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ARKANSAS HEALTH INSURANCE EXAM (
DIFFERENT VERSIONS) | ALL QUESTIONS
AND CORRECT ANSWERS | GRADED A+ |
VERIFIED ANSWERS
ARKANSAS HEALTH INSURANCE EXAM (FIRST EXAM)
An insurance producer MUST notify the Commissioner of a change in legal name, email, or address: within 10 days of the change within 30 days of the change within 6 weeks of the change before renewal of the license ------CORRECT ANSWER---------------Within 30 days of the change One or more necessary or appropriate diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services in a setting other than an acute care unit of a hospital is provided by: long-term care insurance critical care insurance chronic care insurance excess care insurance ------CORRECT ANSWER---------------Long-term care insurance If an agent knows or suspects a fraudulent transaction, they MUST report it to the Commissioner within: 10 days 20 days 30 days 45 days ------CORRECT ANSWER---------------30 days
Anyone who willfully violates a cease and desist order from the Commissioner is subject to a fine of up to: $100 per violation $500 per violation $1,000 per violation $10,000 per violation ------CORRECT ANSWER---------------$1000 per violation Any person who knows or suspects that an insurance transaction or life settlement may be fraudulent has a duty to report it to the Commissioner within: 10 days 15 days 30 days 45 days ------CORRECT ANSWER---------------30 days An insurer may pay a commission in which of the following scenarios? To a licensed non-appointed producer who has sold, solicited, or negotiated a policy of insurance on behalf of the insurer To an unlicensed person who has sold, solicited, or negotiated a policy of insurance on behalf of the insurer To a licensed producer who is appointed with the insurer When a policy is canceled back to inception ------CORRECT ANSWER------ ---------To a licensed non-appointed producer who has sold, solicited, or negotiated a policy of insurance on behalf of the insurer
authorized producer ------CORRECT ANSWER---------------Nonresident producers An HMO must notify its subscribers of any change within 10 days 20 days 30 days 60 days ------CORRECT ANSWER---------------30 days Failing to promptly provide a reasonable explanation for the denial of a claim is considered to be a(n) Fiduciary act unfair claim settlement practice fraudulent act claim liability ------CORRECT ANSWER---------------Unfair claim settlement practice An accident and health policy may NOT be contested by the insurance company after the policy has been in force for a MINIMUM of: one year two years three years four years ------CORRECT ANSWER---------------Two years If a person is convicted of a crime stemming from a hearing, a fine up to $ ___ per violation may be imposed. $ $1,
$50,000 ------CORRECT ANSWER---------------$1,
Which of the following constitutes grounds for suspending an Arkansas producer's license? Summary Action conviction Felony conviction Failure to comply with underwriting guidelines Failure to maintain insurance transaction records for at least 10 years ------ CORRECT ANSWER---------------Felony Conviction ___ is any insurance carrier providing disability benefit plans for a small employer's eligible employees. Employer Adjuster Employer Carrier Broker ------CORRECT ANSWER---------------Employer Carrier An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 davs before submitting another claim bringing legal action against the insurer the insurer will pay the claim purchasing more insurance from this insurer ------CORRECT ANSWER------ ---------Bringing legal action against the insurer Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
Cancel policy if premiums are not paid Increase the premiums on an individual basis Increase the premiums on the basis of an entire classification ------ CORRECT ANSWER---------------Increase the premiums on an individual basis Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. 10 20 31 60 ------CORRECT ANSWER---------------20 days An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim. 10 15 20 25 ------CORRECT ANSWER--------------- 15 When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates? Relation of earnings to insurance provision Change of occupation provision Conformity of state statutes provision Modified occupation provision ------CORRECT ANSWER--------------- Change of occupation provision
A health insurance policy that allows an insurer to change the policyowner's premiums, but NOT cancel the policy is called a(n) guaranteed renewable policy conditionally renewable policy optionally renewable policy noncancelable policy ------CORRECT ANSWER---------------guaranteed renewable policy In which of the following situations would the insurer be liable for a loss? The insured skipped a payment beyond the 31 day grace period The insured was injured while participating in an illegal occupation The insured was given a notice of cancellation from the insurer The insured suffered an injury as an innocent bystander during a bank robbery ------CORRECT ANSWER---------------The insured suffered an injury as an innocent bystander during a bank robbery All of the following are included as part of a contract in the entire contract provision EXCEPT the Riders application changes made by the producer policy ------CORRECT ANSWER---------------Change made by the producer Signatures for an insurance application MUST be obtained by the producer from all of the following sources EXCEPT the producer the insured the policyowner the beneficiary ------CORRECT ANSWER---------------the beneficiary
not liable for the loss liable for the loss ------CORRECT ANSWER---------------liable for the loss How are premiums paid by the insured for personally owned disability income insurance treated for tax purposes? partially tax deductible not tax deductible fully tax deductible tax deferred ------CORRECT ANSWER---------------not tax deductible All of the following are primary risk factors in underwriting individual health insurance policies EXCEPT Geographical location Moral hazard Occupation Physical condition ------CORRECT ANSWER---------------geographical location Field underwriting performed by the producer involves assigning a risk classification to the insured providing commission information to the applicant approving or declining an applicant completing the application and collecting initial premium ------CORRECT ANSWER---------------completing the application and collecting initial premium A person who is a nonsmoker, of average weight, and in excellent health would most likely be in which risk classification?
