Attempt 3
If an agent does not notify the insurer of an address change, what is the maximum penalty that can be imposed for a one-time offense?
$250
L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay?
$900 (deductible + 20% of the bill after the deductible [20% of $2,000])
A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?
15 days
Which of the following disability income policies would have the highest premium?
15-day waiting period / 10-year benefit period
If a parent would like to enroll a child over the age of 5 into the Florida Healthy Kids program, their family income must be under a certain percentage of the federal poverty level. What percentage?
200%
In the state of Florida, it is illegal for a licensee's commissions from controlled business to exceed what percentage of the total in a given year?
50%
What is a material misrepresentation?
A statement by the applicant that, upon discovery, would affect the underwriting decision of the insurance company
Which of the following is true regarding branch agency licensing?
Agent in charge must be licensed.
All of the following would be considered rebating EXCEPT
An agent misrepresents policy benefits to convince a policyowner to replace policies.
Which of the following terms describes making false statements about the financial condition of any insurer that are intended to injure any person engaged in the business of insurance?
Defamation
Circulating deceptive sales material to the public is what type of Unfair Trade Practice?
False advertising
No insurance policy form can be issued, delivered, or used in this state unless it has been
Filed with and approved by the Office of Insurance Regulation.
Which of the following types of LTC is NOT provided in an institutional setting?
Home health care
The Medical Information Bureau (MIB) was created to protect
Insurance companies from adverse selection by high risk persons.
A guaranteed renewable disability insurance policy
Is renewable at the insured's option to a specified age.
Which of the following is INCORRECT concerning Medicaid?
It is solely a federally administered program.
Which of the following does NOT describe hospice care?
It provides care to people with life expectancies of 1 to 2 years.
Premium payments for personally-owned disability income policies are
Not tax deductible.
Under which of the following organizations are the practicing providers compensated on a fee-for-service basis?
PPO
All of the following long-term care coverages would allow an insured to receive care at home EXCEPT
Skilled Care
Which of the following would be a qualifying event as it relates to COBRA?
Termination of employment due to downsizing
Which of the following protects consumers against the circulation of inaccurate or obsolete personal or financial information?
The Fair Credit Reporting Act
Which of the following is NOT covered under Plan A in Medigap insurance?
The Medicare Part A deductible
Which statement is NOT true regarding underwriting group health insurance?
The group is assessed individually for insurability.
Which of the following is an agreement between an insured and an insurer, where the insurer agrees to indemnify the insured for specific losses in exchange for a premium?
The insurance contract
An insured submitted a notice of claim to the insurer, but never received claims forms. He later submits proof of loss, and explains the nature and extent of loss in a hand-written letter to the insurer. Which of the following would be true?
The insured was in compliance with the policy requirements regarding claims.
When an insurer appoints an agent,
The insurer is bound by the agent's acts.
Which of the following is true regarding METs?
They allow several small employers purchase less expensive insurance together.
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?
Time of Payment of Claims
Which provision states that the insurance company must pay Medical Expense claims immediately?
Time of Payment of Claims
When can a Long-Term Care policy deny a claim for losses incurred because of a pre-existing condition?
Within 6 months of the effective date of coverage