FSI Ch 29

All of the following provisions are mandatory in health insurance policies EXCEPT

Change of Occupation

Which of the following is considered a "cost containment" measure of health policies?

Coordination of benefits

All of the following statements regarding group health insurance are correct EXCEPT

Coordination of benefits is required between group policies and Medicare supplements

Which of the following statements is correct about coverage for a handicapped member who reaches adulthood?

Coverage continues if the member is chiefly dependent on the policyholder

Group health insurance policies are required to provide all of the following EXCEPT

Coverage for dental expenses

At what point in time can a policyholder file suit against a health insurance company for failure to pay a claim?

60 days after filing proof of loss

All of the provisions are required by Florida law for group health insurance policies EXCEPT

Coverage must continue until age 25 for a handicapped child that is a family member

All of the following are correct about the required provisions of a health insurance policy EXCEPT

A reinstated policy provides immediate coverage for an illness

Which of the following is NOT provided in a proof-of-loss form?

A statement from the attending physician

Florida's Long Term Care Partnership Program provides which of the following?

Asset protection

If a health insurance policy-owner changes jobs to a more hazardous occupation, which of the following could apply?

Benefits could be reduced if the policy so provides

Legal action may not be taken after how many years from filing a health insurance claim proof of loss?

Five years

Florida's Long Term Care Partnership Program must provide which of the following coverage?

Inflation coverage

Which of the following statements is correct about a group health insurance policy?

It can provide coverage for handicapped children

Which of the following applies to the 10-day free-look privilege in a health insurance contract?

It permits the insured to reject the policy within 10 days of policy delivery and receive a full refund.

A grandfathered health plan means a health plan that was issued on or prior to

March 23, 2010

A health maintenance organization provides which of the following?

Preventive health care for its members

Which of the following practitioners is NOT defined as a "physician" under Florida law?

Sports therapist performing services in a health club

Individual and group health insurance policies and HMO contracts can be canceled for all of the following reasons EXCEPT

The insured develops a serious illness

In which of the following situations is a group health insurance policy NOT required to provide coverage?

Treatment for an occupational illness or injury

A group credit disability policy may be issued to a creditor if the expected new entrants into the plan

are at least 100 persons yearly

All of the following provisions are required by the Florida Employee Health Care Access Act except

coverage must always be renewed by carriers

Florida's "mini-COBRA" applies to employers with

less than 20 employees

The notice to the insurance company of a health insurance claim must include

name of insured

If a health insurance company tests a person for AIDS/HIV which of the following must be signed?

notice of informed consent

All of the following statements about the Outline of Coverage for health insurance policies are correct EXCEPT

principal benefits also shown on the policy need not be included