Iowa Laws, Rules, and Regulations Pertinent to Health Only Rated A+

Iowa Laws, Rules, and Regulations Pertinent to Health Only Rated A+ The individual health insurance reform act requires that insurance carriers issuing individual health benefits plans must make available to eligible individuals who apply and agree to pay the premium a. basic health benefit plans b. specified disease plans only c. Medicare supplement plans d. long term care plans a. basic health benefit plans If an insurance company writing individual health benefit plans in Iowa decides to nonrenew all written health benefit plans in Iowa, they will be prohibited from reentering the market for a period of at least a. 5 years b. 180 days c. 1 year d. 3 years a. 5 years The Healthy and Well Kids in IA program is funded by a. donation by churches and other charitable orgs b. state of Iowa, only c. the federal government, only d. jointly by State of Iowa and federal government d. jointly by State of Iowa and federal government During a replacement of Medicare Supplement coverage, which of the following documents must be provided by insured? a. replacement alternatives brochure b. notice regarding replacement c. buyer's guide d. policy summary b. notice regarding replacement In Iowa, group insurance may be written to provide insurance coverage for any group that conforms to one of the descriptions of eligible groups as established by the Insurance Division or that recieves special approval from the Commissioner Which of the following is NOT a requirement for a partnership qualified LTC policy? the policy must have been issued before January 1, 2010 Which of the following medical conditions must be covered by a long-term care policy? a. drug addiction b. Alzheimer's c. alcoholism d. nervous disorders b. Alzheimer's To be eligible tp purchase a group insurance policy, a nonprofit industrial association must be incorporated for how long? a. 5 years b. 10 years c. 1 year d. 3 years b. 10 years When a terminated employee is eligible for continuation of their health insurance coverage under both the laws of the Iowa Insurance Code and the Federal COBRA laws, which of the laws are applied? a. the law selected by the employer b. Iowa Insurance Code c. COBRA d. the law selected by the employee c. COBRA In Iowa, Long-term coverage may NOT contain a provision that denies a claim for losses based on pre-existing condition that lasts for more than a. 3 months b. 6 months c. 12 months d. 18 months b. 6 months All of the following are types of care that is provided under LTC's home health care EXCEPT occasional visits by which of the following? a. pediatric nurses b. registered nurses c. licensed practical nurses d. licensed vocational nurses a. pediatric nurses If an insurer chooses not to renew all plans, the Commissioner must be given notice how many days prior? a. at least 3 days b. at lease 6 days c. at least 9 days d. at least 15 days a. at least 3 days Individual health insurance policies that provide coverage for a family member of the insured must also provide that health insurance benefits applicable for children are payable for a newborn child commencing a. after the premium is paid b. the moment of birth c. after 5 days d. after 14 days b. the moment of birth How soon after the receipt of a properly completed claim form and proof of loss must a health insurance company accept or pay or deny a claim? a. 90 days b. 10 days c. 20 days d. 30 days d. 30 days The Affordable Care Act requires all U.S. citizens and legal residents to have qualifying health care coverage. This is known as a. special enrollment b. the individual mandate c. the insurance marketplace d. safe harbor mandate b. the individual mandate Which of the following statements is true regarding coverage for prescription contraceptives in group health policies issued in this state? a. it must be added by endorsement b. it is a mandatory coverage c. deductibles for this coverage can be higher than other prescriptions d. insurers may restrict benefits for contraceptives b. it is a mandatory coverage For diabetic supplies to be covered under an individual health benefit plan, such supplies and equipment must be prescribed by a licensed physician To be eligible for tax credits under the ACA, individuals must have income that is what percent of the Federal Poverty Level? between 100% and 400% According to the regulations for long-term care partnership policies, how often must insurers provide a statment of benefits to the insured? monthly Which of the following statments is true regarding cancellation of a Medicare Supplement policy by an insurer? it can be cancelled for nonpayment of premium Which of the following types of LTC care is NOT provided in an institutional setting? home health care What is the required free-look period for Medicare supplement in this state? 30 days In which of the following cases would a credit disability policy be issued? if an individual is in debt to a specific creditor, payments will be made for him/her until the return to work Long-term policies which of the following renewnal provisions? guaranteed renewable How long is a free-look period for replacement Medicare supplment policies? 30 days To be eligible to be enrolled in the HAWK-I health care program, a child must be less than 19 years of age Each individual and group health insurance policy must provide coverage for low-dose screening mammograms for determining the presence of breast cancer. How much coverage must be provided for women age 40 to 49? one biennial mammogram When a terminated employee is eligible for continuation for their health insurance coverage under both the laws of Iowa Insurance Code and the Federal COBRA laws, which of the laws are applied? COBRA In Iowa, Medicare supplement insurance policies must be issued as what type of policy? guaranteed renewable The "time payment of claims provision" requires that a health insurance company pay covered losses immediately after the company receives a written proof of loss Under what circumstances must an insurer provide benefirs for adopted children? when the policy provides coverage for dependent children of the insured