VIRGINIA DEPARTMENT OF PROFESSIONAL AND
OCCUPATIONAL REGULATION (DPOR) | COMPLETE EXAM
QUESTIONS WITH CORRECT ANSWERS.
INTRODUCTION:
This package is designed for candidates preparing for the Virginia Health Insurance Counselor
(HIC) certification examination, administered under the authority of the Virginia State
Corporation Commission's Bureau of Insurance. The 100 questions reflect the core knowledge
areas required for certification, focusing exclusively on Virginia-specific statutes (Title 38.2 of the
Code of Virginia), regulations (Virginia Administrative Code), federal laws as applied in Virginia,
and the standards of practice for licensed HICs. Content centers on Medicare, Medicaid, long-
term care, private health insurance, and consumer rights and protections under Virginia law.
QUESTIONS (100 TOTAL):
1. Under Virginia law (Va. Code § 38.2-3407.15), what is the minimum "free-look" period that
must be offered to a purchaser of a long-term care insurance policy?
A. 10 days
B. 30 days
C. 45 days
D. 60 days
Answer: B
Rationale: Va. Code § 38.2-3407.15 mandates a minimum 30-day "free-look" period for long-
term care insurance policies. The purchaser may return the policy for any reason within this
period for a full premium refund.
2. A Virginia resident enrolled in Original Medicare (Parts A & B) has limited income and
resources. Which Virginia-administered program is designed specifically to help pay for
Medicare premiums, deductibles, and coinsurance?
A. Medicaid (Medallion 4.0)
B. Medicare Savings Program (MSP)
C. FAMIS
,D. Virginia Pharmaceutical Assistance Program
Answer: B
Rationale: The Medicare Savings Program (MSP) is a Virginia Medicaid-administered program
that uses state and federal funds to help eligible individuals pay for Medicare cost-sharing
expenses. It is distinct from full Medicaid coverage.
3. According to Virginia regulations governing HIC conduct (18VAC85-110), which of the
following actions by a certified HIC is expressly prohibited?
A. Assisting a client with completing a Medicaid application.
B. Accepting a fee directly from an insurance company for a client referral.
C. Providing comparative information on Medicare Advantage plans.
D. Conducting a public education seminar on Medicare basics.
Answer: B
Rationale: 18VAC85-110-80 (Standards of Conduct) prohibits HICs from accepting commissions,
fees, or other compensation from insurers, agents, or brokers for referrals or sales. HICs must be
free from conflicts of interest.
4. A client who is a legal immigrant with "qualified non-citizen" status and who has been a
Virginia resident for less than 5 years asks about Medicaid eligibility. What is the HIC's most
accurate response based on Virginia policy?
A. They are eligible for full Medicaid immediately.
B. They are only eligible for emergency Medicaid services.
C. They are subject to a 5-year waiting period from date of entry for full Medicaid, with
exceptions.
D. They are ineligible for all state-funded benefits.
Answer: C
Rationale: Federal law imposes a 5-year bar on "qualified non-citizens" accessing federal
Medicaid benefits, with states having options. Virginia generally follows this 5-year waiting
period from the date of entry, though exceptions exist (e.g., refugees, asylees). Emergency
Medicaid is available regardless.
,5. Under Virginia's Long-Term Care Insurance Partnership Program (established under Va. Code
§ 38.2-3407.16), what is the primary benefit for policyholders who exhaust their long-term care
insurance benefits?
A. Automatic conversion to Medicaid without asset spend-down.
B. Dollar-for-dollar asset protection for Medicaid eligibility purposes.
C. Guaranteed lifetime coverage for all long-term care expenses.
D. A cash refund of premiums paid.
Answer: B
Rationale: Va. Code § 38.2-3407.16 establishes Virginia's Long-Term Care Partnership Program,
which provides dollar-for-dollar asset protection. For every dollar in benefits paid by a qualified
partnership policy, the insured can retain one dollar in countable assets and still qualify for
Medicaid.
6. A Virginia HIC is assisting a client who is turning 65 and wants to enroll in Medicare Part B.
Under federal Medicare rules as applied in Virginia, what is the standard monthly premium for
Medicare Part B in 2024 for most beneficiaries?
A. $0
B. $104.90
C. $174.70
D. $504.90
Answer: C
Rationale: The standard monthly premium for Medicare Part B in 2024 is $174.70 for most
beneficiaries. Higher-income beneficiaries pay an Income-Related Monthly Adjustment Amount
(IRMAA). Virginia HICs must provide current premium information accurate for the enrollment
year.
7. Under Va. Code § 38.2-3438.1 (Virginia's implementation of the Affordable Care Act), what is
the maximum length of any waiting period for coverage of pre-existing conditions in individual
health insurance policies sold in Virginia?
A. 6 months
B. 12 months
C. 18 months
, D. No waiting period is permitted
Answer: D
Rationale: Va. Code § 38.2-3438.1 prohibits pre-existing condition exclusions or waiting periods
in individual health insurance policies. This aligns with the Affordable Care Act's prohibition on
pre-existing condition exclusions for plan years beginning on or after January 1, 2014.
8. Which Virginia agency is responsible for administering the FAMIS (Family Access to Medical
Insurance Security) program?
A. Virginia Department of Health
B. Virginia Department of Medical Assistance Services (DMAS)
C. Virginia Bureau of Insurance
D. Virginia Department of Social Services
Answer: B
Rationale: The FAMIS program, Virginia's Children's Health Insurance Program (CHIP), is
administered by the Virginia Department of Medical Assistance Services (DMAS). It provides
health insurance for uninsured children and pregnant women in families with incomes too high
for Medicaid but below 200% of the federal poverty level.
9. Under Virginia HIC standards of conduct (18VAC85-110-70), what is required regarding the
confidentiality of client information?
A. Confidentiality is encouraged but not legally required.
B. HICs must maintain confidentiality except when disclosure is required by law or authorized by
the client.
C. HICs may share client information with other state agencies without consent.
D. Confidentiality requirements only apply to clients over age 65.
Answer: B
Rationale: 18VAC85-110-70 requires HICs to maintain the confidentiality of client information
and records, with exceptions only for situations where disclosure is required by law (e.g.,
mandatory reporting of abuse) or specifically authorized in writing by the client.
10. A Virginia resident enrolled in both Medicare and full Medicaid (Medallion 4.0) is considered
a "dual eligible." Under Virginia Medicaid policy, what happens to the client's Medicare
premiums?