EXam!!!!!

n Colorado, all returned premiums received from insurers must be remitted to the proper customer within how many days? *14 *15 *30 *45

30

Because states define the scope of their Medicaid coverage, which statement is correct? *Every state provides the same benefits and has the same requirements for eligibility. *States always offer Medicaid and Medicare services and medical care together. *Eligibility for Medicaid assistance is based only on financial need. *Medicaid services are never provided with Medicare.

Eligibility for Medicaid assistance is based only on financial need.

Tom is applying for life insurance and mails Agent Adams the completed application. When Agent Adams reads it, he notices Tom has indicated his occupation as office clerk when, in fact, he is a structural metal worker. How should Adams handle this situation? *Inform Tom that he may not misrepresent his occupation. *Cross out or erase the falsified occupation and enter the correct one. *Ignore the issue because of the commission involved. *Ask Tom to mail the application directly to the company so he will not be involved.

Inform Tom that he may not misrepresent his occupation.

Which Medicare supplement plans limit a person's annual out-of-pocket medical costs related to coinsurance, copays, and deductibles? *K and L *C and D *I and J *M and N

K and L

Which statement is correct about eligibility for Medicare Parts A and B? *Part A is primarily hospital coverage automatically available to persons age 65 and Part B is mandatory medical care coverage available to those covered under Part A. *Part A is primarily hospital coverage that is available on an optional basis to those who are age 65 and older, while Part B is optional for those age 65 and over who have elected to be covered under Part A. *Part A is primarily hospital coverage automatically available to persons age 65 and over, while Part B is optional medical care coverage available to those covered under Part A. *Part A is primarily hospital coverage that is available on an optional basis to those who are age 65 and older, while Part B is mandatory for those age 65 and over who have elected to be covered under Part A.

Part A is primarily hospital coverage automatically available to persons age 65 and over, while Part B is optional medical care coverage available to those covered under Part A.

Which statement about long-term care insurance (LTC) and long-term care services is correct? *Long-term care insurance can be issued only on an individual basis. *The annual costs for long-term care services are generally the same across the country. *The annual cost of long-term care services usually varies from $10,000 to $30,000. *The cost of long-term care services often exceed a person's financial resources.

The cost of long-term care services often exceed a person's financial resources.

A health plan that offers the insured a limited choice of health care providers is: *an unqualified group plan *an HMO or PPO plan *a TPA plan *an indemnity plan

an HMO or PPO plan

How often may the Commissioner conduct a formal financial or market conduct examination of insurers doing business in Colorado? *every year *every two years *every five years *as often as necessary

as often as necessary

Which is not a necessary element of a legally enforceable contract? *offer *acceptance *exchange of consideration *beneficiary

beneficiary

Bill's health policy provides coverage for routine doctor visits, hospital expenses, surgical care, and medical treatment. Which of the following types of plans does Bill have? *any provider plan *limited choice of providers plan *specified plan *comprehensive plan

comprehensive plan

Which of the following is not a duty of the Colorado Insurance Commissioner? *supervising the business of insurance in the state *considering whether rates are excessive *issuing certificates of authority to insurance companies *creating insurance laws

creating insurance laws

Which of the following terms categorize insurers by their location or domicile? *domestic and international *internal and external *private, state, and national *domestic, foreign, and alien

domestic, foreign, and alien

Which term applies to an insurance company domiciled in one state but operating in another, from the perspective of the state in which it operates? *alien company *foreign company *unauthorized company *domestic company

foreign company

Long-term care (LTC) insurance does NOT cover which type of services? *nursing home services and home health-care services *health services for the poor *adult day-care services and residential community living services *respite care services (providing temporary respite for a family member who has assumed caregiving responsibilities)

health services for the poor

When does a waiver of premium rider release the insured from paying the policy's premium? *only when the insured is totally disabled *when the insured is partially disabled *A waiver of premium rider releases the insured from paying the policy's premium during a period of partial or total disability. *during the elimination period when benefits are not payable

only when the insured is totally disabled

Medicare supplement policies do NOT cover: *Medicare Part A deductible *an allowance for blood *prescription drugs *20 percent Part B co-payment

prescription drugs

In Colorado, can a business group of one qualify as a small group for purposes of obtaining group health insurance? *Yes, a business group of one can qualify as a small group. *Yes, but only if the business is formed as something other than a sole proprietorship. *Yes, but only with approval from the Commissioner. *No; a group of one is not a group.

Yes, a business group of one can qualify as a small group.

Beverly owns a small manufacturing business. Her sister, Rose, is her assistant. Beverly could not run the business without Rose. Beverly wants key employee disability insurance because: *It will increase the owner's salary to compensate for the extra work necessary while the key employee is disabled. *It will pay the key employee's wages to the employee during disability. *It will pay cash benefits to the employer if a key employee is disabled. *It will guarantee the business' profitability while the key employee is disabled.

It will pay cash benefits to the employer if a key employee is disabled.

Which of the following involves knowingly, and with the intent to defraud, making a written statement as part of a claim for benefits under an insurance policy? *a fraudulent act *a representation *a warranty *a misrepresentation

a fraudulent act

Steve is the beneficiary of his mother's accidental death and dismemberment policy. At her death, he receives the policy's death benefit in a lump sum. Which statement is correct? *The death benefit is not taxable income. *Only the capital sum is taxable. *The entire death benefit is taxable income. *Only the interest earnings are taxable income.

The death benefit is not taxable income.

In trying to minimize health care costs, a managed care provider emphasizes: *high deductibles *prevention *exclusion of dependent coverage *competition among health care providers

prevention

Which of the following is not a discriminatory practice in the business of insurance? *inquiring about the sexual orientation of an applicant *making a classification based solely on marital status *denying health-care coverage for someone who is a casual motorcycle rider *reducing health insurance benefits under a rider for conditions documented in an application for insurance

reducing health insurance benefits under a rider for conditions documented in an application for insurance

How long is the entire initial enrollment period (IEP) under Medicare? *four weeks *one month *three months *seven months

seven months

What does the insurer guarantee in health insurance policies that are guaranteed renewable? *that during the guaranteed renewable period, it will not cancel the policy or increase the premiums *that during the guaranteed renewable period, it will not cancel the policy and will increase premiums only on all policies of the same class *that during the guaranteed renewable period, it will not cancel the policy and will increase premiums only once every other year *that during the guaranteed renewable period, it will not cancel the policy though it may increase premiums on any policy

that during the guaranteed renewable period, it will not cancel the policy and will increase premiums only on all policies of the same class

When he applied for his individual health insurance policy, Lance forgot to mention that his mother had, and was successfully treated for, skin cancer several years before. His insurer discovers the error when he makes his first claim three years later. How will the policy respond? *The policy will be rendered void. *His claim will be denied. *The policy will pay the claim. *The policy will pay the claim if coverage applies.

the policy will pay the claim if coverage applies

Which of the following is required to contain all of the mandatory coverage provisions of Colorado health benefit plans? *the basic limited mandate health benefit plan *the basic HSA health benefit plan *the basic HSA limited mandate health benefit plan *the standard health benefit plan

the standard health benefit plan

When does a health insurer have the right to have an autopsy performed on the deceased insured? *when it is not prohibited by law *when it suspects suicide *when it suspects homicide *when only with the permission of the insured's family

when it is not prohibited by law