FLORIDA 2-40 CERTIFICATION
EVALUATION 2026 ACTUAL QUESTIONS
WITH SOLUTIONS GRADED A+
⩥ All of the following are state or federal government programs that
provide health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap. Answer: 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.)
⩥ What type of health insurance is available to assist low-income
individuals?. Answer: Medicaid
⩥ What types of reserves are set aside and held by health insurance
companies?. Answer: 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?. Answer:
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. Answer: 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
B) Fraternal associations
C) Stock companies
-Fraternal benefit society. Answer: 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. Answer: 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. Answer: 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
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months. Answer: 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. Answer: 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. Answer:
Fixed amount paid by an HMO to a physician for medical services
⩥ When a person is covered by an HMO, the contract certificate or
member's handbook must be delivered within how many days after
approval of the enrollment by the HMO?
-20 days
-10 days
-5 days
EVALUATION 2026 ACTUAL QUESTIONS
WITH SOLUTIONS GRADED A+
⩥ All of the following are state or federal government programs that
provide health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap. Answer: 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.)
⩥ What type of health insurance is available to assist low-income
individuals?. Answer: Medicaid
⩥ What types of reserves are set aside and held by health insurance
companies?. Answer: 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?. Answer:
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. Answer: 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
B) Fraternal associations
C) Stock companies
-Fraternal benefit society. Answer: 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. Answer: 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. Answer: 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
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months. Answer: 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. Answer: 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. Answer:
Fixed amount paid by an HMO to a physician for medical services
⩥ When a person is covered by an HMO, the contract certificate or
member's handbook must be delivered within how many days after
approval of the enrollment by the HMO?
-20 days
-10 days
-5 days
