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3. Florida Statutes, Rules, and Regulations Pertinent to Health Insurance Questions and Answers 2025

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3. Florida Statutes, Rules, and Regulations Pertinent to Health Insurance Questions and Answers 2025

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2024/2025

Institution Florida Laws & Rules For Psychologists

Course Florida Laws & Rules for Psychologists

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3. Florida Statutes, Rules, and Regulations Pertinent to Health Insurance Questions and Answers 2025

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3. Florida Statutes, Rules, and Regulations
Pertinent to Health Insurance Questions and
Answers 2025
GrandfatheredA-ACORRECTAANSWERSA-exemptAfromAaAnewAlawAorAregulation
IndemnityAcontractA-ACORRECTAANSWERSA-
paysAhealthApolicyAbenefitsAtoAtheAinsuredAbasedAonAaApredetermined,AfixedArate,Aregardle
ssAofAtheAactualAexpenseAincurred
NonrenewA-ACORRECTAANSWERSA-terminateAanAinsuranceApolicyAatAitsAexpirationAdate
WhatAtypeAofAinformationAisANOTAincludedAinAaAcertificateAofAinsurance?A-
ACORRECTAANSWERSA-TheAcostAofAtheAcompanyAisApayingAforAmonthlyApremiums

WhichAofAtheAfollowingAentitiesAmustAapproveAofAallAMedicareAsupplementAadvertisements
?A-ACORRECTAANSWERSA-InsuranceACommissionerAorADirector
AAgroupApolicyAusedAtoAprovideAaccidentAandAhealthAcoverageAonAaAgroupAofApersonsAbein
gAtransportedAbyAaAcommonAcarrier,AwithoutAnamingAtheAinsuredApersonsAindividuallyAisAc
alledA-ACORRECTAANSWERSA-BlanketApolicy
blanketApolicyA-ACORRECTAANSWERSA-
aAsingleApolicyAcoveringAseveralAcertificateAholdersAwithoutAnamingAtheAinsuredsA
individually
TheAinflationAprotectionAfeatureAinAlong-
termAcareApoliciesAissuedAinAthisAstateAmustAprovideAprotectionAforAinflationAatAwhatAperce
ntAannually?A-ACORRECTAANSWERSA-5%
WhichAofAtheAfollowingAdoesANOTAdescribeAhospiceAcare?A-ACORRECTAANSWERSA-
itAprovidesAcareAtoApeopleAwithAlifeAexpectanciesAofA1AtoA2Ayears
AnAHMOAthatAisAfoundAtoAbeAinAviolationAbyAcommittingAanAunfairAtradeApracticeAasAdefineAi
nAtheAact,AmayAsufferAtheApenaltyAofA-ACORRECTAANSWERSA--
SuspensionAofAcertificateAofAauthority
-revocationAofAlicense
-AdministrativeAfine
WhichAofAtheAfollowingAisANOTAanAUnfairATradeAPracticeAunderAFloridaAlawAwithAregardAtoA
HMOAplans?A-ACORRECTAANSWERSA-OperatingAanAHMOAonAaAclosed-panelAbasis
Long-
termAcareApoliciesArequireAthatAinAadditionAtoAtheAapplicantAatAleastAoneApersonAmustAbeAd
esignatedAinAtheApolicy.AWhatAisAtheAroleAofAthatAdesignatedAperson?A-
ACORRECTAANSWERSA-ToAreceiveAnoticeAofApolicyAlapseAorAtermination

AAgroupAblanketAhealthApolicyAisAbestAsuitedAforAwhichAofAtheAfollowing?A-
ACORRECTAANSWERSA-AAsummerAcamp

WhenAanAHMOAknowinglyAmakesAanyAmisleadingArepresentations,AincompleteAorAfraudul
entAcomparisonsAforAtheApurposeAofAinducingAanyApersonAtoAlapse,Aforfeit,Aterminate,Asurr
enderAorAconvertAanyAinsuranceApolicyAorAcontractAwithAanotherAinsuranceAcompanyAorAH
MO,AtheyAareAinAviolationAofAtheAunfairAtradeApracticeAofA-ACORRECTAANSWERSA-twisting

