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ACCIDENT AND HEALTH INSURANCE
EXAM 2025 BRAND NEW ACTUAL EXAM
WITH 100% VERIFIED QUESTIONS AND
CORRECT SOLUTIONS- GUARANTEED
VALUE PACK ACE YOUR GRADES.
A |LTC |policy |that |will |only |pay |for |ADL |given |occasionally |by |a |licensed |professional |is: A: |Skilled |Care B:|Intermediate |Care |C: |Custodial |Care D: |None |of |the |Above |- |correct |answer |- |C: |Custodial |Care Which |of |the |following |policy |provisions |are |optional |in |a |individual |health |policy? A: |Entire |Contract B: |Change |of |Occupation |C: |Entire |Contract D: |Reinstatement |- |correct |answer |- |B: |Change |of |Occupation Which |of |the |following |elements |is |part |of |the |entire |contract |clause? |A: |The |exchange |of |value |between |the |parties
B: |The |agreement |between |the |policyholder |and |insurer
B: |the |first |page |of |the |contract |C: |the |delivery |receipt D: |upon |conditional |receipt |- |correct |answer |- |B: |the |first |page |of |the |contract The |policy |has |all |of |the |following |rights |EXCEPT: A: |Right |to |solely |renew |a |guaranteed |renewable |policy. |B: |Right |to |terminate |a |policy C: |Unilateral |right |to |renew |an |Optionally |renewable |policy D: |Right |to |assign |a |contract |- |correct |answer |- |C: |Unilateral |right |to |renew |an |Optionally |renewable |policy The |part |of |a |contract |that |specifies |which |expenses |may |or |may |not |be |covered |is |known |as |the: A: |Exclusion B: |Eligible |Expense |provision |C: |Insuring |Agreement D: |Consideration |Clause |- |correct |answer |- |B: |Eligible |Expense |provision Which |of |the |following |is |considered |to |be |a |mandatory |provision |in |a |health |policy? A: |Time |Limit |on |Certain |Defenses |B: |Change |of |Occupation C: |Illegal |Occupation
D: |Intoxicant/Narcotic |Usage |- |correct |answer |- |A: |Time |Limit |on |Certain |Defenses Which |of |the |following |may |be |considered |an |eligible |expense |found |in |a |health |policy? A: |Cosmetic |Surgery |B: |Premium |payment |C: |cold |cream D: |Bus |fare |to |receive |treatment |for |a |covered |loss |- |correct |answer |- |D: |Bus |fare |to |receive |treatment |for |a |covered |loss K |has |a |policy |that |covers |doctors |visits |but |limits |the |number |of |visits |per |calendar |year |and |pays |a |limited |indemnification |limit |per |visit. |K |has: A: |Basic |Medical |Expense B: |Physician |Nonsurgical |Coverage |C: |Basic |Surgical |Policy D: |Basic |Hospital |Coverage |- |correct |answer |- |B: |Physician |Nonsurgical |Coverage All |of |the |following |are |CORRECT |about |Medicare |EXCEPT: A: |An |insured |who |is |age | 30 |but |collecting |Social |Security |disability |for |the |last |two |years |is |eligible |for |Medicare. B: |An |insured |who |is |age | 60 |and |is |at |the |end |stage |of |renal |failure |is |eligible |for |Medicare.
A: | 30 |days B:|Immediately |C: | 60 |days D: | 90 |days |- |correct |answer |- |B: |Immediately Health |Care |FSA |contributions |are |limited |to | per|year. |A: |$5, B:|$3, |C: |$2, D: |$3,250 |- |correct |answer |- |C: |$2, A |noncancelable |policy |means |the |company A: |may |not |raise |the |premium |or |terminate |the |policy |except |for |nonpayment |of |premium B: |may |not |cancel |before |the |insured |reaches |age | 50 C: |may |pay |limited |benefits |and |cannot |cancel |all |benefits D: |can |only |terminate |coverage |if |the |insured |switches |occupations |- |correct |answer |- |A: |may |not |raise |the |premium |or |terminate |the |policy |except |for |nonpayment |of |premium The |maximum |number |of |in-hospital |days |coverage |provided |by |an |individual |policy |under |minimum |standards |is:
A: | 30 |days B: | 45 |days C: | 90 |days D: | 180 |days |- |correct |answer |- |D: | 180 |days If |there |is |a |dispute |on |medical |necessity |under |a |HMO, |there |must |be |a |system |in |place |for |a |second |opinion. |If |the |second |opinion |determines |that |a |covered |service |is |in |fact |medically |necessary, |the |HMO |must |provide |service. |The |only |way |that |benefits |are |paid |for |an |out-of- |network |physician |is: A: |if |a |referral |is |given B: |state |law |dictates |when |coverage |out |of |area |exists |C: |if |it |is |an |emergency D: |None |of |the |Above |- |correct |answer |- |A: |if |a |referral |is |given Which |of |the |following |circumstances |may |lead |to |the |renewal |of |a |producer |license |without |the |requirement |of |completing |continuing |education |requirements? A: |There |are |no |exceptions |to |the |continuing |education |law. B: |The |producer |suffers |a |stroke |and |is |incapable |of |completing |any |coursework. C: |The |producer |is |called |up |to |military |duty |and |secures |a |military |waiver. D: |Once |a |producer |has |been |licensed |for |more |than | 30 |consecutive |years |and |is |at |least | 65 |years |of |age, |they |are |exempt |from |continuing |education |requirements. |- |correct |answer |- |C: |The |producer |is |called |up |to |military |duty |and |secures |a |military |waiver.
