Florida State Health Insurance Test
neighbor - ANSAn individual may purchase a life insurance policy on all of the following persons
EXCEPT:
a)dependent
b)spouse
c) business partner
d) neighbor
preexisting condition - ANSregarding long term care insurance, the existence of symptoms that
would cause an ordinarily prudent person to seek diagnosis or treatment, or a condition for
which medical advice or treatment was recommended by or received from a provider of health
care service within six months before the effective date of an insured's coverage is known as:
capitation - ANSMethod of payment in which a provider is paid a specific monthly fee for each
subscriber.
Incontestable policy - ANS2 years
group model HMO - ANScontracts with an independent medical group that specializes in a
variety of medical services in order to provide those services to its HMO subscribers.
prepaid basis - ANSHMO managed health care and the associated costs.
staff model HMO - ANScontracting physicians that are paid employees working on the staff of
the HMO. Operate at the clinic setting at the physical facility.
network model HMO - ANSan HMO that contracts with several medical groups to increase
accessibility to providers as a convenience to subscribers. Each of the medical groups is paid a
capitation fee to provide services to its Star subscribers.
individual practice association model HMO - ANSA group of individual physicians with each
physician operating from his or her own office paid a fee-for-service basis with the fees
negotiated in advance.
closed panel - ANSHMO that provides health care services from a limited number of health care
providers chosen by the HMO
long term care - ANSRefers to care provided for an extended period of time, normally more than
90 days. Depending on the severity of the impairment, assistance may be given at home, at an
adult care center, or in a nursing home.
,This pays for rehabilitative or recuperative care needed after a long illness or hospital.
long term care - ANSdescribed as broad range of medical, personal, and environmental service
designed to assist individual who have lost their ability to remain completely independent in the
community.
inflation protection - ANSincreases benefits to keep up with the anticipated cost increases for
long term care services is said to have:
the purpose of medical expense insurance is to: - ANSreimburse the insured for expenses
incurred for medical care, hospital care, and related services. In contrast, the purpose of
disability income insurance is to provide periodic payments to an insured who cannot work
because of disability. Long term care insurance pays for rehabilitative or recuperative care
needed after a long illness or hospital stay.
-written on a residual basis.
workers compensation - ANSinsurance pays for care related to a worker's injuries, disabilities,
or illness incurred the job regardless of fault.
-benefits include medical care costs and disability income.
-all states have workers' compensation laws.
-laws are designed to return injured persons to work.
-most states offer disabled employees to receive workers comp Monthly.
franchise insurance - ANSAdministered by group methods to individuals with or without
evidence of insurability. issued as individual accident and health insurance policies distributed
on a mass merchandising basis.
misrepresentation - ANSif a producer states that policy dividends are guaranteed when in fact
they are not, this is an example of:
*When an agent tells a prospect that benefits, conditions, rating or advantages exist in a product
when in fact they don't.
a)through a federally funded clinic - ANSwhen a policy covers chemotherapy cancer hormone
treatments and other approved cancel treatments, benefits are available when treatment is
received at all of the following except:
a)through a federally funded clinic
b) through outpatient treatment at a hospital
c)through hospital inpatient treatment.
d)in a doctor's office.
a) 30 days - ANSa licensed agent must notify the Department of Financial Service of his change
of address within how many days?
, a)30 days
b)10days
c) 15 days
d) 60 days
representations - ANSAll statements made by an applicant in an application for life insurance
generally are considered to be:
only written statements are considered this.
comprehensive medical expense covers all the following - ANS-Surgical fees
-Hospital miscellaneous expenses.
-hospital room and board
disability income insurance - ANS-covers loss of income resulting from accident or illness.
-In contrast, the purpose of this is to provide periodic payments to an insured who cannot work
because of disability.
-contracts written on a residual basis.
disability benefit payments - ANSpayments attributed to employee contributions are not taxable
but benefit payments that are attributed to employer contributions are taxable.
-often coordinate and reduce, the payment benefits if social security and other government
benefits are paid.
i.e. when a group disability insurance plan is paid entirely by the employer, benefits paid to
disable employees are:
waiver - ANS-voluntary relinquishment of a known right.
-refuses a legal right under a an insurance policy, it cannot deny a future claim based on
violation of that right.
estoppel - ANS-legal principle that precludes a person. It prevents someone from arguing
something contrary to what they claimed before.
-when the insurer is _______ from denying the claim.
small employer group - ANSMust not use case characteristics other than age, geographic
location, and family composition. it may not use any rating factors other than actual claims
experience without prior approval of the Commissioner.
i.e. all these characteristics are acceptable from above except 10 year medical history is not a
characteristic.
