WISCONSIN HEALTH EXAM PSI

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WISCONSIN HEALTH EXAM PSI

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -68 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: What does grace period protect the policyholder from?

• having to prove whether a condition is pre-existing
• a change in mind about the initial purchase of the policy
• mistakingly omitting a beneficiary from the initial contract
• an unintentional lapse of the policy

Answer:

• an unintentional lapse of the policy

Question 2: What happens with the lifetime maximum benefit limit has been reached?

a) The insured will pay all of the remianing medical costs for as long as the policy is in force

b) The provider who has reached the limit will no longer receive payments from the insurer

c) The insurer will pay all of the remaining medical costs for as long as the policy is in force

d) A new policy is issued and the maximum benefit limit is reset to zero ($0)

Answer:

a) The insured will pay all of the remianing medical costs for as long as the policy is in force

Question 3: When should a buy-sell agreement include a provision for the buy-out of an owner's business interest in the event of a disability?

a) When there is a buy-sell agreement funded with life insurance to buyout the interest of a

deceased owner or partner

b) When there is a buy-sell agreement funded with disability insurance to buyout the interest of

a deceased owner or partner

c) When a company is newly purchased and it is likely the new owner will be disabled within a

year

d) When a takeover of a company with an owner who is in ill-health occurs

Answer:

a) When there is a buy-sell agreement funded with life insurance to buyout the interest of a deceased

owner or partner Question 4: According to the time of payment of claims provision, the insurer must make the payment immediately after receiveing proof of loss EXCEPT

• when the policy is in the incontestability period
• for claims involving periodic payments
• if the insured is able to eventually return to work
• if the death is a suicide or due to pre-existing condition

Answer:

• for claims involving periodic payments

Question 5: In order for an insurer to increase the premium on a noncancellable policy, which of the following MUST be true?

a) The premium increase must be in line with current inflation rates

b) The insured develops a mdeical condition that increaes risk

c) The insured reaches the age of 65

d) The premium increase must be in the contract at the time it is issued

Answer:

d) The premium increase must be in the contract at the time it is issued

Question 6: Obtaining consumer information reports under false pretenses is prosecutable by which of the following?

a) USA Patriot Act

b) State laws where the applicant resides

c) Fair Credit Reporting Act

d) Securities and Exchange Commission

Answer:

c) Fair Credit Reporting Act

Question 7: Which of the following is true for most comprehensive dental policies?

a) Comprehensive dental policies must be offered separately from medical policies

b) Orthodontia typically has a higher coinsurance than other covered services

c) Purely cosmetic procedures are sometimes covered

d) Routine care is provided withount coinsurance or deductibles

Answer:

d) Routine care is provided withount coinsurance or deductibles

Question 8: When will a policy pay on a UCR basis?

• when the treatment is received in a different geographic area than when the insured lives
• when the provider charges a different amount than is listed on the payment schedule
• when particular benefits are not listed on a payment schedule

d) When a surgical procedure is not pre-approved by the insurer

Answer:

• when particular benefits are not listed on a payment schedule

Question 9: What is the maximum amount of time an insurer has to provide the claimant the forms for filing proof of loss?

• 7 days
• 30 days
• 90 days
• 15 days

Answer:

• 15 days

Question 10: When can the premiums of an individually owned health insurance policy be deducted from the individual's income tax?

a) When the taxpayer's medical expenses exceed 7.5% of adjusted gross income during a

taxable year

b) When the taxpayer's medical expenses exceed 5.0% of adjusted gross income during a

taxable year

c) Any taxpayer who itemizes deductions may deduct their health insurance premiums

d) Never because only group owned health insurance premiums may be deducted

Answer:

a) When the taxpayer's medical expenses exceed 7.5% of adjusted gross income during a taxable year

Question 11: A group conversion option may be used in all the following instances EXCEPT

• the termination of the master policy
• loss of coverage due to loss of employment
• loss of eligibility on the part of a class of insureds
• a life-changing event, such as marriage, divorce, or childbirth

Answer:

• a life-changing event, such as marriage, divorce, or childbirth