Health Test
Which of the following is NOT true regarding an optionally renewable policy? a) Insurer can only cancel the policy for reasons stipulated in the contract. b) Renewability is at the option of the insurer. c Nonrenewal can happen on the policy anniversary date. d) Policy premiums can increase at renewal
A
When may HIV-related test results be provided to the MIB? a) When given authorization by the patient b) Only when the test results are negative c) Only if the individual is not identified d) Under all circumstances
C
Each insurer that sells, solicits, or negotiates any form of limited line credit insurance must provide to each individual whose duties will include selling, soliciting, or negotiating limited line credit insurance a) A copy of the Department of Insurance rate plan schedule. b) A course of training that certifies each individual for an insurance solicitor's license. c) A copy of the Fair Credit Reporting Act of 1991 and a program of instruction for its use. d) A program of instruction that may be approved by the Commissioner
D
What is another term for a health insurance policy subscriber? a) Participant b) Underwriter c) Dependent d) Beneficiary
A
What is it called when a doctor accepts the Medicare approved amount? a) Assignment b) Consent c) Verification d) Acceptance
A
A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT a) Part A deductible b) First 3 pints of blood c) 20% of Part B coinsurance amounts for Medicare-approved services d) Part A coinsurance
A
Guaranteeing future dividends is considered to be an unfair or deceptive act known as a) Misrepresentation. b) Twisting. c) False financial statements. d) Rebating.
A
HMOs are known as what type of plans? a) Service b) Health savings c) Consumer driven d) Reimbursement
A
All of the following are true regarding the federal Fair Credit Reporting Act EXCEPT a) The customer must be notified if adverse action is taken as a result of a report. b) Reports may be sent to anyone who requests one c) Insurers are not required to give customers a copy of the report. d) It applies to credit reports ordered in connection with insurance, banking and employment.
B
All of the following statements are goals of TRICARE EXCEPT a) Provide faster, more convenient access to civilian health care. b) Create a more limited system of health care. c) Control escalating costs. d) Improve overall access to health care for members.
B
A person receives his Medicare supplement policy and is not satisfied with the provisions. He can return the policy for a full premium refund if he does so within how many days? a) 10 b) 15 c) 20 d) 30
D
All of the following are requirements of policy forms that are issued for delivery in the state EXCEPT a) It is printed, except for tables, In not less than 12-polnt type b) It contains a table of contents or an alphabetical subject index. c) The style or arrangement of the policy gives no undue prominence to any riders or endorsement d) The text achieves a minimum Flesch scale readability score of 50
A
Which of the following is NOT correct concerning taxation of disability income benefits? a) If paid by the individual, the premiums are tax deductible b) If the employer paid the premiums, income benefits are taxable to the insured as ordinary income c) If the insured paid the premiums, any disability income benefits are tax free. d) If the benefits are for a permanent loss, they are not subject to income taxation no matter who paid the premium.
A
An employee is on an extended leave of absence when the employer group health plan changes from one carrier to another. Before the employee returns to work, what might the employee most likely notice? a) Suspended coverage b) Limited coverage c) Increased benefits d) No change in coverage
B
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? a) A nonforfeiture value is in place. b) The employee is totally disabled. c) The employee is an executive covered under the plan. d) The employee's health savings account pays for the coverage.
B
Regarding the PPACA health care tax credit, which of the following is true? a) Tax credits are sent to the tax payer to reduce monthly insurance premiums. b) Persons receiving Medicaid are not eligible. c) Tax credits are based upon a taxpayer's or family's expected annual medical expenses. d) All wage earners who purchase a health care insurance are eligible for the tax credit.
B
Under the Affordable Care Act, when would pregnancy be considered a pre-existing condition? a) Always b) Never c) Only if specifically excluded by the insurer d) If it begins before the coverage takes effect
B
Utilization management consists of an evaluation of the appropriateness, necessity and quality of health care, and may include a) Preventive care. b) Prospective and concurrent review. c) Cost-saving services. d) Coordination of benefits.
B
Which of the following insurance principles states that ambiguities in a policy will always be construed in favor of the insured? a) Utmost good faith b) Adhesion c) Unilateral d) indemnity
B
Which of the following time periods is the general enrollment period for Medicare Part B? a) March 1 through March 31 each year b) January 1 through March 31 each year c) March 1 through May 31 each year d) January 1 through January 31 each year
B
Who determines if a particular group of employees can be excluded from group health coverage? a) The insurer b) The employer c) The employee union d) The Department of Insurance
B
All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT a) Coverage for emergency services. b) Coverage for pre-existing conditions. c) Dollar limits on essential benefits. d) Guaranteed renewability.
C
All of the following are places where care can be administered for a medical plan EXCEPT a) Surgicenters. b) Urgent care centers. c) Eye centers d) Doctor's office.
C
All of the following could quality as a group for the purpose of purchasing group health insurance EXCEPT a) Multiple employer trust. b) Single employer with 14 employees. c) An association of 35 people. d) Labor union.
C
An employee is covered under COBRA. His previous premium payment was $100 per month. His employer now collects $102 each month. Why does the employer collect an extra $2? a) Premiums go up every year regardless of health conditions b) To cover other employees who qualify to bypass premium payment c) To cover the employer's administration costs d) Penalty for termination
C
An insured recently received his major medical insurance policy. Only 20 days after the policy issue, while recreational rock climbing, the insured suffered a fall that required hospitalization, surgery and physical therapy to repair his broken leg. Which of the following is true? a) The plan will not cover the expenses because the elimination period is not satisfied. b Only the surgery is covered under the plan. c) Both a deductible and colnsurance payments will be required. d) The plan will not cover the expenses due to the hazardous avocation
C
If an insured decided to reduce the coinsurance amount on her major medical insurance, what can the insured expect? a) A lower lifetime benefit payout b) Stop-loss increase c) A higher monthly premium d) A higher deductible
C
If an insured purchases an insurance policy with a large deductible, what risk management technique is the insured exercising? a) Avoidance b) Sharing c) Retention d) Transfer Only
C
Under the long-term care marketing regulations, which of the following questions would a producer NOT have to ask the applicant in order to determine If the purchase is suitable? a) Are you planning to replace an existing health insurance? b) What is the amount of your existing health or long-term care Insurance? c) How much are you able to pay In premiums? d) Do you currently have any Medicare supplement policies?
C
Which of the following statements is INCORRECT? a) The physical exam and autopsy provision gives the insurer the right to examine the insured as often as may be reasonably necessary while a claim is pending. b) The insurer also has the right to conduct an autopsy, if not forbidden by state law. c) The insurer does not have the right to conduct an autopsy. d) The physical exam and autopsy provision gives the insurer the right to examine the insured, at its own expense.
C
An agent's first-year commission CANNOT exceed what percentage of the renewal commission for servicing a Medicare Supplement policy in its second year? a) 10% b) 50% c) 100% d) 200%
D
If a person qualifies for Social Security disability benefits after the 5 month elimination period, when will benefits begin? a) Benefits begin at the beginning of the 6th month and are retroactive to the beginning of the disability. b) Benefits will begin after the 6th month and are retroactive to the beginning of the disability. c) A lump-sum of benefits will be paid at begin at the beginning of the 6th month which are retroactive to the beginning of the disability. d) Benefits begin at the beginning of the 6th month and are not retroactive to the beginning of the disability.
D
If the insurance premiums were not tax deductible, what other taxation will this affect? a) Taxation of interest b) Taxation of the policy's cash value c) Federal income tax d) Taxation of benefits
D
What is the purpose of a benefit schedule? a) To include the average charges for procedures. b) To provide the dates for the payment of benefits. c). To list the insured's copayments and deductibles. d) To state what and how much is covered in the plan.
D
Which of the following is NOT a crucial factor in health insurance underwriting? a) Physical condition b) Morale hazards C) Occupation d) Income
D
Which of the following used to be called Medicare + Choice Plans? a) Medical Insurance b) Medicare Supplement Plans c) Original Medicare Plan d) Medicare Advantage Plans
D
Who acts on behalf of the principal? a) Insurer b) Insured c) The state d) Agent
D
Who makes up the Medical Information Bureau? a) Physicians and paramedics b) Former insureds c) Hospitals d) Insurance companies
D