LIFE AND HEALTH INSURANCE FINAL
EXAM QUESTIONS & ACTUAL
CORRECT ANSWERS PASSED
________ is a health insurance policy that only covers physician services and
procedures. Proves first dollar benefits by the insurer, but low coverage limits. -
CORRECT ANSWER Basic Medical Expense
________ is a health insurance policy that only covers room and board if the insured
stays overnight in a hospital and the miscellaneous expenses that occur because of that
stay. - CORRECT ANSWER Basic Hospital Expense
________ is a health insurance policy that only covers surgeries, surgeons and
anesthesiologists. It provides first dollar benefits by the insurer, but low limits. -
CORRECT ANSWER Basic Surgical Expense
______ is a health insurance policy that offers broad coverage and high benefits for
hospitalization, surgeries, and physician services subject to deductibles and
coinsurance. - CORRECT ANSWER Major Medical Expense
_________ is a type of traditional medical expense insurance designed to reimburse the
policyowner for out of pocket medical expenses. It is characterized by typically low
deductibles (100-500), coinsurance, and stop loss limits. - CORRECT ANSWER
Comprehensive Major Medical
What feature of Major Medical policy requires 100% payment of covered expenses after
the insured's claim cost reaches a certain level? - CORRECT ANSWER Stop Loss
The amount of loss paid by the policyowner before the health insurance policy pays the
claims is known as.. - CORRECT ANSWER Deductible
Mary has a Major Medical policy with a $200 deductible and 80/20 coinsurance
allocation. If she suffers a covered loss of $8200, how much will Mary be required to
pay for this loss? - CORRECT ANSWER $1800
_______ is a health insurance policy that does not have a deductible. The company
pays first when a claim is submitted. - CORRECT ANSWER First Dollar Coverage
Charlie owns a Comprehensive Major Medical policy with a $1000 Base plan, a $500
deductible and 80/20 coinsurance. If he suffers a covered loss of $9500, how much will
the company pay? - CORRECT ANSWER $7400
, Which is the correct order of the basic claim calculation? - CORRECT ANSWER Apply
the base plan; subtract the deductible; allocate the coinsurance; check by adding
You own a Major Medical policy with a $500 deductible and 80/20 coinsurance. You
suffer a covered loss of $4500 and calculate that the company will pay $3200 towards
your loss. The company only pays $3019.78. Which of the following could NOT account
for the difference? - CORRECT ANSWER Elimination Period
The individual who controls a Major Medical policy, pays the premiums and is
authorized to receive any benefits from the contract is known as the - CORRECT
ANSWER owner
Which policy would be covered with the rights of a dependent child? - CORRECT
ANSWER Major Med
Coinsurance does which of the following? - CORRECT ANSWER Reduces the
deductible
All of the following characterizes basic medical EXCEPT - CORRECT ANSWER
Ancillary expenses
Which of the following do Medical Expense companies utilize to eliminate small claims?
- CORRECT ANSWER Deductibles
Which of the following do Medical Expense companies use to reduce adverse
selection? - CORRECT ANSWER Preexisting conditions limitations
The Affordable Care Act allows dependents to remain on a parent/guardian's healthcare
plan until age - CORRECT ANSWER 26
A Disability Income Policy deductible is expressed in time and known as an -
CORRECT ANSWER Elimination Period
______ is the key rating factor for Disability policy - CORRECT ANSWER Occupation
________ requires that the insured to be unable to perform the duties of his or her own
occupation in order to receive disability income benefits. - CORRECT ANSWER Own
Occupation
________ requires the insured to be unable to perform any occupation they would be
reasonably suited to do based on education, training or work experience in order to
receive disability income benefits from the policy. - CORRECT ANSWER Any
Occupation
Short term disability is ______ year(s) or less. - CORRECT ANSWER Two
EXAM QUESTIONS & ACTUAL
CORRECT ANSWERS PASSED
________ is a health insurance policy that only covers physician services and
procedures. Proves first dollar benefits by the insurer, but low coverage limits. -
CORRECT ANSWER Basic Medical Expense
________ is a health insurance policy that only covers room and board if the insured
stays overnight in a hospital and the miscellaneous expenses that occur because of that
stay. - CORRECT ANSWER Basic Hospital Expense
________ is a health insurance policy that only covers surgeries, surgeons and
anesthesiologists. It provides first dollar benefits by the insurer, but low limits. -
CORRECT ANSWER Basic Surgical Expense
______ is a health insurance policy that offers broad coverage and high benefits for
hospitalization, surgeries, and physician services subject to deductibles and
coinsurance. - CORRECT ANSWER Major Medical Expense
_________ is a type of traditional medical expense insurance designed to reimburse the
policyowner for out of pocket medical expenses. It is characterized by typically low
deductibles (100-500), coinsurance, and stop loss limits. - CORRECT ANSWER
Comprehensive Major Medical
What feature of Major Medical policy requires 100% payment of covered expenses after
the insured's claim cost reaches a certain level? - CORRECT ANSWER Stop Loss
The amount of loss paid by the policyowner before the health insurance policy pays the
claims is known as.. - CORRECT ANSWER Deductible
Mary has a Major Medical policy with a $200 deductible and 80/20 coinsurance
allocation. If she suffers a covered loss of $8200, how much will Mary be required to
pay for this loss? - CORRECT ANSWER $1800
_______ is a health insurance policy that does not have a deductible. The company
pays first when a claim is submitted. - CORRECT ANSWER First Dollar Coverage
Charlie owns a Comprehensive Major Medical policy with a $1000 Base plan, a $500
deductible and 80/20 coinsurance. If he suffers a covered loss of $9500, how much will
the company pay? - CORRECT ANSWER $7400
, Which is the correct order of the basic claim calculation? - CORRECT ANSWER Apply
the base plan; subtract the deductible; allocate the coinsurance; check by adding
You own a Major Medical policy with a $500 deductible and 80/20 coinsurance. You
suffer a covered loss of $4500 and calculate that the company will pay $3200 towards
your loss. The company only pays $3019.78. Which of the following could NOT account
for the difference? - CORRECT ANSWER Elimination Period
The individual who controls a Major Medical policy, pays the premiums and is
authorized to receive any benefits from the contract is known as the - CORRECT
ANSWER owner
Which policy would be covered with the rights of a dependent child? - CORRECT
ANSWER Major Med
Coinsurance does which of the following? - CORRECT ANSWER Reduces the
deductible
All of the following characterizes basic medical EXCEPT - CORRECT ANSWER
Ancillary expenses
Which of the following do Medical Expense companies utilize to eliminate small claims?
- CORRECT ANSWER Deductibles
Which of the following do Medical Expense companies use to reduce adverse
selection? - CORRECT ANSWER Preexisting conditions limitations
The Affordable Care Act allows dependents to remain on a parent/guardian's healthcare
plan until age - CORRECT ANSWER 26
A Disability Income Policy deductible is expressed in time and known as an -
CORRECT ANSWER Elimination Period
______ is the key rating factor for Disability policy - CORRECT ANSWER Occupation
________ requires that the insured to be unable to perform the duties of his or her own
occupation in order to receive disability income benefits. - CORRECT ANSWER Own
Occupation
________ requires the insured to be unable to perform any occupation they would be
reasonably suited to do based on education, training or work experience in order to
receive disability income benefits from the policy. - CORRECT ANSWER Any
Occupation
Short term disability is ______ year(s) or less. - CORRECT ANSWER Two
