Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

NY Accident and Health 17-52 exam with complete solutions., Exams of Public Health

NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions. NY Accident and Health 17-52 exam with complete solutions.

Typology: Exams

2023/2024

Available from 09/14/2024

Examprof
Examprof 🇺🇸

4.1

(24)

2.8K documents

1 / 9

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
NY Accident and Health 17-52 exam with
complete solutions.
NY Accident and Health 17-52 exam with
complete solutions.
If an insurance company obtains an investigative consumer report on a prospective
insured , it MUST inform the prospect that it is permitted to do so under which of the
following Federal laws ? - Answer = The Fair Credit Reporting Act
What is the Fair Credit Reporting Act? - Answer = established procedures that
consumer-reporting agencies must follow in order to ensure that records are
confidential, accurate, relevant, and properly used
Obtaining consumer information reports under false pretenses is prosecutable by which
of the following? - Answer = Fair Credit Reporting Act
When requesting a consumer report on a applicant, from whom must their insurer obtain
consent? - Answer = The applicant
How many years must credit information be retained? - Answer = 7 years
What is the Gramm-Leach-Bliley Act? - Answer = Establishes rules for financial
institutions on privacy notices that must be sent to consumers informing what
information is collected, how it's shared and used, and how it is protected.
Which federal law requires financial institutions to provide the consumer with
information on how personal information is used? - Answer = Gramm-Leach-Bliley Act
Which was NOT established under the Patient Protection and Affordable Care Act
(ACA)? - Answer = High deductible health plans (HDHP) (HDHP is established by the
IRS and not the ACA)
Which insurance plans are commonly offered through the worksite (employer
sponsored)? - Answer = Medicare (offered by the federal government)
The benefits paid by Medicare are most similar to? - Answer = Major medical
How long after being entitled to social security benefits will an individual be eligible to
receive Medicare benefits? - Answer = 2 years
All the following can be used to qualify for Medicare Parts A and B EXCEPT - Answer =
financial need
pf3
pf4
pf5
pf8
pf9

Partial preview of the text

Download NY Accident and Health 17-52 exam with complete solutions. and more Exams Public Health in PDF only on Docsity!

complete solutions.

NY Accident and Health 17- 52 exam with

complete solutions.

If an insurance company obtains an investigative consumer report on a prospective insured , it MUST inform the prospect that it is permitted to do so under which of the following Federal laws? - Answer = The Fair Credit Reporting Act What is the Fair Credit Reporting Act? - Answer = established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant, and properly used Obtaining consumer information reports under false pretenses is prosecutable by which of the following? - Answer = Fair Credit Reporting Act When requesting a consumer report on a applicant, from whom must their insurer obtain consent? - Answer = The applicant How many years must credit information be retained? - Answer = 7 years What is the Gramm-Leach-Bliley Act? - Answer = Establishes rules for financial institutions on privacy notices that must be sent to consumers informing what information is collected, how it's shared and used, and how it is protected. Which federal law requires financial institutions to provide the consumer with information on how personal information is used? - Answer = Gramm-Leach-Bliley Act Which was NOT established under the Patient Protection and Affordable Care Act (ACA)? - Answer = High deductible health plans (HDHP) (HDHP is established by the IRS and not the ACA) Which insurance plans are commonly offered through the worksite (employer sponsored)? - Answer = Medicare (offered by the federal government) The benefits paid by Medicare are most similar to? - Answer = Major medical How long after being entitled to social security benefits will an individual be eligible to receive Medicare benefits? - Answer = 2 years All the following can be used to qualify for Medicare Parts A and B EXCEPT - Answer = financial need

complete solutions.

