Other Health Insurance Concepts Practice Questions

Which of the following would best describe total disability? a-A person's inability to perform one of the regular duties of his/ her occupation b-a person's total loss of income c-a person's inability to qualify for insurance coverage d-a person's ability to work is significantly reduced or eliminated for the rest of his/ her life

a person's ability to work is significantly reduced or eliminated for the rest of his/ her life

Which of the following is not true of disability by cell coverage? a-It is typically written to cover partners or corporate officers of a closely held business b-premium payments are not deductible to the business c-the policy's provide funds for the business organization to purchase the business interest of a disabled partner d-benefits are considered taxable income to the business

benefits are considered taxable income to the business

All of the following are true regarding key employee disability income insurance EXCEPT a-benefits are taxable to the employer b-the employer owns the policy c-benefits are paid to the employer to retain a new person d-premiums are not tax deductible for the employer

benefits are taxable to the employer

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-Dental expense b-basic medical expense c-disability income d-major medical

disability income

The Patient Protection and Affordable Care Act includes all the following provisions EXCEPT a-coverage for preventative benefits b-individual tax deduction for premiums paid c-right to appeal d-no lifetime dollar limits

individual tax deduction for premiums paid

Under workers compensation, which of the following benefits are NOT included? a-Income benefits b-death benefits c-legal benefits d-medical and rehabilitation benefits

legal benefits

A woman's health insurance policy dictates which doctors she is allowed to see. Her health providers share an assumed risk for their patience and encourage preventive care. What best describes the health system that the woman is using? a-group health b-managed care c-comprehensive health d-major medical

managed care

Workers compensation benefits are regulated by which entity? a-Insurer b-federal government c-state government d-employer

state government

A provision found an insurance policy's which prevents the insured from collecting twice from the same loss is called a-consent to settle loss b-right of salvage c-appraisal d-subrogation

subrogation

The legal process that gives the insurer, after payment of a loss, the right to seek recovery from a third party that was responsible for the loss is known as a-right of rescission b-principle of indemnity c-subrogation d-adverse selection

subrogation

A man works for company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, a-the insurance through his wife's company is primary b-insurance plans will split the coverage evenly c-both plans will pay the full amount of the claim d-the insurance through his company is primary

the insurance through his company is primary

Which of the following definitions would make it easier to qualify for total disability benefits? a-The more liberal "any occupation" b-the more strict "own occupation" c-the more liberal "own occupation" d-the more strict "any occupation"

the more liberal "own occupation"

Which of the following is not true regarding partial disability? a-The insured can still report to work and receive benefits b-benefit payments are typically 50% of the total disability benefit c-and insured would qualify if he couldn't perform some of his normal duties d-this is a form of insurance that covers part time workers

this is a form of insurance that covers part time workers

When may an insured deduct unreimbursed medical expenses paid under a long-term care policy? a-Only if the insured does not itemize the expenses b-when the expenses exceed a certain percentage of the insured's adjusted gross income c-only if the insured is age 65 or older d-all LTC expenses are tax deductible

when the expenses exceed a certain percentage of the insured's adjusted gross income

For group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense? a-50% b-60% c-90% d-100%

100%

What is the maximum age for qualifying for a catastrophic plan? a-26 b-30 c-45 d-62

30

The transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses? a-subrogation b-arbitration c-salvage d-appraisal

subrogation

Which of the following premium modes would result in the highest annual cost of an insurance policy? a-Monthly b-quarterly c-semi annually d-annually

Monthly

A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of a total disability will cover her for all losses? a-"Own occupation" - more restrictive than other definitions b-"any occupation" - less restrictive than other definitions c-"any occupation" - more restrictive than other definitions d-"own occupation" - less restrictive than other definitions

"own occupation" - less restrictive than other definitions

A non contributory group disability income plan has a 30-day elimination period And offers benefits of $2000 a month. If an employee is unable to work for seven months due to a covered disability, the employee will receive a-$12,000, all of which is taxable b-$14,000, none of which is taxable c-$14,000, all of which is taxable d-$12,000, none of which is taxable

$12,000, all of which is taxable

The sole proprietor of a business makes a total salary of $50,000 a year. This year, his medical expenses have reached a total of $75,000. What amount may the sole proprietor deduct in regards to his medical expenses? a-$10,000 b-$25,000 c-$50,000 d-$75,000

$50,000

An insured is covered under two group health plans - under his own and his spouses. he had suffered a loss of $2000. After the insured paid the total of $500 in deductibles and coinsurance, the primary insurer covered $1500 of medical expenses. What amount, if any, would be paid by the secondary insurer? a-$0 b-$500 c-$1000 d-$2000

$500

An insured has a primary group health plan and an access plan, each covering losses up to 10,000 dollars. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay? a-$10,000 b-$7500 c-$5000 d-$0

$5000

The Patient Protection and Affordable Care Act mandates that insurers provide coverage for adult children of the insured up to the age of a-19 b-21 c-26 d-30