H |has |had |group |LTC |coverage |for |the |last | 5 |months. |H |has |decided |to |leave |his |job |and |find |a |new |career. |Upon |leaving |his |group, |H |would |like |to |convert |his |group |LTC |policy |to |an |individual |plan. |The |insurer |is |most |likely |to: A: |deny |conversion |B: |allow |conversion C: |allow |conversion, |but |they |may |increase |the |premium D: |allow |conversion |as |long |as |H |converts |within | 30 |days |of |leaving |they |group |- |correct |answer |- |A: |deny |conversion If |an |insurance |company |issues |deceptive |statements |about |its |assets, |this |action |is A: |false |advertising. B: |an |unfair |trade |practice. |C: |unfair |discrimination. D: |falsification. |- |correct |answer |- |B: |an |unfair |trade |practice. Other |than |when |an |agent |or |insurer |sells |a |supplement |not |approved |by |the |director, |all |other |violations |may |incur |a |maximum |fine |of: A: |$ |B:|$1, |C: |$5, D: |$10,000 |- |correct |answer |- |C: |$5,
If |an |insurer |discontinues |a |group |policy |they |are |only |liable |for: |A: |their |extent |of |benefits |under |the |old |contract B: |half |of |the |new |carrier's |covered |losses |C: |nothing D: |all |losses |up |to |a |year |- |correct |answer |- |A: |their |extent |of |benefits |under |the |old |contract N |has |a |major |medical |policy |through |an |insolvent |insurer. |The |maximum |the |Guarantee |Association |will |pay |on |N's |losses |is: A: |$500, |B: |$300, |C: |$200, D: |$100,000 |- |correct |answer |- |A: |$500, On |March | 1 |C, |who |holds |an |Illinois |non-resident |license |moves |from |Idaho |to |Iowa. |By |which |date |must |C |notify |the |Illinois |Director |of |Insurance |about |this |move? A: |By |March | 31 B: |C |does |not |have |to |notify |Illinois |since |he |was |a |non-resident |license |holder. C: |By |May | 1 D: |By |March | 16 |- |correct |answer |- |A: |By |March | 31
C: |require |T |pay |more |premium |to |cover |the |loss D: |None |of |the |Above |- |correct |answer |- |A: |cover |the |loss Another |name |for |a |Binder |is: A: |Conditional |Receipt |B: |Unconditional|Receipt C: |Temporary |Coverage |Binder D: |Pre-Conditional |Receipt |- |correct |answer |- |B: |Unconditional |Receipt When |an |agent |sells |an |Accident |and |Health |policy, |he/she |should |do |which |of |the |following |with |the |application? A: |Complete |it |and |have |the |applicant |review |and |sign |it B: |The |agent |should |initial |any |and |all |changes |he/she |may |make |later C: |Have |the |applicant |sign |and |then |carefully |put |in |the |required |information |in |as |thoroughly |and |accurately |a |manner |as |possible D: |Advise |the |applicant |to |provide |information |in |such |a |manner |to |make |certain |the |policy |will |be |issued |without |restrictions |- |correct |answer |- |A: |Complete |it |and |have |the |applicant |review |and |sign |it G |had |his |policy |reinstated |on |August |1. |On |August |5, |G |falls |ill |and |needs |to |spend |a |few |nights |in |the |hospital. |Which |of |the |following |is |most |likely |to |happen? A: |The |insurer |will |pay |full |benefits |for |G's |loss |B: |The |insurer |will |not |pay |for |G's |loss
C: |G |will |have |to |pay |more |premium |to |have |the |loss |covered D: |None |of |the |Above |- |correct |answer |- |B: |The |insurer |will |not |pay |for |G's |loss Which |of |the |rights |of |renewable |will |guarantee |premiums |remain |level? |A: |Guaranteed |Renewable B:|Cancelable |C: |Noncan D: |None |of |the |Above |- |correct |answer |- |C: |Noncan Under |the |Claim |Forms |provision |in |an |Accident |and |Health |policy, |an |insurance |company |must |supply |an |insured |with |claim |forms |within |a |MAXIMUM |of |how |many |days |after |receiving |notice |of |the |loss? A: | 10 B: | 15 C: | 20 D: | 30 |- |correct |answer |- |B: | 15 A |CORRECT |statement |about |benefits |payable |under |a |Disability |Buy- |Out |policy |that |is |owned |by |a |business |entity |is |that |they |are: A: |related |directly |to |salary |B: |paid |in |installments C: |paid |to |the |corporation
