NY Series 17-52 Latest Update -

NY Series 17-52 Latest Update - Exam from Credible Source with 160 Questions and 100% Verified Detailed Correct Answers Guaranteed A+ Approved by Professor A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, - CORRECT ANSWER: The insurance through his company is primary.

A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called - CORRECT

ANSWER: Prepaid plan.

A rating method in which the premium is the same for all covered persons, regardless of

age, sex, or health status is referred to as - CORRECT ANSWER: Community rating

An individual applies for a life policy. Two years ago he suffered a head injury from an accident, so he cannot remember parts of his past, but is otherwise competent. He has also been hospitalized for drug abuse, but does not remember this when applying for insurance. The insurer issues the policy and learns of his history one year later. What

will probably happen? - CORRECT ANSWER: The policy will not be affected.

An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits? -

CORRECT ANSWER: No benefits

At what point must an Outline of Coverage be delivered? - CORRECT ANSWER: At the time of application or upon delivery of the policy

For the purpose of insurance, risk is defined as - CORRECT ANSWER: The uncertainty or chance of loss. 1 / 3

How many eligible employees must be included in a contributory health insurance plan?

- CORRECT ANSWER: 50%

If an employee terminates her employment, which of the following provisions would allow her to continue health coverage under an individual policy, if requested within 60

days? - CORRECT ANSWER: Conversion

If seeking repayment of Medicaid funds per the Medicaid Estate Recovery Act would

cause a hardship to survivors, states may - CORRECT ANSWER: Waive the estate

recovery requirement.

In an HMO policy, one of the main responsibilities of the primary care physician (PCP)

as a gatekeeper is to do which of the following? - CORRECT ANSWER: Help control

costs

In which Medicare supplemental policies are the core benefits found? - CORRECT

ANSWER: All plans

Medicaid provides all of the following benefits EXCEPT - CORRECT ANSWER: Income

assistance for work-related injury.

On a major medical insurance policy, the amount that an insured must pay on a claim

before the insurer will pay is known as - CORRECT ANSWER: Deductible.

Pertaining to insurance, what is the definition of a fiduciary responsibility? - CORRECT

ANSWER: Promptly forwarding premiums to the insurance company

Short term - CORRECT ANSWER: less than 2 years

The insuring clause of a disability policy usually states all of the following EXCEPT - CORRECT ANSWER: The method of premium payment. 2 / 3

The Patient Protection and Affordable Care Act includes all of the following provisions

EXCEPT - CORRECT ANSWER: Individual tax deduction for premiums paid.

The purpose of managed care health insurance plans is to - CORRECT ANSWER:

Control health insurance claims expenses.

To attain currently insured status under Social Security, a worker must have earned at

least how many credits during the last 13 quarters? - CORRECT ANSWER: 6 credits

To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been covered under the previous group plan? -

CORRECT ANSWER: 18 months

Twenty-five days after a health insurance policy is delivered, the policyowner decides that she would like to return the policy and receive a refund of premium. Which of the

following is true? - CORRECT ANSWER: The policyowner will not receive a refund

because the free-look period is over.

Under the Affordable Care Act, a special enrollment period allows an individual to enroll in a qualified health plan within how many days of a qualifying event? - CORRECT

ANSWER: 60 days

Under which of the following circumstances may the uniform individual accident and

sickness policy provisions be changed? - CORRECT ANSWER: If the change is more

favorable to the policyholder

Under which of the following disability income plans would the benefits be subject to

income tax? - CORRECT ANSWER: Group

What is the best way to change an application? - CORRECT ANSWER: Start over with a fresh application

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