Guarantee Exam Questions Brian Caldwell

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An individual is approaching retirement age and is concerned about having proper coverage should he have to be placed in a LTC facility. His agent told him that LTC would provide necessary coverage at all of the following levels EXCEPT: A) acute B) custodial C) intermediate D) skilled

A) acute

When may HIV-related test results be provided to the MIB? A) only if the individual is not identified B) under all circumstances C) when given authorization by the patient D) only when the test is negative

A) only if the individual is not identified

Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy? A) submit the description in their own words on a plain sheet of paper B) be reimbursed any copayment or deductible on the claim C) demand full payment immediately for the claim D) speak with a claims adjuster or another representative from the insurance company

A) submit the description in their own words on a plain sheet of paper

Which of the following is a limited lines license? A) a business entity license B) a portable electronics insurance license C) a temporary insurance producer license D) a nonresident producer license

B) a portable electronics insurance license

An employee dies having 6 quarters of coverage during the previous 13-quarter period. What status of coverage does the employee have under Social Security? A) conditionally insured B) currently insured C) fully insured D) uninsured

B) currently insured

All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT: A) coverage for pre-existing conditions B) dollar limits on essential benefits C) guaranteed renewability D) coverage for emergency services

B) dollar limits on essential benefits

All of the following are requirements of policy forms that are issued for delivery in the state EXCEPT: A) the style or arrangement of the policy gives no undue prominence to any riders or endorsements B) the text archives a minimum Flesch scale readability score of 50 C) It is printed, except ofr tables, in not less than 12-point type D) it contains a table of contents or an alphabetical subject index

C) It is printed, in not less than 12-point type

Medicare Part A services do NOT include which of the following? A) hospitalization B) hospice care c) private duty nursing D) post hospital skilled nursing facility care

C) Private Duty Nursing

What is it called when a doctor accepts the Medicare approved amount? A) verification B) acceptance C) assignment D) consent

C) assignment

Which of the following is true regarding health coverage for mentally disabled children of the insured? A) coverage will terminate when the child reaches age 30 B) coverage is mandatory only until the age of 26 C) coverage must continue after the child reaches limiting age with proof of incapacity D) coverage is only available if purchased from a government plan

C) coverage must continue after the child reaches the limiting age with proof of incapability

Which statement is required to be printed on the first page of a health insurance policy, which signals to the insured that the policy's benefits are limited? A) statute of limitations B) limited benefit statement C) limited policy notice D) benefit notice

C) limited policy notice

An insurance agent visits a potential client and explains various types of policies. The customer displays a lack of interest, so the agent guarantees higher dividends than he knows would be possible. Which term best describes what the agent has done? A) twisting B) defamation C) misrepresentation D) rebating

C) misrepresentation

The license that allows a surviving spouse to enter into a contract to maintain the business of a producer who has died or is unable to perform his duties is called a: A) special broker license B) business entity license C) temporary insurance producer license D) public insurance producer license

C) temporary insurance producer license

An agent's first-year commission CANNOT exceed what percentage of the renewal commission for servicing a Medicare Supplement policy in its second year? A) 10% B) 50% C) 100% D) 200%

D) 200%

An insurance adviser's license may be issued to a corporation if the majority of the officers of the corporation: A) have completed, or are currently in, a formal prelicensing course of insurance producers B) are currently licensed as insurance producers and have completed the individual CE requirements C) are found by the Commissioner to be competent in all respects as insurance solicitors D) are found by the Commissioner to be in all respects qualified for licenses as advisers

D) are found by the Commissioner to be in all respects qualified for licenses as advisers

Regarding major medical plans: A) Higher stop-loss means higher premium B) lower stop-loss means level premium C) lower stop-loss means lower premium D) higher stop-loss means lower premium

D) higher stop-loss means lower premium

An employee is on an extended leave of absence when the employer group health plan changes from one carrier to another. Before the employee returns to work, what might the employee likely notice? A) increased benefits B) no change in coverage C) suspended coverage D) limited coverage

D) limited coverage

Regarding the PPACA health care tax credit, which of the following is true? A) tax credits are based upon a taxpayer's or family's expected annual medical expenses B) all wage earners who purchase a health care insurance are eligible for the tax credit C) tax credits are sent to the tax payer to reduce monthly insurance premiums D) persons receiving Medicaid are not eligible

D) persons receiving Medicaid are not eligible

All of the following statements about mutual insurance companies are correct EXCEPT: A) dividends allow policyholders to share in a mutual company's divisible surplus B) dividends are a return of unused premiums C) mutual companies issue policies referred to as participating D) policy dividends issued by mutual companies are guaranteed and not taxable

D) policy dividends issued by mutual companies are guaranteed and not taxable

MassHealth is a health insurance program available to: A) any residents of MA who are over the age of 65 B) any person who becomes sick or injured in the Commonwealth C) all residents of MA D) residents of MA who meet certain income level requirements

D) residents of MA who meet certain income level requirements

An employer is no longer able to afford the group health insurance plan and the plan terminates. However, one of the employees continues to receive coverage under the plan. Which of the following explains the reason for the continued coverage? A) the employee is an executive covered under the plan B) the employee's health savings account pays for the coverage C) a nonforfeiture value is in place D) the employee is totally disabled

D) the employee is totally disabled

In group health insurance, what is experience rating? A) the larger the group, the more experienced the agent assigned to the policy B) when a larger group gets higher premiums due to its relatively higher health costs C) when a larger group gets lower rates because its median age is fairly low D) when an insurer uses the experience of the group as a whole to determine premiums

D) when an insurer uses the experience of the group as a whole to determine premiums


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