Multiple-employer welfare association (MEWA) - ANS-type of multiple-employer trust or MET
neighbor - ANSAn individual may purchase a life insurance policy on all of the following persons
EXCEPT:
a)dependent
b)spouse
c) business partner
d) neighbor
preexisting condition - ANSregarding long term care insurance, the existence of symptoms that
would cause an ordinarily prudent person to seek diagnosis or treatment, or a condition for
which medical advice or treatment was recommended by or received from a provider of health
care service within six months before the effective date of an insured's coverage is known as:
capitation - ANSMethod of payment in which a provider is paid a specific monthly fee for each
subscriber.
Incontestable policy - ANS2 years
group model HMO - ANScontracts with an independent medical group that specializes in a
variety of medical services in order to provide those services to its HMO subscribers.
prepaid basis - ANSHMO managed health care and the associated costs.
staff model HMO - ANScontracting physicians that are paid employees working on the staff of
the HMO. Operate at the clinic setting at the physical facility.
network model HMO - ANSan HMO that contracts with several medical groups to increase
accessibility to providers as a convenience to subscribers. Each of the medical groups is paid a
capitation fee to provide services to its Star subscribers.
individual practice association model HMO - ANSA group of individual physicians with each
physician operating from his or her own office paid a fee-for-service basis with the fees
negotiated in advance.
closed panel - ANSHMO that provides health care services from a limited number of health care
providers chosen by the HMO
long term care - ANSRefers to care provided for an extended period of time, normally more than
90 days. Depending on the severity of the impairment, assistance may be given at home, at an
adult care center, or in a nursing home.
,This pays for rehabilitative or recuperative care needed after a long illness or hospital.
long term care - ANSdescribed as broad range of medical, personal, and environmental service
designed to assist individual who have lost their ability to remain completely independent in the
community.
inflation protection - ANSincreases benefits to keep up with the anticipated cost increases for
long term care services is said to have:
the purpose of medical expense insurance is to: - ANSreimburse the insured for expenses
incurred for medical care, hospital care, and related services. In contrast, the purpose of
disability income insurance is to provide periodic payments to an insured who cannot work
because of disability. Long term care insurance pays for rehabilitative or recuperative care
needed after a long illness or hospital stay.
-written on a residual basis.
workers compensation - ANSinsurance pays for care related to a worker's injuries, disabilities,
or illness incurred the job regardless of fault.
-benefits include medical care costs and disability income.
-all states have workers' compensation laws.
-laws are designed to return injured persons to work.
-most states offer disabled employees to receive workers comp Monthly.
franchise insurance - ANSAdministered by group methods to individuals with or without
evidence of insurability. issued as individual accident and health insurance policies distributed
on a mass merchandising basis.
misrepresentation - ANSif a producer states that policy dividends are guaranteed when in fact
they are not, this is an example of:
*When an agent tells a prospect that benefits, conditions, rating or advantages exist in a product
when in fact they don't.
a)through a federally funded clinic - ANSwhen a policy covers chemotherapy cancer hormone
treatments and other approved cancel treatments, benefits are available when treatment is
received at all of the following except:
a)through a federally funded clinic
b) through outpatient treatment at a hospital
c)through hospital inpatient treatment.
d)in a doctor's office.
a) 30 days - ANSa licensed agent must notify the Department of Financial Service of his change
of address within how many days?
, a)30 days
b)10days
c) 15 days
d) 60 days
representations - ANSAll statements made by an applicant in an application for life insurance
generally are considered to be:
only written statements are considered this.
comprehensive medical expense covers all the following - ANS-Surgical fees
-Hospital miscellaneous expenses.
-hospital room and board
disability income insurance - ANS-covers loss of income resulting from accident or illness.
-In contrast, the purpose of this is to provide periodic payments to an insured who cannot work
because of disability.
-contracts written on a residual basis.
disability benefit payments - ANSpayments attributed to employee contributions are not taxable
but benefit payments that are attributed to employer contributions are taxable.
-often coordinate and reduce, the payment benefits if social security and other government
benefits are paid.
i.e. when a group disability insurance plan is paid entirely by the employer, benefits paid to
disable employees are:
waiver - ANS-voluntary relinquishment of a known right.
-refuses a legal right under a an insurance policy, it cannot deny a future claim based on
violation of that right.
estoppel - ANS-legal principle that precludes a person. It prevents someone from arguing
something contrary to what they claimed before.
-when the insurer is _______ from denying the claim.
small employer group - ANSMust not use case characteristics other than age, geographic
location, and family composition. it may not use any rating factors other than actual claims
experience without prior approval of the Commissioner.
i.e. all these characteristics are acceptable from above except 10 year medical history is not a
characteristic.
Multiple-employer welfare association (MEWA) - ANS-type of multiple-employer trust or MET
