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With a few exceptions, every disability policy must provide coverege for periodic mammograms for a woman starting at what age

45

According to the metal level classification of health plans, what percentage of health care costs will be covered under a gold plan

80%

If an insurer decides to discontinue a specific type of group health plan, how many days before the date of discontinuation must the employer and covered employees be notified?

90 days

Which of the following is a daily nursing and rehabilitation care that can only be provided by medical personnel, under the direction of a physician?

Skilled Care

Under the long term care marketing regulations, which of the following questions would a producer NOT have to ask the applicant in order to determine if the purchase is suitable?

How much are you able to pay in premiums?

What is the grace period for a monthly policy

10 days

If an individual willfully violates provisions of the Fair Credit Reporting Act, what is the max civil penalty

2500

An insurer must notify in writing that an investigative consumer report has been requested, within how many days of the initial request?

3 days

An individual is approaching retirement age and is concerned about having proper coverege should he have to be placed in a Long Term Care facility. His agent told him that LTC policies would provide necessary coverege at all of the following levels EXCEPT

Acute

Which rider, when added to a disability policy, pays income during the six month waiting period before social security benefits can begin?

Additional Monthy benefit

What is called when a doctor accepts the medicare approved amount

Assignment

An underwriter is reviewing an applicant with an extensive medical history. Which of the following would give the underwriter a better understanding of how the applicant has been treated for various illnesses

Attending Physician's statement

HMO members pay a small fee when they see their primary care physician. This fee is called a

Copay

Darryl is involved in a automobile accident with another motorist. Darryl was at fault. Darryl was injured and hospitalized for 2 months. The other motorist suffered 15000 of medical expense as a result of the accident. Darryl's disability income policy will pay

Darryl's loss of income

Which of the following are considered activities of daily living in most long term care policies

Eating and dressing

All of the following health insurance disability benefits are income tax free EXCEPT

Employer-paid group disability

The presumptive disability provision assumes that the insured is totally disabled upon loss of all of the following EXCEPT

Feeling

An individual buys a disability policy May 1 with a waiver of premium rider. The insured becomes disabled June 1st. It is determined the insured is permanently totally disabled on July 1st, and he recieves his first benefit payment on July 15. When does the waiver of premium provision start

June 1

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?

Limited Policy Notice

Medicare Part B covers all of the following EXCEPT

Long-term care services

Dennis has a cavity filled. His insurer covers his claim up to a predetermined amount, which is indicated by a fee schedule. Which type of plan does he have?

Scheduled.

A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT

Part A deductable

What is another term for health insurance policy subscriber?

Participant

Which of the following does NOT need to be included on the first page of a Medicare supplement policy?

Premium rates

In group insurance, the primary purpose of the Coordination of Benefits provision is to

Prevent overinsurance

Utilization management consists of an evaluation of the appropriateness, necessity, and quality of health care, and may include

Prospective and concurrent review

Which of the following terms relates to disability income insurance?

Residual benefit

Which of the following is NOT a characteristic of a Managed Care Plan?

Risk Retention

All of the following are reasons for group insurance terminations for dependents EXCEPT

The dependent reaches age 21

If a drug is not covered on an insurer's formulary or other list of preapproved drugs and devices, what can be done to provide coverege

The physician can request an individual exception from the insurer

What is the purpose of the interstate insurance product regulation commission

To provide insurers a single point of filing of insurance policy forms

In group health insurance, what is experience rating?

When an insurer uses the experience of the group as a whole to determine the premium.

An employee that becomes ineligible for group coverege because of termination of employment or change in status, must exercise extension of benefits under COBRA

within 60 days


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