Health Insurance Florida 2-40 Practice
Exam Questions #2 and Answers 100%
Pass Solution 2025
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - ANSWER>>Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a business
owner becomes disabled. Expenses such as rent, utilities, telephone,
equipment, employees' salaries, etc.)
All of the following are state or federal government programs that provide
health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - ANSWER>>Medigap (Explanation:A Medigap policy is a
Medicare supplement insurance policy sold by private insurance companies
to fill "gaps" in Medicare Parts A and B.)
What type of health insurance is available to assist low-income individuals?
- ANSWER>>Medicaid
What types of reserves are set aside and held by health insurance
companies? - ANSWER>>Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides for
dividends or experience rating. What is the basis called? -
ANSWER>>Participating (Explanation:Group plans written by mutual
,companies provide for dividends while stock companies frequently issue
experience-rated plans.)
Which of the following is NOT TRUE regarding eligibility for subsidies for
families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - ANSWER>>Can be eligible for Medicaid
Which of the following operates as a corporation, society, or association to
provide life insurance primarily for the mutual benefit of its members, has a
lodge or social system with rituals and representative form of government?
A) Mutual companies
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - ANSWER>>B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay -Fixed
premium whether or not plan is used
-Premium based on how often plan is used - ANSWER>>Fixed premium
whether or not plan is used
Which of the following is correct about those who are eligible for Medicare
and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the Medicare
Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - ANSWER>>They
must be told that'll be getting all the benefits from the Medicare Advantage
plan
,Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce, EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - ANSWER>>Coverage ends after 18
months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each fiscal
year
-Must deposit $100,000 with the Rehabilitation Administration Expense
Fund
-Must be sold by agents licensed and appointed as health insurance agents
- ANSWER>>Must deposit $100,000 with the Rehabilitation Administration
Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration Expense
Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
-Fixed amount paid by an HMO during a policy period
-Fixed amount paid by an HMO to a physician for medical services -Amount
required to be deposited with the State of Florida -
ANSWER>>Fixed amount paid by an HMO to a physician for medical
services
When a person is covered by an HMO, the contract certificate or member's
handbook must be delivered within how many days after approval of the
enrollment by the HMO?
-20 days
-10 days
, -5 days
-14 days - ANSWER>>10 days
Which of the following statements about health service organizations is
true?
-They reimburse Policyowners directly for physicians' fees
-They provide loss of income benefits to Policyowners
-They reimburse Policyowners directly for all medical expenses -They
provide benefit payments directly to the hospitals and physicians
providing services - ANSWER>>They provide benefit payments directly to
the hospitals and physicians providing services
What is the period of time for an HMO "open enrollment"?
-45 days during every 18-month period
-30 days during every 12-month period
-30 days during every 18-month period
-45 days during every 12-month period - ANSWER>>30 days during every
18-month period
If an HMO is found guilty of unfair trade practices, what is the maximum
penalty that can be charged?
-Up to $50,000
-Up to $150,000
-Up to $200,00
-Up to $100,000 - ANSWER>>Up to $200,00
Which of the following statements about Worker's Compensation laws is
INCORRECT?
-Employers can purchase coverage through the state program, private
insurers or can self-insure
-Worker's compensation provides benefits for work-related injuries, illness
or death
-Not all states have a workers compensation law
-Basic principle is that work-related injuries are compensable by the
employer without regard to fault - ANSWER>>Not all states have a workers
Exam Questions #2 and Answers 100%
Pass Solution 2025
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - ANSWER>>Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a business
owner becomes disabled. Expenses such as rent, utilities, telephone,
equipment, employees' salaries, etc.)
All of the following are state or federal government programs that provide
health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - ANSWER>>Medigap (Explanation:A Medigap policy is a
Medicare supplement insurance policy sold by private insurance companies
to fill "gaps" in Medicare Parts A and B.)
What type of health insurance is available to assist low-income individuals?
- ANSWER>>Medicaid
What types of reserves are set aside and held by health insurance
companies? - ANSWER>>Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides for
dividends or experience rating. What is the basis called? -
ANSWER>>Participating (Explanation:Group plans written by mutual
,companies provide for dividends while stock companies frequently issue
experience-rated plans.)
Which of the following is NOT TRUE regarding eligibility for subsidies for
families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - ANSWER>>Can be eligible for Medicaid
Which of the following operates as a corporation, society, or association to
provide life insurance primarily for the mutual benefit of its members, has a
lodge or social system with rituals and representative form of government?
A) Mutual companies
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - ANSWER>>B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay -Fixed
premium whether or not plan is used
-Premium based on how often plan is used - ANSWER>>Fixed premium
whether or not plan is used
Which of the following is correct about those who are eligible for Medicare
and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the Medicare
Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - ANSWER>>They
must be told that'll be getting all the benefits from the Medicare Advantage
plan
,Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce, EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - ANSWER>>Coverage ends after 18
months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each fiscal
year
-Must deposit $100,000 with the Rehabilitation Administration Expense
Fund
-Must be sold by agents licensed and appointed as health insurance agents
- ANSWER>>Must deposit $100,000 with the Rehabilitation Administration
Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration Expense
Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
-Fixed amount paid by an HMO during a policy period
-Fixed amount paid by an HMO to a physician for medical services -Amount
required to be deposited with the State of Florida -
ANSWER>>Fixed amount paid by an HMO to a physician for medical
services
When a person is covered by an HMO, the contract certificate or member's
handbook must be delivered within how many days after approval of the
enrollment by the HMO?
-20 days
-10 days
, -5 days
-14 days - ANSWER>>10 days
Which of the following statements about health service organizations is
true?
-They reimburse Policyowners directly for physicians' fees
-They provide loss of income benefits to Policyowners
-They reimburse Policyowners directly for all medical expenses -They
provide benefit payments directly to the hospitals and physicians
providing services - ANSWER>>They provide benefit payments directly to
the hospitals and physicians providing services
What is the period of time for an HMO "open enrollment"?
-45 days during every 18-month period
-30 days during every 12-month period
-30 days during every 18-month period
-45 days during every 12-month period - ANSWER>>30 days during every
18-month period
If an HMO is found guilty of unfair trade practices, what is the maximum
penalty that can be charged?
-Up to $50,000
-Up to $150,000
-Up to $200,00
-Up to $100,000 - ANSWER>>Up to $200,00
Which of the following statements about Worker's Compensation laws is
INCORRECT?
-Employers can purchase coverage through the state program, private
insurers or can self-insure
-Worker's compensation provides benefits for work-related injuries, illness
or death
-Not all states have a workers compensation law
-Basic principle is that work-related injuries are compensable by the
employer without regard to fault - ANSWER>>Not all states have a workers
