NC - Health Insurance - Practice Exam
Questions With Correct Answers
All |of |the |following |are |true |regarding |Key |Employee |Disability |Income |insurance |EXCEPT
A) |Premiums |are |not |tax |deductible |for |the |employer.
B) |Benefits |are |taxable |to |the |employer.
C) |The |employer |owns |the |policy.
D) |Benefits |are |paid |to |the |employer |to |retrain |a |new |person. |- |VERIFIED |ANSWER✔✔-B) |Benefits |are
|taxable |to |the |employer.
Key |person |disability |income |premiums |are |not |deductible |to |the |business, |but |the |benefits |are |
received |income |tax |free |by |the |business.
How |is |emergency |care |covered |for |a |member |of |an |HMO?
A) |A |member |of |an |HMO |can |receive |care |in |or |out |of |the |HMO |service |area, |but |care |is |preferred |in
|the |service |area.
B) |A |member |of |an |HMO |may |receive |care |at |any |emergency |facility, |at |the |same |cost |as |if |in |his |or |
her |own |service |area.
C) |HMOs |have |salaried |member |physicians, |but |they |do |not |cover |emergency |care.
D) |An |HMO |emergency |specialist |will |cover |the |patient. |- |VERIFIED |ANSWER✔✔-A. |A |member |of |an |
HMO |can |receive |care |in |or |out |of |the |HMO |service |area, |but |care |is |preferred |in |the |service |area.
Emergency |care |must |be |provided |for |the |member |in |or |out |of |the |HMO's |service |area. |If |emergency |
care |is |being |provided |for |a |member |outside |the |service |area, |the |HMO |will |be |eager |to |get |the |
member |back |into |the |service |area |so |that |care |can |be |provided |by |salaried |member |physicians.
After |appointing |an |agent, |how |long |does |an |insurer |have |to |file |with |the |Commissioner |the |form |
detailing |the |agent's |name, |address, |and |other |needed |information?
,A) |15 |days
B) |30 |days
C) |45 |days
D) |60 |days |- |VERIFIED |ANSWER✔✔-B) |30 |days
Insurers |have |30 |days |to |file, |in |a |form |prescribed |by |the |Commissioner, |the |names, |addresses, |and |
other |information |required |by |the |Commissioner |for |its |newly |appointed |agents.
Bethany |studies |in |England |for |a |semester. |While |she |is |there, |she |is |involved |in |a |train |accident |that |
leaves |her |disabled. |If |Bethany |owns |a |general |disability |policy, |what |will |be |the |extent |of |benefits |
that |she |receives? |- |VERIFIED |ANSWER✔✔-None
Which |of |the |following |are |the |main |factors |taken |into |account |when |calculating |residual |disability |
benefits?
a)Present |earnings |and |earnings |prior |to |disability
b)Earnings |prior |to |disability |and |the |length |of |disability
c)Employee's |full-time |status |and |length |of |disability
d)Present |earnings |and |standard |cost |of |living |- |VERIFIED |ANSWER✔✔-a)Present |earnings |and |
earnings |prior |to |disability
Residual |disability |will |help |pay |for |loss |of |earnings |by |making |up |the |difference |between |the |
employee's |present |earnings |and |what |they |were |earning |prior |to |disability.
How |can |a |new |physician |be |added |to |the |PPO's |approved |list?
a)Fill |out |the |appropriate |paperwork |and |wait |the |12 |month |pre-certification |period.
b)Pay |an |annual |fee |for |being |on |the |PPO |list.
c)New |physicians |are |only |added |once |a |year, |and |are |selected |by |the |PPO's |Board |of |Directors.
d)Agree |to |follow |the |PPO |standards |and |charge |the |appropriate |fees. |- |VERIFIED |ANSWER✔✔-
d)Agree |to |follow |the |PPO |standards |and |charge |the |appropriate |fees.
, Any |physician |or |hospital |that |qualifies |for |and |agrees |to |follow |the |PPO's |standards |and |charges |the |
established |fees |can |be |added |to |the |PPO's |approved |list |at |any |time. |The |providers |may |withdraw |
their |name |from |the |list |at |any |time, |as |well.
Under |the |uniform |required |provisions, |proof |of |loss |under |a |health |insurance |policy |normally |should |
be |filed |within
a)90 |days |of |a |loss.
b)20 |days |of |a |loss.
c)30 |days |of |a |loss.
d)60 |days |of |a |loss. |- |VERIFIED |ANSWER✔✔-a)90 |days |of |a |loss.
Under |the |Uniform |Required |Provisions, |proof |of |loss |under |a |health |insurance |policy |normally |should
|be |filed |within |90 |days |of |a |loss.
Which |of |the |following |must |an |insurer |obtain |in |order |to |transact |insurance |within |a |given |state?
a)Business |entity |license
b)Insurer's |license
c)Certificate |of |authority
d)Producer's |certificate |- |VERIFIED |ANSWER✔✔-c)Certificate |of |authority
All |insurers |(domestic, |foreign, |or |alien) |must |obtain |a |certificate |of |authority |before |transacting |
insurance |within |a |given |state.
