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