Accident and Health Final Exam
Questions & Answers
Question #87480
The Insurance Commissioner may deny an insurance license application without a
hearing:
AUnder no circumstances
BIf the applicant has a final conviction of a felony
CIf the applicant made a misstatement on his or her license application
DIf the applicant waives his or her legal rights - ANSWERSB
Explanation:
The Commissioner may, without a hearing, deny a licensing application if the applicant
has committed a felony as shown by a plea of guilty or nolo contendere, or by a final
judgment of conviction.
Question #87483
All are true about transacting insurance EXCEPT:
AIt includes soliciting insurance
BTransacting without a license is felony
CIt includes the transaction of matters subsequent to execution of the contract and
arising out of it
DIt includes the execution of a contract of insurance - ANSWERSB
Explanation:
Any person who transacts insurance without a valid license is guilty of a misdemeanor
punishable by a fine not exceed $50,000 or by imprisonment in a county jail for a period
not exceeding one year, or by both that fine and imprisonment.
Question #87487
Entities that provide both health care services and health care coverage are known as:
,ADual choice plans
BExclusive provider organizations
CHealth maintenance organizations
DPreferred provider organizations - ANSWERSC
Explanation:
Health maintenance organizations (HMOs) provide both health care services and health
care coverage to their subscribers under one umbrella. In contrast, insureds covered by
traditional health insurance indemnity plans receive health care services from the
medical profession and coverage for those services from an insurance company.
Question #87531
All of the following are true regarding the Medical Information Bureau (MIB) EXCEPT:
AMIB reports are based upon information supplied by doctors and hospitals
BInsurers may not refuse to accept an application solely due to information in an MIB
report
CMIB information is reported to underwriters in coded form
DApplicants have the right to see any information the MIB holds on them - ANSWERSA
Explanation:
The information contained in MIB reports comes from the underwriting disclosures
made by applicants to MIB member insurers on prior insurance applications.
Question #87476
An insurer organized under the laws of another state who is legally transacting
insurance in this state is known as:
AAn alien insurer
BA foreign insurer
CA non-admitted insurer
DA domestic insurer - ANSWERSB
Explanation:
A domestic insurer is organized in this state, a foreign insurer is organized in another
state and an alien insurer is organized in another country.
Question #87489
A Basic major medical insurance plan will cover all of the following EXCEPT:
APhysician visits
, BHospital expenses
CPrivate nurses
DSurgical expenses - ANSWERSC
Explanation:
Although a basic medical expense policy will cover services provided by nurses while
the insured is hospitalized, private nursing is not covered.
Question #87512
Part A of original Medicare provides coverage for those who are terminally ill and have
six months or less to live, which is known as:
AHome health care
BSkilled nursing facility care
CHospice care
DHospital care - ANSWERSC
Explanation:
Part A of original Medicare provides hospice care coverage to Medicare beneficiaries
who are terminally ill and have 6 months or less to live.
Question #87496
Medical expense insurance policies often contain a provision which states that during
the first 12 months after the policy's effective date, there is no coverage for a pre-
existing sickness that recurs. This provision is known as:
AA probationary period
BAn impairment rider
CAn elimination period
DAn exclusion - ANSWERSA
Explanation:
A "probationary period" protects the insurer from insured's who buys health insurance
because they are already sick. Traditionally, new medical expense policies stated that
any sickness that the insured was treated for during the six month period before they
purchased the policy will not be covered if it recurs within 12-months of the date the
policy became effective. However, under the Patient Protection and Affordable Care
Act, medical expense insurance plans can no longer limit or deny benefits or deny
coverage for a child younger than age 19 because the child has a "pre-existing"
condition. Starting in the year 2014, these protections will be extended to applicants of
all ages.
Question #87498
Questions & Answers
Question #87480
The Insurance Commissioner may deny an insurance license application without a
hearing:
AUnder no circumstances
BIf the applicant has a final conviction of a felony
CIf the applicant made a misstatement on his or her license application
DIf the applicant waives his or her legal rights - ANSWERSB
Explanation:
The Commissioner may, without a hearing, deny a licensing application if the applicant
has committed a felony as shown by a plea of guilty or nolo contendere, or by a final
judgment of conviction.
Question #87483
All are true about transacting insurance EXCEPT:
AIt includes soliciting insurance
BTransacting without a license is felony
CIt includes the transaction of matters subsequent to execution of the contract and
arising out of it
DIt includes the execution of a contract of insurance - ANSWERSB
Explanation:
Any person who transacts insurance without a valid license is guilty of a misdemeanor
punishable by a fine not exceed $50,000 or by imprisonment in a county jail for a period
not exceeding one year, or by both that fine and imprisonment.
Question #87487
Entities that provide both health care services and health care coverage are known as:
,ADual choice plans
BExclusive provider organizations
CHealth maintenance organizations
DPreferred provider organizations - ANSWERSC
Explanation:
Health maintenance organizations (HMOs) provide both health care services and health
care coverage to their subscribers under one umbrella. In contrast, insureds covered by
traditional health insurance indemnity plans receive health care services from the
medical profession and coverage for those services from an insurance company.
Question #87531
All of the following are true regarding the Medical Information Bureau (MIB) EXCEPT:
AMIB reports are based upon information supplied by doctors and hospitals
BInsurers may not refuse to accept an application solely due to information in an MIB
report
CMIB information is reported to underwriters in coded form
DApplicants have the right to see any information the MIB holds on them - ANSWERSA
Explanation:
The information contained in MIB reports comes from the underwriting disclosures
made by applicants to MIB member insurers on prior insurance applications.
Question #87476
An insurer organized under the laws of another state who is legally transacting
insurance in this state is known as:
AAn alien insurer
BA foreign insurer
CA non-admitted insurer
DA domestic insurer - ANSWERSB
Explanation:
A domestic insurer is organized in this state, a foreign insurer is organized in another
state and an alien insurer is organized in another country.
Question #87489
A Basic major medical insurance plan will cover all of the following EXCEPT:
APhysician visits
, BHospital expenses
CPrivate nurses
DSurgical expenses - ANSWERSC
Explanation:
Although a basic medical expense policy will cover services provided by nurses while
the insured is hospitalized, private nursing is not covered.
Question #87512
Part A of original Medicare provides coverage for those who are terminally ill and have
six months or less to live, which is known as:
AHome health care
BSkilled nursing facility care
CHospice care
DHospital care - ANSWERSC
Explanation:
Part A of original Medicare provides hospice care coverage to Medicare beneficiaries
who are terminally ill and have 6 months or less to live.
Question #87496
Medical expense insurance policies often contain a provision which states that during
the first 12 months after the policy's effective date, there is no coverage for a pre-
existing sickness that recurs. This provision is known as:
AA probationary period
BAn impairment rider
CAn elimination period
DAn exclusion - ANSWERSA
Explanation:
A "probationary period" protects the insurer from insured's who buys health insurance
because they are already sick. Traditionally, new medical expense policies stated that
any sickness that the insured was treated for during the six month period before they
purchased the policy will not be covered if it recurs within 12-months of the date the
policy became effective. However, under the Patient Protection and Affordable Care
Act, medical expense insurance plans can no longer limit or deny benefits or deny
coverage for a child younger than age 19 because the child has a "pre-existing"
condition. Starting in the year 2014, these protections will be extended to applicants of
all ages.
Question #87498
