Page | 1
HEALTH INSURANCE FLORIDA 2-40
PRACTICE EXAM QUESTIONS #2 2025
QUESTIONS AND ANSWERS.
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - solution - Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a
business owner becomes disabled. Expenses such as rent, utilities,
telephone, equipment, employees' salaries, etc.)
All of the following are state or federal government programs that
provide health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - solution - Medigap (Explanation:A Medigap policy is a
Medicare supplement insurance policy sold by private insurance
companies to fill "gaps" in Medicare Parts A and B.)
, Page | 2
What type of health insurance is available to assist low-income
individuals?
- solution - Medicaid
What types of reserves are set aside and held by health insurance
companies? - solution - Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides
for dividends or experience rating. What is the basis called? -
solution - Participating (Explanation:Group plans written by mutual
companies provide for dividends while stock companies frequently
issue experience- rated plans.)
Which of the following is NOT TRUE regarding eligibility for
subsidies for families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - solution - Can be eligible for Medicaid
Which of the following operates as a corporation, society, or
association to provide life insurance primarily for the mutual
benefit of its members, has a lodge or social system with rituals
and representative form of government?
A) Mutual companies
, Page | 3
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - solution - B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay
-Fixed premium whether or not plan is used
-Premium based on how often plan is used - solution - Fixed premium
whether or not plan is used
Which of the following is correct about those who are eligible for
Medicare and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the
Medicare Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - solution - They
must be told that'll be getting all the benefits from the Medicare
Advantage plan
Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce,
EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
, Page | 4
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - solution - Coverage ends after 18
months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each
fiscal year
-Must deposit $100,000 with the Rehabilitation Administration
Expense Fund
-Must be sold by agents licensed and appointed as health insurance
agents
- solution - Must deposit $100,000 with the Rehabilitation
Administration Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration
Expense Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
-Fixed amount paid by an HMO during a policy period
-Fixed amount paid by an HMO to a physician for medical services
-Amount required to be deposited with the State of Florida -
solution - Fixed amount paid by an HMO to a physician for medical
services
HEALTH INSURANCE FLORIDA 2-40
PRACTICE EXAM QUESTIONS #2 2025
QUESTIONS AND ANSWERS.
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - solution - Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a
business owner becomes disabled. Expenses such as rent, utilities,
telephone, equipment, employees' salaries, etc.)
All of the following are state or federal government programs that
provide health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - solution - Medigap (Explanation:A Medigap policy is a
Medicare supplement insurance policy sold by private insurance
companies to fill "gaps" in Medicare Parts A and B.)
, Page | 2
What type of health insurance is available to assist low-income
individuals?
- solution - Medicaid
What types of reserves are set aside and held by health insurance
companies? - solution - Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides
for dividends or experience rating. What is the basis called? -
solution - Participating (Explanation:Group plans written by mutual
companies provide for dividends while stock companies frequently
issue experience- rated plans.)
Which of the following is NOT TRUE regarding eligibility for
subsidies for families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - solution - Can be eligible for Medicaid
Which of the following operates as a corporation, society, or
association to provide life insurance primarily for the mutual
benefit of its members, has a lodge or social system with rituals
and representative form of government?
A) Mutual companies
, Page | 3
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - solution - B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay
-Fixed premium whether or not plan is used
-Premium based on how often plan is used - solution - Fixed premium
whether or not plan is used
Which of the following is correct about those who are eligible for
Medicare and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the
Medicare Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - solution - They
must be told that'll be getting all the benefits from the Medicare
Advantage plan
Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce,
EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
, Page | 4
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - solution - Coverage ends after 18
months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each
fiscal year
-Must deposit $100,000 with the Rehabilitation Administration
Expense Fund
-Must be sold by agents licensed and appointed as health insurance
agents
- solution - Must deposit $100,000 with the Rehabilitation
Administration Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration
Expense Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
-Fixed amount paid by an HMO during a policy period
-Fixed amount paid by an HMO to a physician for medical services
-Amount required to be deposited with the State of Florida -
solution - Fixed amount paid by an HMO to a physician for medical
services