, WhichAofAtheAfollowingAwasAdesignedAtoAensureAcontinuedAaccessAtoAaffordableAhealthAins
uranceAcoverageAforAemployeesAofAsmallAemployers,AtheirAdependents,AandAotherAqualifie
dAbeneficiariesAnotAcurrentlyAprotectedAbyACOBRA?A-ACORRECTAANSWERSA-
FloridaAHealthAInsuranceACoverageAContinuationAAct
AnAindividualApurchasedAaaAMedicareAsupplementApolicyAinAMarchAandAdecidedAtoAreplac
eAitA2AmonthsAlater.AHisAhistoryAofAcoronaryAarteryAdiseaseAisAconsideredAaApre-
existingAcondition.AWhichAofAtheAfollowingAisAtrue?A-ACORRECTAANSWERSA-TheApre-
existingAconditionAwaitingAperiodAfulfilledAinAtheAoldApolicyAwillAbeAtransferredAtoAtheAnewAp
olicy,AtheAnewAoneApickingAupAwhereAtheAoldAoneAleftAoff
TheAFloridaAEmployeeAHealthACareAAccessAActAservesAwhichAofAtheAfollowingApurposes?A
-ACORRECTAANSWERSA-
ItAregulatesAgroupAhealthAinsuranceAprovisionsAprovidedAbyAinsurersAorAHMOsAtoAsmallAe
mployers
AAmedicalAinsuranceAplanAinAwhichAtheAhealthAcareAproviderAisApaidAaAregularAfixedAamoun
tAforAprovidingAcareAtoAtheAinsuredAandAdoesAnotAreceiveAadditionalAamountsAofAcompensa
tionAdependentAuponAtheAprocedureAperformedAisAcalledA-ACORRECTAANSWERSA-
PrepaidAplan
WhichAtypesAofAinsuranceAcompaniesAmarketingAlong-
termAcareAinsuranceAcoverageAmustAestablishAproceduresAtoAassureAthatAanyAcomparison
AofApoliciesAbyAitsAagentsAwillAbeAfairAandAaccurate?A-ACORRECTAANSWERSA-

EveryAcompanyAisArequiredAtoAestablishAmarketingAprocedures
AnAinsuranceAadvertisementAexaggeratesAtheAbenefitsAofAanAinsuranceApolicy,AdueAtoAhu
manAerrorAatAtheAinsurer'sAadvertisingAagency.AWhoAwillAtheADepartmentAofAInsuranceAhol
dAresponsibleAforAtheAexaggeration?A-ACORRECTAANSWERSA-
TheAinsurerAwillAbeAheldAresponsible
AnAinsurerAhiresAaArepresentativeAtoAadvertiseAitsAcompanyAatAaAlocalAconvention.ATheArep
resentativeAliesAaboutAtheAdetailsAofAsomeAofAtheApolicies,AinAanAattemptAtoAsecureAmoreAb
usinessAforAtheAcompany.AWhoAisAresponsibleAforAtheArepresentative'sAclaims?A-
ACORRECTAANSWERSA-theAinsurerAwillAbeAresponsible

WhichAofAtheAfollowingAdoesANOTAhaveAtoAbeAdisclosedAinAaAlong-
termAcareA(LTC)Apolicy?A-ACORRECTAANSWERSA-
TheAaggregateAamountAofApremiumsAdue
TheAFloridaAHealthAInsuranceACoverageAContinuationAactArequiresAinsurersAthatAsellAhealt
hAplansAtoAsmallAemployersAtoAofferAinAthoseAplansAaArightAtoAelectAtoAcontinueAcoverage,A
withoutAprovidingAevidenceAofAinsurability,AtoAemployeesAwhoAloseAtheirAcoverageAandAare
AunableAtoAreplaceAit.ATheApremiumArateAforAthisAcoverageAmayANOTAexceedA-

ACORRECTAANSWERSA-115%AofAtheAregularAgroupArate

WhichAofAtheAfollowingAMedicareAsupplementAplansAwouldAbeAavailableAtoAaAreasonablyAh
ealthyA91-yearAoldAfemale?A-ACORRECTAANSWERSA-A-
NA(allAmedicareAsupplementAplansAmustAbeAmadeAavailableAtoAqualifyingAapplicants
AtAwhatAageAdoAindividualsAbecomeAINELIGIBLEAforAFloridaAHealthyAKidsAcoverage?A-
ACORRECTAANSWERSA-19

WhichAofAtheAfollowingAisANOTAamongAtheAgoalsAofAaMedicareAsupplementAapplication?A-
ACORRECTAANSWERSA-

PresumingAtheAapplicantAisAeligibleAforAMedicaid,AbasedAonAtheAnatureAofAtheApolicy

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