HEALTH INSURANCE EXAM-ILLINOIS

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HEALTH INSURANCE EXAM-ILLINOIS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -100 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Incontestability Clause

Answer:

after the policy has been in effect two years the insurance company cannot contest a policy doe to any misstatement or concealment unless it can prove fraud

Question 2: Health Savings Accounts (HSAs)

Answer:

cover hospital/medical expenses not covered by a high deductible health plan

Question 3: Under Medicare Advantage Plan, Medicare pays

Answer:

Part A and B costs to the insurance company

Question 4: (tax) group expense coverage is usually

Answer:

no tax on benefits (tax free)

Question 5: Daily hospital benefits

Answer:

pays for hospital room, board, general nursing care, and other routine services

Question 6: Nonretroactive waiting (elimination) period provision

Answer:

will usually have a lower premium during waiting period

Question 7: (tax) premiums on ind. hospital/medical expense policies

Answer:

can sometimes be tax deducted; depends on whether an ind is self-employed and if ind. itemizes on tax returm

Question 8: (tax)Individual Disability income policy premiums usually

Answer:

cannot be tax deducted; no tax on ind. Disability income benefits (tax free)

Question 9: Purpose of probationary period provision

Answer:

is to avoid adverse selection

Question 10: Disability income insurance protects

Answer:

an insured against the financial risk of loss of income due to disability

Question 11: Limited Disease coverage

Answer:

It is a supplement to other coverages and pays benefits only if the insured incurs a disease specified in the policy (ex cancer or heart disease); pays a fix, stated amount and is non-coordinating

Question 12: State insurance regulations authorize #

Answer:

14 Medicare supplement plans lettered A through N

Question 13: unacceptable question on application to base premiums

Answer:

past medical history, gender, occupation, ethnicity

Question 14: Workers Compensation Insurance

Answer:

is a type of casualty insurance not health insurance; Private, Blue Cross/Blue Shield, PPOs and HMO plans usually exclude expenses covered by Workers Comp

Question 15: Social Security Disability Benefits (fully insured status)

Answer:

contributed to Social Security at least 40 quarters or 10 years

Question 16: Co-Payment

Answer:

is a small, specific amount that the insured must pay before the insurance company begins to indemnify for a particular type of expense

Question 17: Non-coordinating policy

Answer:

is a policy that does not include a coordination of benefits provision Question 18: Definitions of Total Disability: Any occupation

Answer:

insured is unable to perform the functions of any occupation at all (low premiums; most conservative)

Question 19: Affordable care act ___contain impairment riders

Answer:

cannot

Question 20: (tax) premiums paid by an ind. on ind. diability income policies

Answer:

usually cannot be tax deducted (non qualified)

Question 21: Maximum Out-of-Pocket

Answer:

is the max the insured will be required to pay under both the deductible and policyholder participation requirements

Question 22: Waiver of Premium Rider

Answer:

extra premium charge; it waives premiums as long as the policy owner is disabled starting after a specified period, such as after the sixth month of disability

Question 23: Miscellaneous Hospital Expense benefits

Answer:

pays for hospital laboratory, x-ray, anesthetic, operating room, and medicine and dressing expenses

Question 24: (tax) contributions to HSAs are

Answer:

usually tax deductible Question 25: All insurance companies that offer Medicare Supplement Plans must offer

Answer:

Plan A

Question 26: Double Benefit provision

Answer:

pays double the principal (capital) sum, if the insured dies in a specified type of accident, such as while a fare paying passenger on a common carrier; also called double indemnity

Question 27: Hospital expense coverage

Answer:

pays benefits for only hospital expenses. Deductibles, coinsurance and/or co-payments may apply Question 28: (tax) ind. expense policies, ind disability income policies, are usually

Answer:

tax free and have no tax on the benefits

Question 29: Blue Shield originally assured payment of

Answer:

physician's charges