26

When a disabled dependent child reaches the age limit for coverage, how long does the policy owner have to provide proof of dependency in order for the dependent to remain covered under the policy? a-15 days b-31 days c-60 days d-10 days

31 days

Under which condition would an employees group medical benefits be exempt from income taxes? a-And employees group medical benefits are generally exempt from taxation as income b-an employee's group medical benefits are never exempt from taxation as income c-when the premiums and the other unreimbursed medical expenses exceed 5% of the employees adjusted gross income d-when the premiums and other unreimbursed medical expenses exceed 10% of the employees adjusted gross income

And employees group medical benefits are generally exempt from taxation as income

All of the following statements concerning workers compensation are correct EXCEPT a-all states have workers compensation b-benefits include medical, disability income, and rehabilitation coverage c-a worker received benefits only if the work related injury was not his/ her fault d-workers compensation laws are established by each state

a worker received benefits only if the work related injury was not his/ her fault

Which of the following statements regarding the change of beneficiaries provision is false? a-The policy owner has the right to change beneficiaries in any case b-a policy owner can change beneficiaries without the consent of the former revocable beneficiary c-the policy owner cannot change beneficiaries if he/ she has chosen to have in irrevocable beneficiary, unless the policy owner has the permission the irrevocable beneficiary d-all policies that allow a death benefit must at least provide the option of a change of beneficiary provision

The policy owner has the right to change beneficiaries in any case

Disability income coverage specifies that the policy covers the insured if he is unable to perform any job for which he is qualified. In this case, total disability is defined as a-own occupation - less restrictive than other definitions b-any occupation - more restrictive than other definitions c-any occupation - less restrictive than other definitions d-own occupation -more restrictive than other definitions

any occupation - more restrictive than other definitions

All of the following are true of the key person disability income policy EXCEPT a-the income may be used to find a replacement for the key employee b-benefits are considered taxable income to the business c-premiums are not deductible to the business d-it is typically written to protect the company in the event a key employee becomes disabled and is unable to work

benefits are considered taxable income to the business

Which of the following is NOT true regarding workers compensation? a-benefits are not regulated by the federal government b-benefits vary from state to state c-benefits are regulated by the state government d-benefits are offered by the insurer

benefits are offered by the insurer

Alexander has a policy with his ex wife as it 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

change of beneficiary

A woman obtains health coverage through the marketplace on October 1. Two weeks later she finds out that she is 3 months pregnant. Which of the following is true about coverage for pregnancy? a-Pregnancy will only be covered if additional premium is paid b-pregnancy will not be covered as a pre-existing condition c-pregnancy may be covered with the insurer's special approval d-pregnancy will be covered immediately

pregnancy will be covered immediately

A policy owner names his five children as primary beneficiaries and his wife as a contingent beneficiary. If the policy owner in one of his children die, who would receive policy benefits? a-The remaining four primary beneficiaries b-the oldest surviving primary beneficiary c-the insured's estate d-the wife (contingent beneficiary)

The remaining four primary beneficiaries

The purpose of managed care health insurance plans is to a-control health insurance claims expenses b-provide for the continuation of coverage when an employee leaves the plan c-give the insured and unlimited choice of providers d-coordinate benefits

control health insurance claims expenses

Workers compensation insurance covers a workers medical expenses resulting from work related sickness or injuries and covers loss of income from a-job termination b-plant or office Closings c-temporary job layoffs d-work-related disabilities

work-related disabilities

An employee is injured in a construction accident, rendering him unable to work for a year. Which of the following plans would provide him with medical expense coverage in income assistance? a-Long term care b-Social Security disability c-workers compensation d-major medical insurance

workers compensation

The transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses? a-Salvage b-appraisal c-Subrogation d-arbitration

Subrogation

Premium payments for personally-owned disability income policy are a-eligible for tax credits b-tax deductible c-tax deductible to the extent that they exceed 10% of the adjusted gross income of those itemizing deductions d-not tax deductible

not tax deductible

According to the PPACA mental levels classification, if a health plan is expected to cover 90% of the cost for an average population, and the participants would cover the remaining 10%, what type of plan is that? a-silver b-gold c-platinum d-bronze

platinum

Which of the following is correct regarding the taxation of group medical expense premiums and benefits? a-Premiums are not tax deductible and benefits are not taxed b-premiums are tax deductible and benefits are taxed c-premiums are tax deductible and benefits are not taxed d-premiums are not tax deductible and benefits are taxed

premiums are tax deductible and benefits are not taxed

In all health care plans under the Affordable Care Act (ACA), how many essential benefit categories are there? a-5 b-10 c-12 d-15

10

Which of the following statements is correct concerning taxation of long term care insurance? a-Excessive benefits may be taxable b-benefits may be taxable as ordinary income c-premiums may be taxable as income d-premiums are not deductible in any case

Excessive benefits may be taxable