Missed Questions Accident and Health State Exam Simulator
Health insurance will typically cover which of the following perils?
Injury due to accident
A doctor who accepts Medicare Assignment agrees to which of the following?
Doctor cannot charge more than Medicare's scheduled coverage
What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?
Dread disease policy
Benefits for a Medicare Supplement policy
Must not duplicate Medicare benefits
What is the tax liability for employer contributions in Health Savings Accounts (HSA's)?
No tax payment needed
Disability Income plans which requre that the insurer can NEVER change or alther premium rate are usually considered
Noncancellable
All Health Benefit Plans issued after January 1, 2014 must provide
Preventative health services
What is the purpose of the Medical Information Bureau(MIB)
TO help underwriters evaluate risk
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must
be the same and the premium cannot exceed 102%
Preferred risk policies with reduced premiums are issued by insurance companies because the insured has
better than avg mortality or morbidity experience
Medicare provides coverage for each of the following EXCEPT - hospital room and board - doctor and surgeon services -prescription drugs - custodial care
custodial care
Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)
deductible
A pharmacy benefits covers prescription drugs derived from a list called a(n)
drug formulary
Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the
employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan
Key Person Disability Insurance pays benefits to the
employer
A field underwriter's main task is to
ensure an applicant's medical info is accurate and complete
The waiting period for a disability insurance policy
excludes payments for a short-term illness or injury
A payment system for health care in which the provider is paid for each service given is called
fee-for-service
An indemnity plan
provides the insured a specific dollar amount for services
Karen is a producer who has obtained personal information about a client without having a legitimate reason to do so. Under the McCarran-Ferguson Act, what is the minimum penalty for this?
$10,000
The typical long-term care policy is designed to provide a minimum of ____ year(s) of coverage 1 3 5 7
1
Which of the following is NOT taken into consideration when determining eligibility for Medicare benefits
Income
Sole proprietors are permitted tax deductions for health costs paid from theri earnings in the amount of
100% of costs
After a disability policy has been in force for ___ year(s), it is considered incontestable. - 1 -2 -3 -4
2
Long-term care insurance and Medicare Supplement plans have a free-look period of ______ days
30
Prior to a disciplinary hearing the director is required to give at least ____ days notice
30 days
As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer.30%40%50%60%
50%
What percentage of a participants income are group long term disability benefit amounts typically limited to
60%
Proof of loss on a health insurance claim must be submitted to an insurer within _____ days after the insured's date of loss
90 days
Which of the following is an example of the insured's consideration?
A paid premium
The term which describes the fact that both parties of a contract may not receive the same value is referred to as
Aleatory
The waiver of premium does NOT include which provision
All future premiums are waived if the insured recovers from the disability
The deeds and actions of a producer indicate what kind of authority
Apparent
Implied authority is defined as
Authority that is not specifically given to an agent in the agency contract, but that an agent can reasonably assume to carry out his.her duties
A disability policyowner is injured and becomes totally disabled. The benefits pay for 2 years, starting from the date of the injury. What is this time period called?
Benefit period
XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?
Benefits are fully taxable
Which of the following would be considered an underwriting duty of an agent
Completing all applications and collecting initial premiums
Which of these is NOT a qualifying event for MEdicare
Falling below the federal poverty level
Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance?
Hospital Indemnity
The authority granted to a licensed producer is provided via the - producers apparent authority - written contract -Law of Agency - Principal Capacity
Law of Agency
How do insurers predict the increase of individual risks?
Law of large numbers
Which contract element is insurable interest a component of?
Legal Purpose
The election of COBRA for continuation of health coverage will
Maintain the same coverage and increase premium
Which type of plan would be most appropriate for an individual on Medicare and is concerned that Medicare will not pay for charges exceeding the approved amount?
Medicare supplement Plan F
Which of the following is a legal entity created for the sole purpose of providing affordable group health coverage to its participants
Multiple Employer Welfare Arrangement (MEWA)
Insurance policy that is renewable only at the option of the insurance company. Policy is considered to be
Optionally renewable
Typically, Long-Term Disability benefits are coordinated with which benefit plan?
Social Security
What is the elimination period of an individual disability policy?
Time period a disabled person must wait before benefits are paid
A medical provider that accepts Medicare Assignment must
accept payment based upon a defined Medicare schedule as a payment in full
An underwriter's primary responsibility to an insurer is to protect against
adverse selection
MEdical expense would cover
an injury occurring at the insured's residence
The power given to an individual producer that is not specifically addressed in his/her contract is considered what type of authority?
implied authority
An accident and health policy that provides reimbursement benefits makes them payable to the
insured
A dread disease policy is considered to be a type of
limited health insurance policy
The reinstatement provision in a health insurance policy is
mandatory
Group health plans may deny participation based upon the
member' part time employment status
Which of the following is NOT an example of utilization review
on going inspection of accident prone individuals
A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n)
optional renewability clause
States that have "no loss no gain" laws require a replacing policy to
pay for ongoing claims under the policy it replaces
The date when you receive coverage is when
premium paid and when the effective date is
In an insurance contract, the applicant's "consideration" is the
statements made in the application and the premium
Distributions from a Health Savings Account (HSA) for qualified medical expenses are
tax free
The MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes
the entire insurance contract between parties
MAjor Medical expense plans provide coverage for each of the following EXCEPT
work related injuries