State Exam Simulator - 200 Questions And And Answers

In group health, what is the purpose of coordination of benefits provision? - ANS Determines what is paid by the primary and secondary insurers in the event of a claim According to the principal of utmost good faith, the insured will answer questions on the application to the best of their knowledge and pay the required premium, while the insurer will deal fairly with the insured and it's - ANS Promises made Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of - ANS 100% of costs Insurable interest does not occur in which of the following relationships? - ANS Business owner and business client After an insured gives notice of loss, what must he/she do if the insured does not furnish forms? - ANS File written proof of loss Joe is a Medicare participant who receives his benefits through a managed healthcare plan. Which Medicare plan does he have? - ANS Part C Ambiguities in an Insurance policy are always resolved in favor of the - ANS insured What does a Medicare supplement policy cover? - ANS Allowable amounts under Medicare part B Which of the following would evidence ownership in a participating health insurance contract? - ANS Policy ownership In what form do disability income policies typically pay benefits? - ANS Periodic income Before holding a hearing regarding a producer's unfair or deceptive practice, the Commissioner must give how many days notice? - ANS 10 When comparing an HMO to a PPO, the PPO - ANS provides a greater choice of providers Medicaid is a government funded program designed to provide health care to - ANS poor people Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss. - ANS 20 An individual can enroll in a part C Medicare advantage plan at what time? - ANS When becoming eligible for Medicare Someone needing custodial care at home would require which type of coverage? - ANS long term care In which of the following situations would the insurer be liable for the loss? - ANS The insured suffered an injury as an innocent bystander during a bank robbery What is issued to each employee of an employer health plan? - ANS certificate Coordination of benefits regulation applies to all of the following plans except? - ANS Preferred provider organization plan which of these would not be considered a presumptive disability? - ANS Loss of a leg or arm Which of the following is not considered rebating - ANS Sharing commission with an agent licensed in the same line of business The federal employees benefit program consists of two types of health plans for federal civilian employees. The two plans are fee-for-service and - ANS prepaid Which of the following is not considered advertising - ANS A rating from a rating service company, such as A.M. Best ABC insurance company transfer part of their risk to XYZ insurance company. This situation is called - ANS Reinsurance Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental? - ANS Accidental bodily injury provision What makes an insurance policy unilateral contract? - ANS Only the insurer is legally bound Small employers who are sponsored by an insurer to provide group benefits to its employees are called - ANS MEWA (multiple employer welfare association) Which of the following is not a valid reason for the suspension of a producer license? - ANS Filing bankruptcy The IRS states that a taxpayer's medical expenses that exceed 7.5% of their adjusted gross income is tax deductible. Which of the following may be considered a medical expense under this rule? - ANS Long-term care insurance premiums In contrast to a guaranteed renewable policy, a noncancellable policy - ANS may never raise premiums Richard owns an insurance policy that is renewable only at the option of the insurance company. His policy is considered to be - ANS Optionally renewable What is implied authority defined as - ANS Authority that is not specifically given to an agent in the agency contract, but that an agent can reasonably assume to carry out his/her duties