Medicare? - Answer = A federal program of health insurance for persons 65 years of age and older, people who have be entitled for social security disability, or people who have permanent kidney failure etc... What is the primary qualifier for Medicare? - Answer = Age What is the primary qualifier for Medicaid? - Answer = Financial need What is Medicare part B? - Answer = medical insurance that covers outpatient medical services; services from doctors and other health care providers, home health care, medical equipment Which statement regarding Medicare is FLASE? - Answer = Part A paid for following your retirement What is Medicare part A? - Answer = hospital insurance; inpatient hospital stays, care in skilled nursing facility, hospice care, and some home health care. Under the Medicare Part B home health care benefit, all of the following are eligible expenses EXCEPT - Answer = blood transfusions Under Medicare supplement Policy, preexisting conditions CANNOT be excluded after how many months from the effective date of the policy? - Answer = 6 months Which of the following plans can be purchased to provide coverage in place of Medicare Parts A and B combined? - Answer = Medicare Advantage (part C) Which part of Medicare is also known as Medicare Advantage? - Answer = Part C What part of Medicare covers prescription drugs? - Answer = Part D Which of the following is the most common method to supplement Medicare coverage - Answer = Coverage offered by private insurers A woman is diagnosed with Alzheimer's 3 months before she applies for a Medicare Supplement policy. Can her condition be excluded under her MSP? - Answer = Yes, but her condition will be covered after 6 months What is the primary purpose of a Medicare Supplement policy (MSP)? - Answer = to pay for many of the medical expenses that Medicare coverage does not. (Fill in the gaps in Medicare) What is the purpose of a Medicare Supplement policy (MSP)? - Answer = pay for medical expenses not covered by Medicare. (Fill in coverage holes)

complete solutions.

The Affordable Care Act offers cost-sharing reductions such as lower co-payment, coinsurance, and out-of-pocket limits to insureds in what metal tier plan category? - Answer = Sliver Under the employer shared responsibility provision of the Affordable Care Act, an employer is exqmpt from penalties for not offering health insurance coverage if the employer has less than how many full-time employees? - Answer = 50 Which is NOT an essential benefit required under the Affordable Care Act? - Answer = Adult oral and vision care What is the main difference between the levels of coverage offered through the ACA? - Answer = percentage of coinsurance What is coinsurance? - Answer = The amount you pay for covered health care after you meet your deductible. Copayment - Answer = An amount of money that is paid at the time of medical service Deductible - Answer = Amount you must pay before you begin receiving any benefits from your insurance company Which regulation was established by the Federal Trade Commission and Federal Communications Commission to protect consumers? - Answer = National Do Not Call List How often do organizations need to check the Do Not Call Registry in order to stay in compliance? - Answer = Every 31 days The National Do Not call list pertains to what type of calls? - Answer = unsolicited sales calls What is the federal legislation that was established to set rules for commercial email advertisements? - Answer = CAN-SPAM What does a Long Term Care policy cover? - Answer = respite care Which level of Long Term Care must be provided occasionally by a skilled practitioner following doctor's orders? - Answer = Intermediate care What is the minimum level of renewability for a Long Term Care policy as required by State Law? - Answer = Guaranteed renewable According to the National Association of Insurance

complete solutions.

Commissioner's Model Law regulating the sale of Long Term Care insurance, your first year's rommission on an LTC sale could be no more than what amount if your second year's renewal commission is $400? - Answer = $800 (double) Which is NOT required by a Long Term Care contract? - Answer = Prior hospitalization Which is NOT an Activity of Daily Living as defined by a Long Term Care policy? - Answer = driving What is also known as ambulatory care? - Answer = outpatient care What is covered by a Long Term Care policy? - Answer = Alzheimer's Which is NOT a benefit of a Long Term Care policy? - Answer = Acute (serious) hospital care What peril(risk) does a Long Term Care insurance policy cover? - Answer = Aging What is the highest level of care under a Long Term Care policy? - Answer = Skilled nursing care Which is TRUE concerning the replacement requirements for either an LTC (Long Term Care) or an MSP (Medicare secondary Payer)? - Answer = The Notice to Applicant Regarding Replacement must be delivered to the policy owner prior to the issuance or delivery of the potsy. Which statement is TRUE concerning a Long Term Care policy? - Answer = The policy may be issued on a guaranteed renewable basis What coverage is designed for the inability to perform the Activities of Daily Living (ADLs)? - Answer = Long term care Which is the major reason why long term care insurance is becoming increasingly important? - Answer = As life expectancy increases, the chances of needing long term care also increase. The policy that is designed to provide nursing home benefits on an extended basis for NOT less than 12 consecutive months is - Answer = long term care Which is NOT a benefit paid by a Medical Expense policy? - Answer = pain, suffering Which of the following, by definition, provides benefits for expenses incurred as a result of in-hospital medical treatment and surgery as well as certain outpatient expenses

