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Answers (Latest Update 2024)
H has suffered a covered disability away from her job and will shortly begin collecting benefits. The insurer sends a letter to H stating that she will not receive any benefit amounts greater than her income. This clause is known as: A: Over-insurance clause B: free look C: relation of earning to insurance D: relation of economic value - Correct Answer ✅C: relation of earning to insurance The insured should be aware of the issue date upon delivery a policy and the date should be listed on: A: the policy summary 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:
Answers (Latest Update 2024)
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
Answers (Latest Update 2024)
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. C: An insured who turns age 65 and is still employed is eligible for Medicare. D: An insured who has Medicare Part A is eligible to enroll for Medigap policies within six months of enrolling in Part A. - Correct Answer ✅D: An insured who has Medicare Part A is eligible to enroll for Medigap policies within six months of enrolling in Part A. 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
Answers (Latest Update 2024)
The purpose of the Fair Credit Reporting Act is to: A: protect the consumer from having an adverse action against them based of obsolete credit information B: to ensure that credit information used in underwriting is accurate and updated C: make sure that any financial institution handles an individual's credit in a correct, proper manner D: All of the Above - Correct Answer ✅D: All of the Above Most Accident and Health policies require that claims must be paid _________ upon written proof of loss. A: 30 days B: Immediately C: 60 days D: 90 days - Correct Answer ✅B: Immediately A LTC policy that will only pay for ADL given occasionally by a licensed professional is: A: Skilled Care
Answers (Latest Update 2024)
A: A insured must wait 5 months before collecting benefits B: To qualify an insured must be unable to do any job in the American economy C: To qualify an insured must be disabled for a year or longer or die within a two year period. D: The insured must have a certain amount of Social Security credits based off age. - Correct Answer ✅C: To qualify an insured must be disabled for a year or longer or die within a two year period. 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
Answers (Latest Update 2024)
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
Answers (Latest Update 2024)
D: A and B only - Correct Answer ✅D: A and B only Under minimum standards, the probationary waiting period for illness may not exceed A: 10 days B: 20 days C: 30 days D: 40 days - Correct Answer ✅C: 30 days If a policy owner of a Medicare Supplement becomes eligible for Medicaid, a supplement can be suspended for up to ______ as long as they give the insurer notice within 90 days of being eligible for Medicaid. A: 6 months B: 12 months C: 24 months D: 36 months - Correct Answer ✅C: 24 months
Answers (Latest Update 2024)
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: $
Answers (Latest Update 2024)
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 V has an HMO who has been financial impaired, the most the HMO Guarantee Association will pay for V's claims is: A: $100, B: $250, C: $300, D: $500,000 - Correct Answer ✅D: $500, What action would be required of a producer who fails to reinstate a lapsed producer license within the statutory allowed time period? A: The person is barred from entering the insurance business for 5 years.
Answers (Latest Update 2024)
B: The person is barred from entering the insurance business for life. C: The person would be required to take a certified prelicensing course and state exam for each line or authority sought and then to submit an application with the payment of a $180 license fee. D: The person would be required to take a certified prelicensing course and state exam for each line or authority sought and then to submit an application with the payment of a $360 license fee. - Correct Answer ✅C: The person would be required to take a certified prelicensing course and state exam for each line or authority sought and then to submit an application with the payment of a $180 license fee. T has recently replaced her Medicare Supplement policy which was in force for 7 months. The contract has a probationary waiting period on all illness related losses for the first ten days of coverage. On day 5, T suffers an illness. The replacing insurer is most likely to: A: cover the loss B: deny the claim C: require T pay more premium to cover the loss D: None of the Above - Correct Answer ✅A: cover the loss
Answers (Latest Update 2024)
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
Answers (Latest Update 2024)
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 D: paid directly to the employee - Correct Answer ✅C: paid to the corporation The rider that an insurer uses to specifically name and exclude a preexisting condition from coverage is known as: A: Exclusionary Rider B: Preexisting Condition Rider C: Impairment Rider D: Exclusion Rider - Correct Answer ✅C: Impairment Rider Lifetime, Per Cause, and Annual maximums are all examples of: A: Benefit Exclusions B: Benefit Limits
Answers (Latest Update 2024)
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
Answers (Latest Update 2024)
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:
