HEALTH INSURANCE FLORIDA 2-40 PRACTICE EXAM

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HEALTH INSURANCE FLORIDA 2-40 PRACTICE EXAM

QUESTIONS 1

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -51 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Five years ago, at age forty-five, X stated that he was forty years old on a disability income insurance application. X now submits a claim and the insurer discovers X's true age. The insurer will most likely take which of the following actions?-Deny the claim due to material misrepresentation on the application -Pay the claim as filed because the policy becomes incontestable after two years -Pay the claim and cancel the policy -Adjust the benefits downward according to the benefits that X would have been entitled to based on the premiums

Answer:

Adjust the benefits downward according to the benefits that X would have been entitled to based on the premiums Question 2: The PRIMARY purpose of Medicaid is to: -pay for expenses not covered by Medicare -provide Disability Income benefits to people on Medicare -provide Medical Expense coverage to persons meeting certain minimum income requirements -provide funds for people injured in natural disasters

Answer:

provide Medical Expense coverage to persons meeting certain minimum income requirements

Question 3: The Internal Revenue Service (IRS) considers Disability Income benefits paid under

an employer-paid group Disability Income (generally) to be:

Taxable for thirteen weeks only Non-taxable for twenty-six weeks only Fully taxable Non-taxable

Answer:

Non-taxable Question 4: Because health insurance policies are offered on a "take it or leave it" basis, they are referred to as which of the following types of contracts?Aleatory Contracts Executory Contracts Unilateral Contracts Contracts of Adhesion

Answer:

Contracts of Adhesion Question 5: The Elimination Period in most Disability Income policies applies: To each separate disability To claims for accidents only Only the first time the insured is disabled during the first 30 days of the contract

Answer:

To each separate disability Question 6: The Coordination of Benefits clause found in group health master contracts is used

to:

Integrate Disability Income benefits with Medical Expense benefits Avoid double payment of benefits to an insured who has duplicate group coverage Investigate the claims history of an insured and his dependents Avoid duplicate premium charges to an employer for the same employee

Answer:

Avoid double payment of benefits to an insured who has duplicate group coverages Question 7: Which of the following types of provisions guarantees renewability to a specified date or age unless certain specified events occur?-Noncancellable -Optionally Renewable -Guaranteed Renewable -Conditionally Renewable

Answer:

Conditionally Renewable Question 8: The Notice of Claim provision in an Accident and Health policy requires that an insured give written notice to the insurer within a MAXIMUM of how many days after a loss?7 10 15 20

Answer:

20 Question 9: Medicare Supplement policies are primarily designed to: -offset the high cost of Medicare -provide additional retirement income to supplement Social Security retirement benefits -provide additional benefits beyond those provided by Medicare -provide a reinsurance network that spreads the Medicare risk among private insurance companies

Answer:

provide additional benefits beyond those provided by Medicare Question 10: A producer and an applicant complete an application for a health policy and submit it to the insurer for underwriting without any premium. The underwriter issues a policy and mails it to the producer for delivery to the applicant. The producer should take all of the

following actions during the delivery of the policy to the applicant EXCEPT:

Collect the initial premium payment Issue a conditional receipt Have the applicant complete a statement of continued good health Explain the Free Look provision which begins on the policy delivery date

Answer:

Issue a conditional receipt Question 11: Under the Claims Forms provision of a health policy, if the insurance company fails to send out the claim forms within the time period required by the provision, the insured

should:

Demand a full refund of all premiums paid plus interest Submit the claim in any form, which must be accepted by the company as adequate proof of loss Request the state Department of Insurance to act as umpire in settling the claim Do nothing until the claim form arrives

Answer:

Submit the claim in any form, which must be accepted by the company as adequate proof of loss Question 12: An Eligible Expenses provision in a comprehensive major medical health insurance policy commonly identifies all of the following types of health care services as being

covered by that policy EXCEPT:

-professional services of doctors and other medical practitioners -hospital charges for semi-private room and board -experimental and investigative services -services of Registered Nurses

Answer:

experimental and investigative services Question 13: An insured becomes disabled three years after his Disability Income policy is issued. The disability is caused by a condition that existed prior to the policy issue date but was not specifically excluded from coverage. In this situation, the insurer will most likely take which of the following actions?-Pay the full claim -Pay the claim for a maximum of six months only -Deny the claim on the basis of misrepresentation -Deny the claim because it involves a pre-existing condition

Answer:

Pay the full claim Question 14: All of the following elements are required of a contract EXCEPT: -assignment -acceptance -legal capacity -legal purpose

Answer:

assignment Question 15: A prehospitalization authorization program (pre-certification) is a good example of: Managed care Traditional indemnity Medicare Workers' Compensation

Answer:

Managed care