complete solutions.

How do insurance companies protect themselves against adverse selection when underwriting individual health insurance policies? - Answer = They pay for AIDS testing of all applicants Who created the Medical Information Bureau and why was it created? - Answer = the insurance companies to use as an underwriting tool The ability of an applicant to meet an insurer's underwriting requirements is also Known as - Answer = Insurability Which policy contains a Corridor Deductible? - Answer = Comprehensive Major Medical Which health insurance policy requires a beneficiary designation? - Answer = Travel accident What would a mandatory second surgical opinion likely result in? - Answer = Higher premium cost Jim has a Major Medical policy when a covered illness results in a hospital bill of $10,298.37. Jim's company pays $8,214.15. All of the following could account for the difference EXCEPT the - Answer = Elimination period Lynn owns a Comprehensive Major Medical policy with a $1,000 Base Plan, a $ Corridor Deductible, and an 80/20 Coinsurance Clause, If she incurs medical bills of $5,500 following a covered illness, how much will the company pay? - Answer = 4, A claimant must complete and return the claim forms within how many days of the loss or as soon thereafter as reasonably possible? - Answer = 90 days All life insurance and health insurance contracts contain all of the following EXCEPT - Answer = inmaterial representations The primary purpose of Health Reimbursement Accounts (HAs) is to assist - Answer = covered employees with the payment of medical expenses on a high deductible plan funded through pre-tax contributions. Evan's Major Medical policy is reinstated on February 1. When he suffers a heart attack on February 6th, he files a claim. How should the company handle the claim? - Answer = The claim is denied due to a 10-day probationary period. What is a moral hazard? - Answer = consumer attitude or behavior that leads to a higher utilization of health care services when the services are covered by insurance

complete solutions.

Which of the following is an example of a moral hazard? - Answer = Filing a false insurance claim Upon the issuance of a conditional receipt for a renewal when the premium is paid AFTER the time granted by the insurer, what is the maximum amount of time for reinstatement of the policy? - Answer = 45 days A Basic Hospital Policy pays expenses for - Answer = hospital room and board homogeneous - Answer = of a similar kind hetergeneous - Answer = different; dissimilar In order to make an accurate determination of the relative risk of an applicant for a health policy, an underwriter would need to be able to examine a - Answer = large number of homogeneous risks. Which benefit exists solely to encourage a disabled policy owner to attempt to return to work? - Answer = Recurrent Disability Dental coverage plans which list all covered dental procedures and the price the coverage will pay for each procedure are known as what type of plan? - Answer = Scheduled Dr. Martin purchases a $20,000 per month Own Occupation Disability Income policy, and Dr. Foster buys an identical policy. Dr. Martin loses his right hand in a boating accident at age 35 and is paid $240,000 per year for the rest of his life. Dr. Foster pays his premium until age 65 and never files a disability claim. This clearly demonstrates that insurance policies are what kind of contracts? - Answer = Aleatory Contracts Which comparison of a Probationary Period to an Elimination Period is TRUE? - Answer = Disability Income policies can contain both. A Health Maintenance Organization (HMO) differs from a traditional insurer in that an HMO - Answer = emphasizes preventive medicine The group conversion option is allowed for all of the following EXCEPT - Answer = during the annual benefits enrollment period. Ann's Major Medical policy lapsed 6 months ago. When she fills out her reinstatement application, the company can ask for no more than how many days of - Answer = 60 days