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HEALTH INSURANCE FLORIDA 2-40 PRACTICE EXAM
QUESTIONS WITH ANSWERS 100% VERIFIED ALREADY
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"Which of the following statements is correct about a Disability Income policy with a Guaranteed Insurability rider? -The insured may periodically increase the amount of benefits payable under the policy. -The insured may assign the policy to a member of the insured's family. -The insurer is not permitted to cancel the policy.
-The insurer will issue the policy without a medical examination. - CORRECT ANSWER=> The insured
may periodically increase the amount of benefits payable under the policy." "An insurer must provide claim forms to an insured within a MAXIMUM of how many days after receiving notice of an Accident & Health claim? -Five -Fifteen -Twenty
-Thirty - CORRECT ANSWER=> Fifteen"
"J has a physical impairment, attends school, and is incapable of self-sustaining employment and/ or self care. Which of the following statements is correct about J's medical coverage under J's father's group plan? -J's coverage ceases, but J may apply for group student coverage. -J's coverage automatically discontinues at age twenty-six. -J's coverage continues only as long as J is a full-time student. -J's coverage continues as long as J is continually incapacitated and is financially dependent on J's father.
- CORRECT ANSWER=> J's coverage continues as long as J is continually incapacitated and is financially dependent on J's father." "The insurance policy clause that identifies the contracting parties and defines the scope and limits of coverage is called the: -Insuring clause -Benefit clause -Consideration clause
-Renewal clause - CORRECT ANSWER=> Insuring clause"
"Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to: Increase the premium rate for one insured without increasing the rate for others in the same class Increase the premium rate for an entire class of insured, only on the anniversary date
Increase the benefits for an individual insured
Decrease benefits for one insured without decreasing benefits for others in the same class - CORRECT
ANSWER=> Increase the premium rate for an entire class of insured, only on the anniversary date"
"When periodic claim payments are required under a long-term disability income policy, an insurer MUST make payments to an insured at least once every: -month -three months -six months
-year - CORRECT ANSWER=> month"
"M and N own a small interior design studio that employs six people. The owners are concerned about the financial continuation of the business if either of them should become permanently disabled. In this situation, a producer would MOST likely recommend which of the following types of contracts? -Basic Hospital -Disability Buy-Out -Comprehensive Major Medical
-Short-Term Disability Income - CORRECT ANSWER=> Disability Buy-Out"
"Which of the following health policies requires a beneficiary designation? -Travel Accident -Medicare Supplement -Blanket
-Long Term Care - CORRECT ANSWER=> Travel Accident"
"Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy features? -Extensions of coverage -Benefits clause -Riders
-Exclusions - CORRECT ANSWER=> Exclusions"
"An insured whose Disability Income policy contains a Change of Occupation clause takes a new job in a more hazardous occupation and fails to notify the insurer of the change. One year later, the insured becomes disabled. The insurer will most likely take which of the following actions? -Cancel the policy and refund one year's premiums -Settle the claim according to what the premiums would have purchased under the more hazardous occupation -Pay the claim in full and then cancel the policy
-Pay the claim after deducting an extra one-year premium payment - CORRECT ANSWER=> Settle the
claim according to what the premiums would have purchased under the more hazardous occupation"
provision. On July 3, Producer T attempted to deliver the policy but found that S was not at home. On July 5, Producer T was able to deliver the policy to S. On July 7, S decided he did not want the policy. S had 10 days from which of the following dates to return the policy to the company and obtain a full premium refund? -July 1 -July 3 -July 5
-July 7 - CORRECT ANSWER=> July 5"
"Five years ago, at age forty-five, X stated that he was forty years old on a disability income insurance application. X now submits a claim and the insurer discovers X's true age. The insurer will most likely take which of the following actions? -Deny the claim due to material misrepresentation on the application -Pay the claim as filed because the policy becomes incontestable after two years -Pay the claim and cancel the policy -Adjust the benefits downward according to the benefits that X would have been entitled to based on
the premiums - CORRECT ANSWER=> Adjust the benefits downward according to the benefits that X
would have been entitled to based on the premiums" "All of the following elements are required of a contract EXCEPT: -assignment -acceptance -legal capacity
-legal purpose - CORRECT ANSWER=> assignment"
"Which of the following types of provisions guarantees renewability to a specified date or age unless certain specified events occur? -Noncancellable -Optionally Renewable -Guaranteed Renewable
-Conditionally Renewable - CORRECT ANSWER=> Conditionally Renewable"
"In an Accidental Death and Dismemberment (AD&D) policy, the term "capital sum" refers to: -the benefit paid for death caused by a dread disease -the monthly disability income paid if an insured loses a limb or the sight in one or both eyes -a lump sum payment made when disease causes the amputation of an arm or a leg
-a lump sum payment made for an accidental dismemberment - CORRECT ANSWER=> a lump sum
payment made for an accidental dismemberment" "The PRIMARY purpose of Medicaid is to: -pay for expenses not covered by Medicare -provide Disability Income benefits to people on Medicare -provide Medical Expense coverage to persons meeting certain minimum income requirements
-provide funds for people injured in natural disasters - CORRECT ANSWER=> provide Medical Expense
