guaranteed health exam try 1

A retail shop owner is insured under a business overhead expense policy that pays a maximum monthly benefit of $2,500. His actual monthly expenses are $3,000. If the owner becomes disabled, the monthly benefit payable under his policy will be

$2,500

what is the max increase in health insurance rates that an insurer can impose on a small employer in one year due to claim experience

15%

how many days after passing their state exam does an applicant have to apply for a license

180 days

an agents first year commision cannot exceed what percentage of the renewal commission for servicing medicare supplement policy in its second year

200%

To be acceptable to insurance companies, what percentage of eligible employees must be enrolled under a contributory group health insurance plan? a) 65% b) 75% c) 100% d) 50%

75%

if an insurer decides to discontinue a specific type of group health insuance plan, how many days before the day of discontiunuation must the empolyer and covered employees be notified

90 days

a statement made by a policyholder that promotes the insurer and its policy by describing benefits favorable treatment or other experience under a policy is called

a testimonial a statement made by a policyholder or certificate holder which promotes the insurer and its policy by describing such persons benefits favorable treatment or other experience under the policy

which of the following insurance principles state that ambiguities in a policy will always be construed in favor of the insured

adheason the insured has to sign to adhere to an contract because of this, the policy will be interpreted in favor of the insured

which of the following is not an allowable reason for policy cancelleation prior to its experiation date

any misrepresentation by the insured insurance policies may be cancelled by the insurer prior to the expiration of the agreed term for all the reasons stated above execpt for a nonmaterial misrepresentation of the insured

what is it called when a doctor accepts the medicare approved amount

assignment

conrad receives $50,000 from a $100,000 accidental death and dismemberment policy as a result of the loss of his left arm in an accident. conrad has received the

capital amount capital amount is usually 50% of the principal, and paid for loss of a single body part.

which of the following elements of an insurance contract requires payment of premium

consideration consideration on the part of the insured is the promise to pay in the event of loss

which of the following meets the insured's personal needs and is provided by nonmedical personnel

custodial care it is the meeting personal needs such as assistance in eating dressing or bathining provided under a doctor's orders by a non medical personnel

If an agent follows the rules and terms of his agent contract, he is exercising his

express authority express authority is the legitimate authority written into an agent contract

which of the following is not a medicaid qualifer

insurability

all of the following are used to keep costs down for dental insurance except

limitation on the number of teeth that may be treated in a given year

credit disability insurance will pay

monthly payments until the insured recovers or the loan is paid off

Under ACA, when would pregnancy be considered a pre-existing condition?

never

When may HIV-related test results be provided to the MIB?

only if the individual is not identified insurance companies must maintain strict confidentiality regarding HIB related test results or diagnoses. test results may not be provided to the MIB if the individual is identified

all of the following would be considered advertisment on the part of the insurer execpt

printer materials for soliciting company employees

hmos are known fas what type of plans

service

medicare is a health insurance program for all the following individuals execpt

those with low income and low assets

if an insured purchases an insurance policy with a large deductible, what risk management technique is the insured exercising

retention when an insured purchased a policy with a large deductible, they received a lower premium rate, in return for the lower premium rate, the insured was required to retain a larger amount of a loss should it occur

what does the application of contract of adhesion mean

since the insured does not participate in preparing the contract, any ambiguites would be resolved in favor of the insured

Once the initial benefit limit in Medicare Part D is reached, how is the beneficiary affected?

the beneficiary is then responsible for a portion of prescription drug costs once the initial benefit limit is reached, the beneficiary is responsible for paying 25% of the prescription drug costs

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

the employee is totally disabled

an acceptable reason that a colorectal cancer examination for an insured under the age of 50 will be covered by a disability policy would be

the insured is at high risk for cancer

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 covereage?

the physician can request an individual exemption from the insured insurers use a formulary or other list of preapproved drugs and devices must have a process to permit a physician to request an individual exemption for coverage of a drug or device not normally covered under the plan

an applicant completes an app for a disability policy and pays the initial premium. the producer gice the applicant a conditional reciept. when does insurance covereage for the app become effective

when the insurance company accepts the risk

under the madatory uniform provision notice of claim, written notice of a claim must be submitted to the insurer within what time parameters

within 20 days