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NATIONAL HEALTH INSURANCE PRACTICE TEST PEARSON VUE – HEALTH INSURANCE CERTIFICATION (2025) COMPLETE PRACTICE QUESTIONS WITH ANSWERS A+ VERIFIED LATEST VERSION

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This document includes a comprehensive set of multiple-choice practice questions and answers focused on health and accident insurance concepts, including disability income, Medicare, policy provisions, and claims procedures. It covers essential exam topics such as renewability, exclusions, group insurance, and legal aspects of health policies. The material is structured to reflect Pearson VUE-style certification exams and is suitable for exam preparation and knowledge reinforcement.

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NATIONAL HEALTH INSURANCE PRACTICE TEST PEARSON VUE – HEALTH INSURANCE
CERTIFICATION (2025) COMPLETE PRACTICE QUESTIONS WITH ANSWERS A+ VERIFIED
LATEST VERSION
1. An insurer must provide claim forms to an insured within a MAXIMUM of
how many days after receiving notice of an Accident & Health claim?

A. Five

B. Fifteen

C. Twenty

D. Thirty: b
2. Under a group health plan, an employer may offer additional benefits to
classes of employees on the basis of all of the following factors EXCEPT:

A. length of employment

B. gender

C. salary grade

D. job category: b
3. Which of the following statements is CORRECT about a Waiver of Premium
provision in a Disability Income policy?

A. It allows the insurer to deduct premiums due from the disabled insured's
benefit payments.

B. It allows the insurer to increase the amount of premium during the in-
sured's time of disability.

C. It allows the insured to extend the length of the Grace Period while dis-
abled.

D. It allows the insured to maintain a policy in force while disabled and unable
to pay premiums.: d


, NATIONAL HEALTH INSURANCE PRACTICE TEST PEARSON VUE – HEALTH INSURANCE
CERTIFICATION (2025) COMPLETE PRACTICE QUESTIONS WITH ANSWERS A+ VERIFIED
LATEST VERSION
4. Suicide, pre-existing conditions and self-inflicted injuries are dealt with in
which of the following policy features?

A. Extensions of coverage

B. Benefits clause

C. Riders

D. Exclusions: d
5. 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?

A. Pay the full claim

B. Pay the claim for a maximum of six months only

C. Deny the claim on the basis of misrepresentation

D. Deny the claim because it involves a pre-existing condition: a
6. A health care plan that reimburses a flat fee for medical care it provides at
a clinic it owns and operates is referred to as:

A. Health Maintenance Organization

B. Medicaid

C. Medicare

D. Multiple Employer Trust (MET): a
7. Which of the following laws requires an insurer to notify an applicant in
writing that an investigative consumer report may be made on the applicant?


, Pearson Vue National Health Insurance Practice Test
Study online at https://quizlet.com/_8k4370


A. Uniform Provisions Law

B. Freedom of Information Act

C. Medical Information Bureau Disclosure Act

D. Fair Credit Reporting Act (Insurance Information and Privacy Protection
Act): d
8. Under a Guaranteed Renewable Accident & Health policy, an insurer retains
the right to:
A. increase the premium rate for one insured without increasing the rate for
others in the same class

A. increase the premium rate for one insured without increasing the rate for
others in the same class

B. increase the premium rate for an entire class of insureds

C. increase the benefits for an individual insured

D. decrease benefits for one insured without decreasing benefits for others
in the same class: d
9. Under a Guaranteed Renewable Accident & Health policy, an insurer retains
the right to:
A. increase the premium rate for one insured without increasing the rate for
others in the same class

A. increase the premium rate for one insured without increasing the rate for
others in the same class

B. increase the premium rate for an entire class of insureds

C. increase the benefits for an individual insured

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