Which |of |the |following |rights |of |renewability |stipulate |that |the |insured |has |the |sole |right |to |end |coverage? A: |Period |of |Time |B: |Noncancelable |C: |Cancelable D: |Conditionally |Renewable |- |correct |answer |- |B: |Noncancelable All |of |the |following |statements |are |true |about |a |specified |disease |plan |EXCEPT: A: |Cancer |may |be |covered |up |to |a |fixed |dollar |benefit |amount. B: |A |specified |disease |plan |is |a |good |substitute |for |a |major |medical |policy |because |it |is |cheaper |premiums. C: |A |specified |disease |plan |will |only |cover |one |specific |loss. D: |No |policy |will |cover |a |specified |disease |if |diagnosed |occurred |before |the |policy |was |applied |for. |- |correct |answer |- |B: |A |specified |disease |plan |is |a |good |substitute |for |a |major |medical |policy |because |it |is |cheaper |premiums. Which |of |the |following |are |exclusions |under |a |health |policy? |A: |an |annual |eye |exam B: |a |biannual |dental |check-up C: |a |worker |that |is |injured |while |working |on |the |job D: |All |of |the |Above |- |correct |answer |- |D: |All |of |the |Above
The |mandatory |provision |that |stipulates |the |insurer's |rights |during |underwriting |and |proving |fraud |is |the: A: |Proof |of |Loss |provision B: |Physical |Examination |and |Autopsy |C: |Entire |Contract |Provision D: |Legal |Action |Provision |- |correct |answer |- |B: |Physical |Examination |and |Autopsy What |is |a |contract's |grace |period |if |a |premium |is |paid |on |a |quarterly |basis? A: | 7 |days B: | 10 |days C: | 31 |days D: | 90 |days |- |correct |answer |- |C: | 31 |days Doctors |in |a |Preferred |Provider |Organization |are |paid: |A: |Capitation B: |Fee |for |Service |C: |Salary D: |Reimbursement |- |correct |answer |- |B: |Fee |for |Service In |a |health |policy, |the |probationary |period |begins:
C: |pay |covered |losses D: |share |in |premium |payment |- |correct |answer |- |C: |pay |covered |losses All |of |the |following |benefits |may |require |a |referral |EXCEPT: |A: |A |doctor |seen |in-network |under |a |PPO B: |A |subscriber |uses |their |point |of |service |plan |for |a |covered |specialist |C: |A |subscriber |utilizes |their |HMO |coverage |for |a |cardiologist. D: |None |of |the |Above |- |correct |answer |- |A: |A |doctor |seen |in-network |under |a |PPO T |has |just |returned |back |to |work |after |a |total |disability |but |is |only |able |to |work |half |the |day. |T's |policy |pays |the |difference |between |what |the |employer |pays |T |and |what |T |earned |prior |to |disability. |T |has: A: |Own |Occupation |B: |Residual|Disability |C: |Partial |Disability D: |Any |Occupation |- |correct |answer |- |B: |Residual |Disability If |an |agent |has |completed |the |initial |continuing |education |for |long |term |care, |next |renewal |they |must |complete |ongoing |education |that |is | of |continuing |education. A: | 4 |hours B: | 8 |hours C: | 12 |hours
D: | 24 |hours |- |correct |answer |- |A: | 4 |hours Which |of |the |following |is |not |true |regarding |Medicare |Supplement |minimum |standards? A: |Supplements |can |only |exclude |illness |or |treatment |that |are |excluded |under |Medicare. B: |If |a |group |Supplement |was |terminated, |the |insurer |does |not |have |to |offer |certificate |holders |a |right |to |convert |to |an |individual |policy. C: |Supplements |cannot |base |payments |on |standards |such |as |reasonable |and |customary. D: |A |preexisting |condition |is |limited |to | 6 |months |before |effective |date |of |coverage. |- |correct |answer |- |B: |If |a |group |Supplement |was |terminated, |the |insurer |does |not |have |to |offer |certificate |holders |a |right |to |convert |to |an |individual |policy. Which |of |the |following |is |an |a |example |of |a |unfair |trade |practice? |A: |a |company |rates |an |individual |based |on |partial |blindness B: |a |company |rates |an |individual |with |a |disability C: |an |agent |discriminates |a |client |because |of |they |are |totally |blind |D: |All |of |the |Above |- |correct |answer |- |D: |All |of |the |Above A |producer |violates |the |written |order |from |the |Director |pertaining |to |their |market |conduct |activities. |What |is |the |maximum |civil |penalty |that |can |be |assessed |by |the |Director |against |a |producer |in |this |circumstance? A: |$10,
