Exam fX questions

An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescription drug cost is the insured responsible for paying?

25%

Disclosure statements issued to an applicant for a Medicare supplement policy in this state must include or prominently displayed all of the following information except

A commission payable to the producer

Of $10,000 in premiums a producer wrote over the past year, $3,000 came from sales to a business which employs the producer's spouse. This is considered

A legal practice

In order to reduce the premium to the lowest monthly amount on his disability income policy, the insured could choose

A longer elimination period and a shorter benefit period

When transacting business in this state an insurer formed under the laws of another country is known as/an

Alien insurer

Which of the following is a requirement for standard Medicare supplement plans

All plans must offer the core benefits

Which of the following persons would qualify for Medicare Part A

Anyone who has permanent kidney failure

To be eligible for tax credits under the ACA, individuals must have income that is what percent of the Federal Poverty Line

Between 100% and 400%

If both parents have family coverage on their respective group health plans and both of the plans include a coordination of benefits clause which of the following methods would be used to split a claim payment for a covered child

Birthday rule

HMOs operate on what basis?

Capitated

If an employee is injured on the job, which of the following will NOT be a standard benefit through Worker's Compensation

Caregiver benefits

All of the following features of a medical plan are expressed as a set dollar amount EXCEPT

Co-insurance

All of the following features of a medical plan are expressed as a set dollar amount EXCEPT

Coinsurance

In NY, how much all medical expense health insurance sold to individuals or small groups be rated

Community rated

Which of the following types of health insurance options will generally cover any sickness or accidents

Comprehensive policy

Which of the following standards is used to determine premiums rates under the Affordable Care Act

Family composition

What phase begins after a new policy is delivered?

Free-look period

All of the following are characteristics of group health insurance EXCEPT

Groups may be formed for the purpose of purchasing insurance

To be eligible for a Health Savings Account, an individual must be covered by a

High-deductible health plan

Which of the following is NOT covered under Medicare Part B?

Hospital room and board coverages

Under which of the following circumstances may the uniform individual accident and sickness policy provisions should be changed

If the change is more favorable to the policyholder

Medicaid provides all of the following benefits EXCEPT

Income assistance for work-related injury

Which of the following refers to "own occupation" disability?

Insured is unable to perform duties of the occupation for which he/she was educated and trained

All of the following statements regarding Medicare Supplement insurance are true EXCEPT

Insurers use the traditional risk rating of preferred, standard, and substandard in underwriting

Regarding health insurance coverage for small groups, insurers are permitted to do any of the following EXCEPT

Limit enrollment to a specific number

Which of the following types of health policies cover medical and hospital expenses, and have deductibles, coinsurance, and high maximum limits

Major medical policies

The term "subscriber" is most commonly associated with which type of medical plan?

Managed care

Which of the following is a private health insurance plan?

Medicare supplement policies

According to the Unpaid Premium provision in health insurance policies, what will the insurer do if the insured missed a premium payment and then submitted a claim

Pay the claim but withhold the amount of the premium due

Which of the following is a characteristic of PPOS?

Plan members who use the services of an in-network facility will pay a lower amount

A guaranteed renewable health insurance policy allows the

Policyholder to renew the policy to her stated age with the company having the right to increase premiums on the entire class

When a health care insurers negotiate contracts with health care providers or physicians to provide health care services for subscribers at a favorable cost, it is called

Preferred Provider Organization (PPO)

All of the following is true regarding key person disability income insurance EXCEPT

Premiums are tax deductible as a business expense

An insured owns a disability policy and is in an accident which leaves him permanently blind. Which of the following provisions in a disability policy would qualify the insured for benefits, even if the insured is able to resume working?

Presumptive Disability

LTC coverage may be provided by any of the following EXCEPT

Rider to Medicare Part A

For which of the following reasons can the Department of Financial Services issue a temporary license?

Servicing existing business

Which of the following terms defines an illness that first appears when the policy is in force?

Sickness

Which of the following terms defines an illness that first appears while the policy is in force

Sickness

When an insured chooses the indemnity method of benefit payment, the insurer will pay

The fixed benefit amount, regardless of the actual charge

The Affordable Care Act requires all US citizens and legal residents to have qualifying health care coverage. This is known as

The individual mandate

If an insured has had a New York State Partnership LTC policy for 3 years, and is now eligible for Medicaid benefits, what will happen to the LTC policy assets

The insured will retain all assets

An agent who solicits and files applications for the sale of life insurance represents

The insurer

All of the following characteristics are required in order to establish a group health plan for an association EXCEPT?

The plan must be contributory

Which of the following is an example of a producer's fiduciary duty?

The trust that a client places in the producer in regard to handling premiums

Which of the following is NOT the purpose of the HIPAA?

To provide immediate coverage to new employees who had been previously covered for 18 months

When does the free-look period begin in insurance policies

When the policy's delivered