Health Insurance Exam

A health plan policy cannot be issued or delivered in Minnesota until which of the following has been filed with the Commish? A. Both risk classification and premium rates B. Neither risk classification or premium rates C. Risk Classification only D. Premium rates only

A

If the insured under disability income insurance policy changes to a more hazardous occupation after the policy has been issued, and a claim is filed, the insurance company should do which of the following? A. Adjust the benefit in accordance with the increased risk B. Cancel the policy C. Increase the premium D. Exclude coverage for on the job injury

A

What is the major difference between a stock company and a mutual company? A. Ownership B. Amount of death benefit C. Number of producers D. Types of whole life policies

A

What type of policy allows the insurance company to cancel a policy at any time? A. Cancellable B. Renewable C. Guaranteed renewable D. Non-cancellable

A

Which one of the following is an eligibility requirement for Social Security disability income benefits? A. Fully insured status B. Experiencing at least on year of disability C. Being at least 50 years of age D. Currently employed status

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 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? A. Full benefits until the blindness lifts B. No benefits C. Full benefits D. Partial benefits

B

Occasional visits by which of the following medical professionals will NOT be covered under LTCs home heath care? A. Community-based organization professionals B. Attending physician C. Registered nurses D. Licensed practical nurses

B

The purpose of the reinstatement provision is? A. To specify the period of time following the premium due date for the policy owner to pay the premium B. To determine the process for reactivation coverage once a policy has lapsed C. To allow the policy owner to continue coverage under the policy beyond the current policy year D. To permit the insurer to terminate coverage at any time

B

Which of the following is NOT an exclusion in medical expense insurance policies? A. Routine dental care B. Coverage for dependents C. Military duty D. Self-inflicted injuries

B

All applicants for life, annuity or endowment contracts must be given notice concerning policyholders rights in the event that their insurance company become? A. An unauthorized insurer B. A surplus lines insurer C. Insolvent D. Offered for sale

C

An applicant just got hired to work for ABC company and wants to sign up for a group health insurance. In which of the following situations evidence of insurability will not be required? A. Currently having health insurance B. Falling into the no-risk group C. Signing up during open enrollment D. Having had health insurance through through another employer within the last 30 days

C

An insurer publishes intimidating brochures that portray the insures competition as financially and professionally unstable. Which of the following best describes this act? A. Illegal until endorsed by the Guaranty Association B. Legal provided that the other insurers are paid royalties for the usage of their names C. Illegal under any circumstances D. Legal, provided that the information can be verified

C

In group insurance, the underwriter will examine a groups experince rating, which is associated most closely with the groups A. Legal history B. Forecasted growth C. Claims experience D. Length of existence

C

When delivering a policy, which of the following is an agent's responsibility? A. Approve or decline the risk B. Collect medical statement from physician C. Collect payment at time of delivery D. Issue the policy if the applicant is present

C

Which of the following is the term for the specific dollar amount that mist be paid by an HMO member for a service? A. Premium B. Cost share C. Copayment D. Deductible

C

A guaranteed renewable health insurance policy allows the? A. Policy holder to renew the policy to a stated age and guarantees the premium for the same period B. Policy to be renewed at time of expiration, but the policy can be canceled for cause during the policy term C. Insurer to renew the policy to a specified age D. Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class

D

How is the Minnesota Comprehensive Health Association funded? A. By NAIC B. By the department of insurance C. By the government D. By its members - authorized insurers

D

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company? A. As soon as possible B. Within 20 C. Within 60 days D. Within 90 days or as soon as reasonably possible, but not to exceed 1 year

D

If an insurer meets all the states requirements, their certificate of authority should arrive within how many days of applying? A. 90 B. 20 C. 30 D. 60

D

The commish must examine the affairs and conditions of every insurer licensed in the State not less frequently than A. Annually B. Every 2 years C. Every 3 years D. Every 5 years

D

The premium charged for exercising the Guaranteed Insurability Rider is based upon the insureds? A. Assumed age B. Average age C. Issue age D. Attained age

D

What is the period of coverage for events such as death or divorce under COBRA? A.60 days B. 31 days C. 12 months D. 36 months

D

Which of the following is NOT a feature of guarenteed renewable provision? A. The insured has a unilateral right to renew the policy for the life of the contract B. Coverage is not renewable beyond the insureds age 65 C. The insureds benefits cannot be reduced D. The insurer can increase the policy premium on an individual basis

D

Which of the following is an example of a producer being involved in an unfair trade practice of rebating? A. Induing the insured to drop a policy in favor of another one when it is not in the insurers best interest B. Charging a client a higher premium for the same policy as another client in the same insuring class C. Making deceptive statements about a competitor D. Telling a client his first premium will be waived if her purchases the insurance policy today

D

Which of the following statements is true about business owners policies (BOPs)? A. Insurers prefers to exclude standard coverages in BOPs as a way of offering customized coverage B. Because of federal regulations, BOPs cannot be customized C. If a business wants to customize a BOP, the business must convert to a personal lines policy D. BOPs may be customized by adding optional coverages

D

Which type of medicare policy requires insureds to use specific healthcare providers and hospitals (network providers), except in emergency situations? A. Medicare Advantage B. Medicare Part A C. Preferred D. Medicare SELECT

D

Who can provide skilled nursing care? A. Spouse B. Family member C. Community volunteer D. Doctor

D