Pearson Vue National Health Insurance Practice Test Questions and Answers Latest Updated 2024/2025 | Graded A+

Pearson Vue National Health Insurance Practice Test Questions and Answers Latest Updated 2024/2025 | Graded A+. 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: correct answer- 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 Pearson Vue National Health Insurance Practice Test Questions and Answers Latest Updated 2024/2025 | Graded A+ 2 / 15 C. salary grade D. job category: correct answer- 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 insured'stime of disability. C. It allows the insured to extend the length of the Grace Period while disabled.D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums.: correct answer- d 4. Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy features? 3 / 15 A. Extensions of coverage B. Benefits clause 4 / 15 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 policyissue 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 5 / 15 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? 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: 6 / 15 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 7 / 15 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: b 10. An individual who has had a heart murmur since birth is likely to be issued an individual disability policy that includes: A. Guaranteed Insurability rider B. an Exclusionary/ Impairment rider C. Waiver of Premium rider D. Double Indemnity rider: b 11. Which of the following statements is CORRECT about coinsurance? A.It applies to deductibles as well as to claim payments. 8 / 15 A. It applies to deductibles as well as to claim payments. B.It helps control overutilization of benefits. C. It is effective for the first claim payment and waived for future claims. D. Insurance companies may adjust the coinsurance ratio after issuing a policy.: b 12. The insurance policy clause that identifies the contracting parties and defines the scope and limits of coverage is called the: A. Insuring clause B. Benefit clause C. Consideration clause D. Renewal clause: a 13. In an Accidental Death and Dismemberment (AD&D) policy, the term "capital sum" refers to: 9 / 15 A.the benefit paid for death caused by a dread disease A. the benefit paid for death caused by a dread disease B. the monthly disability income paid if an insured loses a limb or the sight in one or both eyes C. a lump sum payment made when disease causes the amputation of an arm or a leg D. a lump sum payment made for an accidental dismemberment: d 14. A group long-term disability plan is integrated with Social Security when which of the following statements is CORRECT? A. Social Security and group benefits pay a combined maximum limit. B. Full group benefits are paid in addition to Social Security benefits.