coverage to persons meeting certain minimum income requirements" "A health care plan that reimburses a flat fee for medical care it provides at a clinic it owns and operates is referred to as: -Health Maintenance Organization -Medicaid -Medicare
-a Multiple Employer Trust (MET) - CORRECT ANSWER=> Health Maintenance Organization"
"A health care plan designed to combine small employers together into a group to purchase medical expense insurance for their employees is called a: -risk retention group -Multiple Employer Trust (MET) -Preferred Provider Organization (PPO)
-Third Party Administrator (TPA) - CORRECT ANSWER=> Multiple Employer Trust (MET)"
"Medicare Supplement policies are primarily designed to: -offset the high cost of Medicare -provide additional retirement income to supplement Social Security retirement benefits -provide additional benefits beyond those provided by Medicare -provide a reinsurance network that spreads the Medicare risk among private insurance companies -
CORRECT ANSWER=> provide additional benefits beyond those provided by Medicare"
"An applicant for insurance submits an application to an insurer for underwriting but does not forward any premium payment with the application. Legally, the applicant is making -an inquiry for an offer -an offer -a counteroffer
-an acceptance - CORRECT ANSWER=> an inquiry for an offer"
"Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability Income policy? -It allows the insurer to deduct premiums due from the disabled insured's benefit payments. -It allows the insurer to increase the amount of premium during the insured's time of disability. -It allows the insured to extend the length of the Grace Period while disabled. -It allows the insured to maintain a policy in force while disabled and unable to pay premiums. -
CORRECT ANSWER=> It allows the insured to maintain a policy in force while disabled and unable to
pay premiums." "Which of the following provisions explains that a producer does not have the authority to waive the provisions of an insurance contract? -Legal actions -Reinstatement
An Exclusionary/ Impairment rider A Waiver of Premium rider
A Double Indemnity rider - CORRECT ANSWER=> An Exclusionary/ Impairment rider"
"In which of the following health policies are both the renewability and the premiums guaranteed? Non-cancellable Optionally Renewable Guaranteed Renewable
Conditionally Renewable - CORRECT ANSWER=> Non-cancellable"
"Medicare Part A covers which of the following expenses? Hospital room and board Surgical expenses Medications
Physicians' services - CORRECT ANSWER=> Hospital room and board"
"The Notice of Claim provision in an Accident and Health policy requires that an insured give written notice to the insurer within a MAXIMUM of how many days after a loss? 7 10 15
20 - CORRECT ANSWER=> 20"
"Under the Claims Forms provision of a health policy, if the insurance company fails to send out the claim forms within the time period required by the provision, the insured should: Demand a full refund of all premiums paid plus interest Submit the claim in any form, which must be accepted by the company as adequate proof of loss
Request the state Department of Insurance to act as umpire in settling the claim
Do nothing until the claim form arrives - CORRECT ANSWER=> Submit the claim in any form, which
must be accepted by the company as adequate proof of loss" "Which of the following provisions designates the person to whom claim payments are to be made? Time of Payment of Claims Entire Contract Notice of Claim
Payment of Claims - CORRECT ANSWER=> Payment of Claims"
"The Consideration clause in an accident and health policy states that: The applicant pays the initial premium Insurable interest must exist between the parties involved Any attachments to the policy constitute the entire contract of insurance
Certain claims will be excluded under the policy - CORRECT ANSWER=> The applicant pays the initial
premium" "The Elimination Period in most Disability Income policies applies: To each separate disability To claims for accidents only Only the first time the insured is disabled during the first
30 days of the contract - CORRECT ANSWER=> To each separate disability"
"Which of the following statements is CORRECT about coinsurance? It applies to the deductible as well as to claim payments. It helps control overutilization of benefits. Insurance companies generally charge more for a policy that contains a Coinsurance provision than for one that does not.
Attending physician's report Inspection report
Producer's report - CORRECT ANSWER=> Inspection report"
"The purpose of the Medical Information Bureau (MIB) is to: -recommend the premium rates that should be charged for health policies issued to substandard risks -share medical data among member companies -provide background data used to experience-rate large group health plans
-provide actuarial information to participating members on dread diseases - CORRECT ANSWER=>
share medical data among member companies" "Because health insurance policies are offered on a "take it or leave it" basis, they are referred to as which of the following types of contracts? Aleatory Contracts Executory Contracts Unilateral Contracts
Contracts of Adhesion - CORRECT ANSWER=> Contracts of Adhesion"
"Person who is considered an under-average or impaired insurance risk because of physical conditions family or personal history of disease, occupation, residence in unhealthy climate or dangerous habits. -
CORRECT ANSWER=> Substandard Risk"
“Which of the following laws requires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant? -Uniform Provisions Law. -Freedom of Information Act. -Medical Information Bureau Disclosure Act
-Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) - CORRECT ANSWER=>
Fair Credit Reporting Act (Insurance Information and Privacy Protection Act)" "Group health insurance specifies that what percentage of eligible individuals MUST be offered coverage under a noncontributory plan?
-100 - CORRECT ANSWER=> 100"
"Under an Accidental Death and Dismemberment (AD&D) policy, insurable interest must exist at which of the following times? -When a change of beneficiary is requested -At the inception of the policy -When a beneficiary other than a relative is named
-At the time a claim is submitted - CORRECT ANSWER=> At the inception of the policy"
