Missed Questions - Health Guarantee Exam

To attain "fully insured" status under social security, an individual must have worked and contributed to social security for at least ____ calendar quarters:

40 (which is 10 years)

An employee that becomes ineligible for group coverage because of termination of employment or change in status must exercise benefits under COBRA within...

60 days

An agent delivers a policy to an applicant, but the applicant does not give a statement of good health. The applicant is in violation of...

Consideration

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?

Currently insured

Carlos's health insurance policy pays benefits according to a list which indicates the amount that is payable under each type of covered procedure. This means that it provides benefits on a...

scheduled basis

All of the following are characteristics of catastrophic plans except...

high premiums

If a producer replaces a Medicare supplement plan with a more comprehensive plan, the insurer must...

Issue coverage without proof of insurability

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

Never **All insurance plans must cover pregnancy and childbirth

An insured has a disability income policy with a 30 day waiting period. If they get injured within the 30 days, what would the insured receive?

Nothing

Who has the authority to make changes to an existing policy?

Only the executive officer of the insurance company

What type of insurers use a formal sharing agreement?

Reciprocal insurer

Who is responsible for verifying that an insurer is authorized to sell insurance in this state?

Soliciting producers

Before an insurer can contract business in a state, they need to meet the _____________________ requirements.

Solvency

If an insured submits a written proof of loss, what is the maximum amount of time after the submittal that the insured has to negotiate legal action?

3 years

A change in a health insurance policy would only be valid if approved by...

A CEO of the insurer

What is a prerequisite for receiving commission from an insurance transaction?

An appropriate license

A major medical expense would not exclude coverage for something like...

drug addiction

Whose responsibility is it to ensure than an application for health insurance is complete and accurate?

The agent's

Darryl is involved in an automobile accident with another motorist. Darryl was at fault. What will disability pay for?

Darryl's loss of income.

All of the following are features on a health insurance plan purchased in the health marketplace except...

Dollar limits on essential benefits