Standard Substandard Acceptable Preferred ------CORRECT ANSWER---------------preferred A person covered with an individual health plan is issued a policy is issued a certificate of medical costs does not contract directly with the insurance company is not subject to medical underwriting ------CORRECT ANSWER--------------- Is issued a policy Which of the following is typically NOT eligible for coverage in a group health policy? Full-time employee Temporary employee Business owner Partner in a partnership ------CORRECT ANSWER---------------Temporary Employee How many employees must an employer have for a terminated employee to be eligible for COBRA? 20 30 40 50 ------CORRECT ANSWER---------------20 employees The election of COBRA for continuation of health coverage will
emplover employee producer sponsor ------CORRECT ANSWER---------------Employee Which of the following would evidence ownership in a participating health insurance contract? Stock ownership Irrevocable beneficiary status Policy ownership Collateral assignment ------CORRECT ANSWER---------------Policy ownership If an employee contributes 50% toward the disability plan premium provided by an employer, what would be considered the taxable income of a $1,000 monthly disability benefit? $ $ $ $1,000 ------CORRECT ANSWER---------------$ Which of the following does Coordination of Benefits allow? Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid Allows both a group health plan and individual health plan to coordinate their benefit payments Allows the deductible to be spread out between all the health providers Allows each health provider to pay 100% of the claim ------CORRECT ANSWER---------------Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
The purpose of the Coordination of Benefits provision in group accident and health plans is to avoid overpayment of claims reduce out-of-pocket costs reduce adverse selection lower the cost of premiums ------CORRECT ANSWER---------------avoid overpayment of claims When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? When a change of management has occurred within the group When the annual number of claims has increased by 25% When contribution or participation rules have been violated When group participation has increased by 25% ------CORRECT ANSWER---------------When contribution or participation rules have been violated Credit Accident and Health plans are designed to permit creditors the ability to require that coverage be purchased through insurers of their choice provide permanent protection help pay off existing loans during periods of disability not permit free choice of coverage selection ------CORRECT ANSWER------ ---------help pay off existing loans during periods of disability Which of the following decisions would a Health Savings Account (HSA) owner NOT be able to make?
Administrator Policyowner Insurance company Gatekeeper ------CORRECT ANSWER---------------gatekeeper Which of the following is Medicare Part B also known as? Hospital insurance Medical insurance Long-term care insurance Medigap ------CORRECT ANSWER---------------Medical Insurance Medicare Part B covers most medically necessary doctors' services, preventive care, durable medical equipment, hospital outpatient services, laboratory tests, x-rays, mental health care, and some home health and ambulance services. You pay a monthly premium for this coverage. Maria is a Preferred Provider Organization (PPO) subscriber and received care from an out-of-network provider. Which of the following is the likely result? Care is covered Care is not covered Care is only covered in a government facility Care is only covered if primary care physician gives a referral ------ CORRECT ANSWER---------------Care is covered At what age will a person normally enroll with an insurance carrier under a Part C Medicare Advantage Plan? Age 59 1/ Age 60
Age 62 Age 65 ------CORRECT ANSWER---------------age 65 Small employers who are sponsored by an insurer to provide group benefits to its employees are called Fraternal Benefit Society Surplus lines brokers Lloyd of London MEWA ------CORRECT ANSWER---------------MEWA Which of the following is NOT taken into consideration when determining eligibility for Medicare benefits? Chronic kidney disease Income Age Social Security disability ------CORRECT ANSWER---------------income The open enrollment period for Medicare Part B is January 1 through March 31 January 1 through April 30 January 1 through May 31 January 1 through June 30 ------CORRECT ANSWER---------------January 1 through March 31 Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have? Calendar-year deductible
An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is the insured responsible for? $ $ $ $800 ------CORRECT ANSWER---------------$ How is a health provider reimbursed if they do NOT have an agreement in place with the insurance company? With a contingent fee With a scheduled fee With a usual, customary, and reasonable fee With a reasonably appropriate fee ------CORRECT ANSWER--------------- With a usual, customary, and reasonable fee An insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured have to pay? $ $5, $5, $5,600 ------CORRECT ANSWER---------------$5, Major medical insurance will typically cover medical expenses that result from a crime committed by the insured a self-inflicted injury intoxication
a negative reaction to prescribed medication ------CORRECT ANSWER----- ----------a negative reaction to prescribed medication Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance? MEWA Mutual Group Hospital indemnity ------CORRECT ANSWER---------------Hospital indemnity The elimination period under a hospital indemnity plan is the period in which pre-existing conditions are not taken into consideration the period in which all deductibles are eliminated the specified number of days after an insurance policy's issue date during which coverage is not afforded for sickness the specified number of days an insured must wait before becoming eligible to receive benefits for each hospitalization ------CORRECT ANSWER-------- -------the specified number of days an insured must wait before becoming eligible to receive benefits for each hospitalization A fee for service health insurance plan will normally cover vitamins and natural remedies cosmetic procedures gym membership a disease ------CORRECT ANSWER---------------A disease Which of the following statements is NOT true regarding a Critical Illness Plan?
