Insurance test
In order to collect Social Security disability benefits, the claimant must be able to demonstrate that the disability will last at least
12 months
The patient protection and affordable care act mandates that insurers provide coverage for adult children of the insured up to the age of
26
A person buys an individual long-term care policy and is not satisfied with the provisions. Within how many days will the insured be able to return the policy for a full premium refund?
30 days
If a legal action is taken against an agent for violating an insurance law, within what period of time must a report to be filed with the director?
30 days
A small employer must have at least two but no more than 50 workers actively engaged in business for at least how many of the working days doing the preceding calendar quarter?
50%
Medicaid is sponsored by what kind of sources?
Both state and federal
Which of the following terms describes a specific dollar amount of the cost of care that must be paid by the member?
Copayment
And insured is receiving hospice care. His insurance will pay for pain killers but not for an operation to reduce the size of a tumor. What term best fits this arrangement?
Cost containment
Which of the following authorities is responsible for assessing the financial stability of an insurer?
Director
Because of the history of cancer in her family, Julie purchased a policy that specifically covers the expense of treating cancer. Her policy would be classified as what type of policy?
Dread disease policy
Concerning the group medical and dental insurance, which of the following circumstances is incorrect?
Employee benefits are tax deductible do year in which they were received
Which of the following are the authorities that an agent can hold
Express and implied
What type of benefit helps to pay for accidental injuries that are not severe enough to qualify as disabilities?
Medical reimbursement benefit
All of the following are covered by part A of Medicare except?
Physicians and surgeons services
According to the PPACA metal levels classification, if a health plan is expected to cover 90% of the cost of an average population in the participants would cover the remaining 10%, what type of plant is that?
Platinum- Bronze level benefit plans pay 60% of expected healthcare costs, silver plans pay 70%, gold level plans pay 80%, and platinum level plans pay 90%
Which of the following would be a qualifying event as it relates to COBRA?
Termination of employment due to downsizing
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?
indemnity
An applicant is considered to be high risk but not so much that the insurer wants to deny coverage. Which of the following is not true?
the insurer will issue a conditional coverage
And insured has a major medical policy with a $500 deductible and coinsurance clause of 80/20. If he incurs medical expenses of $4000, the insurer will pay?
$2,800 pays 80% after the $500 deductible
A hospital indemnity policy will pay
A benefit for each day the insured is in a hospital.
All of the following are correct about the required provisions of a health insurance policy except
A reinstated policy provides immediate coverage for an illness
Which of the following is true regarding health insurance?
It could provide payments for loss of income.
Which of the following is excluded in dental insurance plans?
Lost dentures
All of the following are true regarding the medical information bureau (MIB) Except?
MIB reports are based upon information supplied by doctors and hospitals
And insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive presumptive disability benefits?
No benefits, requires loss of two limbs or permanent blindness
An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare part a and part B. What is the insurance company obligated to do?
Offer the supplement policy on a guaranteed issue basis
Which renewal option does not guarantee renewal and allows the insurance company to refuse renewal of a policy at any premium due date?
Optionally renewable
All of the following are examples of risk retention except?
Premiums
Under a disability income policy, the insurer does not pay a monthly benefit that is equal to the insured's previous income. The reason for paying a benefit amount that is less than the insured's income is to
Prevent overutilization and malingering
Which of the following answers does not describe the principal goal of a preferred provider organization?
Provide medical services only from physicians in the network
Which type of insurance is based on mutual agreements among subscribers?
Reciprocal insurance
Which of the following may not be included in an insurance companies advertisement?
That its policies are covered by the State Guaranty Association
Which of the following is not covered under Plan A and Medigap insurance?
The Medicare part A deductible
And employee becomes insured under a PPO plan provided by his employers, if the insured decides to go to a physician who is not a PPO provider, which of the following will happen?
The PPO will pay reduced benefits
A husband and wife are insured under a group health insurance plans at their own places of employment, and as dependents under their spouses coverage. If one of them and Carrie's hospital expenses, how old those expenses likely be paid?
The benefits will be coordinated
Which of the following provisions must be included on the first page of a Medicare supplement policy, which states the insurers right to change premium accounts?
The continuation provision
And insured purchased a non-cancelable health insurance policy one year ago. Which of the following circumstances would not be a reason for the insurance company to cancel the policy?
The insured is in an accident and incurs a large claim
An individual purchased a Medicare supplement policy in March and decided to replace it two months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true?
The pre-existing condition waiting period Fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off
Which of the following is true regarding MET's?
They allow several small employers purchased less expensive insurance together
Which of the following provides insurance Coverage for sickness, bodily injury, or accidental death and may include benefits for disability income?
Accident and health or sickness
Which of the following is the closest term to an authorized insurer?
Admitted
Long-term care insurance policies must cover which of the following
Alzheimer's disease
In order to get a nonresident license in the state a producer must
Apply and pay a fee to a non-resident state that reciprocates
What is the maximum period of time during which an insurer make contest fraudulent miss statements made in a health insurance application?
As long as the policy is in force
Occasional visits by which of the following medical professionals will not be covered under LTC's home health care?
Attending physician
If an insurer willfully engages in an unfair trade practices, the director may issue a cease and desist order in oppose a maximum fine of?
$15,000 per violation
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to?
insured
Assuming that all of the following people are covered by a high deductible health plan and are not claimed as dependents on anyone's tax returns, which would not be eligible for a health savings account?
An individual must be covered by a high deductible health plan, must not be covered by other health insurance except for specific injury, accident, disability, dental care, vision care, long-term care insurance, must not be eligible for Medicare, and can't be claimed as a dependent on someone else's tax return
Under HIPAA, which of the following is incorrect regarding eligibility requirements for conversion to an Individual policy?
An individual who was previously covered by group health insurance for six months is eligible
If an insurance company makes a statement that its policies are guaranteed by the existence of the insurance guaranty Association, that would be considered?
An unfair trade practice
Which of the following is not true of disability buy sell coverage
Benefits are considered taxable income to the business
Which of the following statements is correct concerning taxation of long-term care insurance?
Excessive benefits may be taxable.
Which of the following is not a government funded insurance program
Federal Deposit insurance Corporation the FDIC
Under the fair Credit reporting act, individuals rejected for insurance due to information contained in a consumer report
Must be informed of the source of the report
