Health exam

100% of the amount paid to the insurer.

A Medicare supplement policy is returned to the issuing insurer 10 days after policy delivery. What portion of the premium will be refunded to the policy owner?

Medical expense insurance.

A PPO provides which type of insurance protection?

An indemnity plan

A medical insurance plan that pays a fixed amount regardless of the actual charge is called?

A. Controlled Business

A producer who writes a majority of his insurance business on the employees and officers of a restaurant owned by his wife is transacting? A. Controlled Business, B. Replacement Business, C. Surplus Lines Business, D. Group Insurance Business.

Limited

Carl purchases a round-trip travel accident policy at the airport before leaving on a business trip. Which type of insurance is his policy?

Defamation

Circulation of a maliciously critical statement about an insurer's financial condition to damage the insurer's reputation or business is an unfair practice known as?

B. Education

Factors used by health underwriters to classify risks would include all the following EXCEPT? A. Age, B. Education, C. Occupation, D. Lifesyle

Cannot be converted to an individual's or firm's own use.

Funds held by an insurance producer in a fiduciary capacity?

A disclosure of protected health information.

Health Insurance Portability and Accountability Act (HIPAA) imposes requirements on health care providers with respect to.

B. 60

How many days must the insured wait to take legal action against a health insurer after submitting written proofs of loss if the insurer refuses to pay? A.90,B.60,C.20,D.15

A medical expense policy.

Jeff has a policy that will pay expenses he incurs as the result of in-hospital medical treatment, as well as some of the expenses he incurs on an outpatient basis. Jeff was probably has

D. Stop Loss

Major Medical Policies that pay 100% of covered expenses above a specified amount contain what kind of provision?

A.15

Once the insurance company receives a notice of a claim, how many days do they have to send the claim form? A.15, B.30,C.90, D. 20

C. Individual health insurance applicants.

The Medical Information Bureau provides information about? A. Insurance co health underwriting practices, B. Producers and agents who are licensed to sell health and long-term insurance, C. Individual health insurance applicants, D. doctors and surgeons associated with health insurance companies.

Issue the policy with an impairment rider

The insured takes out a policy and states they have had several surgeries for a recurring problem with calcium deposits on the knee. The insurance company likely do which of the following?

D. 5 mo.

The waiting period to qualify for Social Security disability benefits is? A. 6 mo. B. 3 mo., C. 12 Mo. D. 5 mo.

Is terminated due to gross misconduct.

Under COBRA, the right to continue existing group health coverage is NOT available to the an individual who?

D. Ethical Conduct

Using simple, layman's language while discussing insurance concepts, refraining from making inaccurate remarks about other agents or insurers, and placing customer interests above one's own are all examples of an agent's?

B. Genetics test conducted in a medical lab w/o full disclosure.

What would be acceptable source of information for health insurance underwriting expect? a. Consumer credit B. Genetics test w/o full disclosure. C. EKG D. Attending physician statement

Promptly submitting an insured's premium to the home office.

When agents uphold their fiduciary duty an example of this is?

Entire contract clause

which provision states that the application is part of the contract and nothing can be incorporated by reference?

Individuals who created a special club in order to purchase insurance on a group basis.

All of the following would be recognized as a true "group" for insurance purposes EXCEPT? A. Members of Labor Union B. Employees of Municipality C. Employees of Hospital D. Individuals who created special club in order to purchase insurance on a group basis.

C. Suitability standards

An agent who takes into account the applicant's financial goals and needs, ability to pay for the proposed coverage, and the applicant's existing coverage prior to making a purchase recommendation is complying with the industry's? a. unfair trade practices req. b. policy replacement laws, C. suitability standard, d. duty of good faith and fair dealing laws. D. duty of good faith and fair dealing laws.

Preexisting conditions clause

An insured gets major medical policy delivered on Sept. 1 and is told by her doctor on Sept 7 that she is 2 months pregnant. The condition is NOT covered because of which of the following?

B. Primary

An insured is covered under a group health insurance plan by their employer, and they are also covered by their spouse's plan. Under the Model Coordination of Benefits Act, what is the insured's policy considered? A. Excess, B. Primary, C. Surplus, D. Secondary

Unfair discrimination is demonstrated by this situation.

An insurer assigns a premium rating to an applicant because of studies that suggest members of the applicant's race have a shorter-than-average life expectancy.

To apply financial incentives that reduce the quantity and cost of services.

Which of the following is a goal of managed care?

Hospital indemnity

Which of the following policies pays a fixed hospital benefit directly to the insured,regardless of the actual hospital expenses incurred?

noncancelable

Which type of health insurance policy prevents the insurer from changing the premium rate or modifying the coverage in any way?

COBRA (Consolidated Omnibus Budget Reconciliation Act) requires

employers with 20 + employees to allow former employees to continue benefits under the employer's group health insurance plan.