

Under HIPAA portability, which of the following are NOT protected under required benefits?

Groups of one or more

Whose responsibility is it to determine that all the questions on an insurance application are answered?

agents

Substandard Risk

An applicant or insured who has a HIGHER than normal probability of loss, and who may be subject to an increased premium.

Standard risk

An applicant or insured who is considered to have an AVERAGE probability of a loss based on health, vocation and lifestyle.

Conrad receives $50,000 from a $100,000 accidental death % dismemberment policy as a result of the loss of his left arm in an accident. Conrad has received the..

Capital amount

An employer group health insurance plan, the covered employee receives

certificate of insurance

An agent's first-year commission CANNOT exceed what percentage of the renewal commission for servicing a Medicare Supplement policy in its second year?

200%

An insurer must notify the consumer in writing that an investigative consumer report has been requested within how many days of the initial request

3 days

How long is the free look period of a Medicare supplement policy

30 days

What happens to the copy of the application for health insurance once the policy is issued

It becomes part of the entire contract

Which of the following used to be called Medicare + choice plans

Medicare Advantage Plans

With respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy

Only an executive officer of the company

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 major medical policy?

Submit the description in their own words on a plain sheet of paper

If the insurance premiums were not tax deductible, what other taxation will this affect?

Taxation of benefits

Once the initial benefit limit in Medicare Part D is reached, how is the beneficiary affected?

The beneficiary is then responsible for a portion of prescription drug costs

Who acts on behalf of the principal

agent

Who determines if a particular group of employees can be excluded from group health coverage

employer

To qualify for disability income benefits under Social Security, a worker must have an impairment that

is expected to last at least 12 months or result in death.

every medicare supplement policy must have a notice to buyer on the front page that states which of the following

this policy may not cover all of your medical expenses

A subscriber has been treated for a medical condition by his primary care physician for 3 months with experimental remedies without a significant health improvement before being referred to a specialist. Which of the following types of plans does the subscriber have?

A gatekeeper HMO plan to control the costs

Preferred risk

An insurance classification for applicants who have a LOWER expectation of incurring loss, and who, therefore, are covered at a reduced rate.

The Uniform Provision Law that prevents an insurance company from altering its agreement with a policyholder by referring to documents or other items not contained in the policy is called the

Entire Contract provision

In insurance, the agents have authorization to represent the company and may exercise this relationship through

Express authority Implied authority Apparent authority

Regarding major medical plans

Higher stop-loss means lower premium

Which of the following is not correct concerning taxation of disability income benefits

If paid by the individual, the premiums are tax deductible.


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