According |to |the |Future |Increase |Option |Rider |(FIO), |which |of |the |following |is |NOT |a |qualifying |event |
to |increase |an |insured's |benefit |level?
a)Death |of |a |spouse
b)Age |40
Questions With Correct Answers
All |of |the |following |are |true |regarding |Key |Employee |Disability |Income |insurance |EXCEPT
A) |Premiums |are |not |tax |deductible |for |the |employer.
B) |Benefits |are |taxable |to |the |employer.
C) |The |employer |owns |the |policy.
D) |Benefits |are |paid |to |the |employer |to |retrain |a |new |person. |- |VERIFIED |ANSWER✔✔-B) |Benefits |are
|taxable |to |the |employer.
Key |person |disability |income |premiums |are |not |deductible |to |the |business, |but |the |benefits |are |
received |income |tax |free |by |the |business.
How |is |emergency |care |covered |for |a |member |of |an |HMO?
A) |A |member |of |an |HMO |can |receive |care |in |or |out |of |the |HMO |service |area, |but |care |is |preferred |in
|the |service |area.
B) |A |member |of |an |HMO |may |receive |care |at |any |emergency |facility, |at |the |same |cost |as |if |in |his |or |
her |own |service |area.
C) |HMOs |have |salaried |member |physicians, |but |they |do |not |cover |emergency |care.
D) |An |HMO |emergency |specialist |will |cover |the |patient. |- |VERIFIED |ANSWER✔✔-A. |A |member |of |an |
HMO |can |receive |care |in |or |out |of |the |HMO |service |area, |but |care |is |preferred |in |the |service |area.
Emergency |care |must |be |provided |for |the |member |in |or |out |of |the |HMO's |service |area. |If |emergency |
care |is |being |provided |for |a |member |outside |the |service |area, |the |HMO |will |be |eager |to |get |the |
member |back |into |the |service |area |so |that |care |can |be |provided |by |salaried |member |physicians.
After |appointing |an |agent, |how |long |does |an |insurer |have |to |file |with |the |Commissioner |the |form |
detailing |the |agent's |name, |address, |and |other |needed |information?
,A) |15 |days
B) |30 |days
C) |45 |days
D) |60 |days |- |VERIFIED |ANSWER✔✔-B) |30 |days
Insurers |have |30 |days |to |file, |in |a |form |prescribed |by |the |Commissioner, |the |names, |addresses, |and |
other |information |required |by |the |Commissioner |for |its |newly |appointed |agents.
Bethany |studies |in |England |for |a |semester. |While |she |is |there, |she |is |involved |in |a |train |accident |that |
leaves |her |disabled. |If |Bethany |owns |a |general |disability |policy, |what |will |be |the |extent |of |benefits |
that |she |receives? |- |VERIFIED |ANSWER✔✔-None
Which |of |the |following |are |the |main |factors |taken |into |account |when |calculating |residual |disability |
benefits?
a)Present |earnings |and |earnings |prior |to |disability
b)Earnings |prior |to |disability |and |the |length |of |disability
c)Employee's |full-time |status |and |length |of |disability
d)Present |earnings |and |standard |cost |of |living |- |VERIFIED |ANSWER✔✔-a)Present |earnings |and |
earnings |prior |to |disability
Residual |disability |will |help |pay |for |loss |of |earnings |by |making |up |the |difference |between |the |
employee's |present |earnings |and |what |they |were |earning |prior |to |disability.
How |can |a |new |physician |be |added |to |the |PPO's |approved |list?
a)Fill |out |the |appropriate |paperwork |and |wait |the |12 |month |pre-certification |period.
b)Pay |an |annual |fee |for |being |on |the |PPO |list.
c)New |physicians |are |only |added |once |a |year, |and |are |selected |by |the |PPO's |Board |of |Directors.
d)Agree |to |follow |the |PPO |standards |and |charge |the |appropriate |fees. |- |VERIFIED |ANSWER✔✔-
d)Agree |to |follow |the |PPO |standards |and |charge |the |appropriate |fees.
, Any |physician |or |hospital |that |qualifies |for |and |agrees |to |follow |the |PPO's |standards |and |charges |the |
established |fees |can |be |added |to |the |PPO's |approved |list |at |any |time. |The |providers |may |withdraw |
their |name |from |the |list |at |any |time, |as |well.
Under |the |uniform |required |provisions, |proof |of |loss |under |a |health |insurance |policy |normally |should |
be |filed |within
a)90 |days |of |a |loss.
b)20 |days |of |a |loss.
c)30 |days |of |a |loss.
d)60 |days |of |a |loss. |- |VERIFIED |ANSWER✔✔-a)90 |days |of |a |loss.
Under |the |Uniform |Required |Provisions, |proof |of |loss |under |a |health |insurance |policy |normally |should
|be |filed |within |90 |days |of |a |loss.
Which |of |the |following |must |an |insurer |obtain |in |order |to |transact |insurance |within |a |given |state?
a)Business |entity |license
b)Insurer's |license
c)Certificate |of |authority
d)Producer's |certificate |- |VERIFIED |ANSWER✔✔-c)Certificate |of |authority
All |insurers |(domestic, |foreign, |or |alien) |must |obtain |a |certificate |of |authority |before |transacting |
insurance |within |a |given |state.
According |to |the |Future |Increase |Option |Rider |(FIO), |which |of |the |following |is |NOT |a |qualifying |event |
to |increase |an |insured's |benefit |level?
a)Death |of |a |spouse
b)Age |40
