1|Page
PEARSON VUE HEALTH INSURANCE PRACTICE
EXAM UPDATED 2025 2026 WITH ALL NEW
QUESTIONS AND EXACTLY RIGHT ANSWERS |
A+ QUALITY GUARANTEE
Charges for which of the following items is NOT considered a covered expense
under a Medicare Supplement policy (Part B)? - ANSWER: Dental services
Health insurance policies are offered on a "take it or leave it" basis and referred to
as which of the following types of contracts? - ANSWER: Contracts of Adhesion
Under the Claims Forms provision of a health policy, if the insurance company
fails to send claim forms within the time period required, the insured should: -
ANSWER: Submit the claim in any form, which must be accepted by the
company as adequate proof of loss
In an Accidental Death and Dismemberment (AD&D) policy, capital sum refers to:
- ANSWER: A lump sum payment made for an accidental dismemberment
The Coordination of Benefits clause found in group health master contracts is used
to: - ANSWER: Avoid double payment of benefits to an insured who has duplicate
group coverages
Which of the following definitions MOST accurately describes the Probationary
Period? - ANSWER: The waiting period a new hire must satisfy prior to becoming
eligible for group health coverage
A Health Maintenance Organization (HMO) differs from a traditional insurer in
that an HMO: - ANSWER: Emphasizes preventive medicine
,2|Page
A married insured has an Accidental Death and Dismemberment (AD&D) policy
that names their sibling as the primary beneficiary and their child as the contingent
beneficiary. If the insured and their sibling are both killed instantly in a train
accident, the policy proceeds would be paid to which of the following? -
ANSWER: The insured's child
The Social Security program provides all of the following benefits EXCEPT: -
ANSWER: Workers compensation
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the
right to: - ANSWER: Increase the premium rate for an entire class of insureds
A Disability Income policy may provide benefits for which of the following
losses? - ANSWER: Residual Disability
Which of the following statements about the Medicare program is CORRECT? -
ANSWER: It is a federally sponsored program.
A child has a physical impairment, attends school, and is incapable of self-
sustaining employment and/or self care. Which of the following statements is
CORRECT about the child's medical coverage under their parent's group plan? -
ANSWER: The child's coverage continues as long as they are continually
incapacitated and financially dependent on their parent.
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which
of the following policy features? - ANSWER: Exclusions
The PRIMARY purpose of Medicaid is to: - ANSWER: Provide Medical Expense
coverage to persons below certain minimum income requirements
, 3|Page
Which of the following provisions designates to whom claim payments are made?
- ANSWER: Payment of Claims
Under an Accidental Death and Dismemberment (AD&D) policy, insurable
interest must exist at which of the following times? - ANSWER: At the inception
of the policy
When periodic claim payments are required under a long-term disability income
policy, an insurer MUST make payments to an insured at least once every: -
ANSWER: Month
A 68 year-old employee that is covered by a group medical insurance plan has
medical expenses. The employee's company health plan is the: - ANSWER:
Secondary payor
An insured whose Disability Income policy contains a Change of Occupation
clause takes a new job in a more hazardous occupation and fails to notify the
insurer of the change. One year later, the insured becomes disabled. The insurer
will most likely take which of the following actions? - ANSWER: Settle the claim
according to what the premiums would have purchased under the more hazardous
occupation
The purpose of the Medical Information Bureau (MIB) is to: - ANSWER: Share
medical data among member companies
Which of the following laws requires an insurer to notify an applicant in writing
that an investigative consumer report may be made on the applicant? - ANSWER:
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection Act)
PEARSON VUE HEALTH INSURANCE PRACTICE
EXAM UPDATED 2025 2026 WITH ALL NEW
QUESTIONS AND EXACTLY RIGHT ANSWERS |
A+ QUALITY GUARANTEE
Charges for which of the following items is NOT considered a covered expense
under a Medicare Supplement policy (Part B)? - ANSWER: Dental services
Health insurance policies are offered on a "take it or leave it" basis and referred to
as which of the following types of contracts? - ANSWER: Contracts of Adhesion
Under the Claims Forms provision of a health policy, if the insurance company
fails to send claim forms within the time period required, the insured should: -
ANSWER: Submit the claim in any form, which must be accepted by the
company as adequate proof of loss
In an Accidental Death and Dismemberment (AD&D) policy, capital sum refers to:
- ANSWER: A lump sum payment made for an accidental dismemberment
The Coordination of Benefits clause found in group health master contracts is used
to: - ANSWER: Avoid double payment of benefits to an insured who has duplicate
group coverages
Which of the following definitions MOST accurately describes the Probationary
Period? - ANSWER: The waiting period a new hire must satisfy prior to becoming
eligible for group health coverage
A Health Maintenance Organization (HMO) differs from a traditional insurer in
that an HMO: - ANSWER: Emphasizes preventive medicine
,2|Page
A married insured has an Accidental Death and Dismemberment (AD&D) policy
that names their sibling as the primary beneficiary and their child as the contingent
beneficiary. If the insured and their sibling are both killed instantly in a train
accident, the policy proceeds would be paid to which of the following? -
ANSWER: The insured's child
The Social Security program provides all of the following benefits EXCEPT: -
ANSWER: Workers compensation
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the
right to: - ANSWER: Increase the premium rate for an entire class of insureds
A Disability Income policy may provide benefits for which of the following
losses? - ANSWER: Residual Disability
Which of the following statements about the Medicare program is CORRECT? -
ANSWER: It is a federally sponsored program.
A child has a physical impairment, attends school, and is incapable of self-
sustaining employment and/or self care. Which of the following statements is
CORRECT about the child's medical coverage under their parent's group plan? -
ANSWER: The child's coverage continues as long as they are continually
incapacitated and financially dependent on their parent.
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which
of the following policy features? - ANSWER: Exclusions
The PRIMARY purpose of Medicaid is to: - ANSWER: Provide Medical Expense
coverage to persons below certain minimum income requirements
, 3|Page
Which of the following provisions designates to whom claim payments are made?
- ANSWER: Payment of Claims
Under an Accidental Death and Dismemberment (AD&D) policy, insurable
interest must exist at which of the following times? - ANSWER: At the inception
of the policy
When periodic claim payments are required under a long-term disability income
policy, an insurer MUST make payments to an insured at least once every: -
ANSWER: Month
A 68 year-old employee that is covered by a group medical insurance plan has
medical expenses. The employee's company health plan is the: - ANSWER:
Secondary payor
An insured whose Disability Income policy contains a Change of Occupation
clause takes a new job in a more hazardous occupation and fails to notify the
insurer of the change. One year later, the insured becomes disabled. The insurer
will most likely take which of the following actions? - ANSWER: Settle the claim
according to what the premiums would have purchased under the more hazardous
occupation
The purpose of the Medical Information Bureau (MIB) is to: - ANSWER: Share
medical data among member companies
Which of the following laws requires an insurer to notify an applicant in writing
that an investigative consumer report may be made on the applicant? - ANSWER:
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection Act)
