TEXAS LIFE AND HEALTH: TYPES OF HEALTH POLICIES

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TEXAS LIFE AND HEALTH: TYPES OF HEALTH POLICIES

EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -57 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

Answer:

90 days Question 2: Which of the following is true regarding inpatient hospital care for HMO members?

Answer:

Care can be provided outside of the service area Question 3: In long-term health insurance, what type of care is provided with intermediate care?

Answer:

Occational nursing or rehabilitative care

Question 4: What are the 2 types of Flexible Spending Accounts?

Answer:

Health Care Accounts and Dependent Care Accounts

Question 5: Bethany studies in England for a semester. While sh is there, she is involved in a train accident that leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that shes receives?

Answer:

none Question 6: Which of the following would be an example of a limited accident and health insurance policy?

Answer:

A dread disease policy - limited risk policies cover specific illness or accidents

Question 7: Who can provide skilled nursing care?

Answer:

Doctor Question 8: In long-term care (LTC) policies, as the benefit period lengthens, the premium

Answer:

Increases Question 9: The insured's health policy only pays for medical costs related to accidents. Which of the following types of policies does the insred have?

Answer:

Accident-only Question 10: Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?

Answer:

Adult day care Question 11: All of the following are true regarding key person disability income insurance

EXCEPT

Answer:

Premiums are tax deductible as a business expense

Question 12: What is a penalty tax for nonqualified distributions from a health savings account?

Answer:

20% Question 13: A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as

Answer:

Critical illness Question 14: Which of the following would basic medical expense coverage NOT cover?

Answer:

Surgeons services

Question 15: COBRA applies to employers with at least

Answer:

20 employees Question 16: Which of the following is NOT covered under a long-term care policy?

Answer:

Acute care in a hospital Question 17: Your client wants to know what the tax implications are for the contributions to a Health Savings Account. You should advise her that the contributions are

Answer:

Tax deductible Question 18: A small company offers group health insurance to its employees, but recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?

Answer:

Convert to an individual health policy - It is legal for a company to terminate the master contrat of a group health insurance policy.

Question 19: An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?

Answer:

The PPO will pay reduced benefits - the group health plan will not pay the full amount charged by the non-PPO doctor Question 20: A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?

Answer:

15 days - a probationary period refers to the amount of time that coverage is not avaiable for illness-related disabilities, so it would not apply to a broken leg. The elimination period is the time that must elapse between the onset of the disability and when benefits will start being paid. In this case, the individual is considered disabled for 45 days, and the benefits will start to be paid after 30 days.Question 21: If an insured is not required to pay a deductible, what kind of coverage does he/she have?

Answer:

First dollar Question 22: Can an individual who belongs to a POS plan use an out of network physician?

Answer:

Yes, and they may use any prefeered physician, even if not part of the HMO Question 23: Which of the following is NOT true of a major-medical health insurance policy?

Answer:

It is designed to pay of a first dollar of expense basis Question 24: Which of the following special policies covers unusual risks that are NOT normally included under Accidental Death and Dismemberment coverage?

Answer:

Special Risk Policy - covers unusual types of risks that are not normally covered under AD&D policies. It covers only the specific hazard or risk identified in the policy, such as a racecar driver test-driving a new car.