COMPREHENSIVE TEST PAPER QUESTIONS
AND CORRECT ANSWERS GRADED A+
⩥ Which type of insurance policy combines Basic Medical Expense
Coverage with Major Medical Coverage?
A) Supplemental Major Medical
B) Hospital Expense
C) Comprehensive Major Medical
D) Surgical Expense. Answer: Comprehensive Major Medical
(A Comprehensive Major Medical Policy combines the best features of
the basic policies and Major Medical policy into a single policy and
provides the most complete hospital coverage.)
⩥ Many insurers pay benefits based on the average fee charged in a
geographical area. This is referred to as?
A) Reimbursement
B) Cash
C) Scheduled
D) Usual Customary and Reasonable. Answer: Usual Customary and
Reasonable
,(UCR is not scheduled, but is based on the average fee charged by all
doctors in a given geographical area.)
⩥ Which policy may be written with Basic Medical Expense Coverage
utilizing a Corridor Deductible after the basic plan benefits have been
exhausted and before Major Medical benefits begin?
A) Supplementary Major Medical
B) Hospital Expense
C) Comprehensive Major Medical
D) Surgical Expense. Answer: Supplementary Major Medical
(The question is describing the characteristics and mechanics of a
Supplemental Major Medical Policy.)
⩥ Which type of Accident and Health policy would provide
reimbursement for expenses involved with a broken hip?
A) Endowment Policy.
B) Medical Expense Policy.
C) Accidental Death and Dismemberment Policy.
D) Disability Income Policy.. Answer: Medical Expense Policy.
(Key word is in the question "expenses". The question specifies to
reimburse for expenses, not death, dismemberment, or loss of income.)
,⩥ Jasper owns a policy that combines the best features of the traditional
Basic Plans and Major Medical Insurance into a single policy to give
him the most complete hospital coverage. Jasper owns a?
A) Supplementary Major Medical Policy
B) Combination Major Medical Policy
C) Comprehensive Major Medical Policy
D) Blanket Major Medical Policy. Answer: Comprehensive Major
Medical Policy
(Jasper owns a Comprehensive Major Medical policy. It combines the
best features on the Basic Plans and Major Medical insurance into a
single policy.)
⩥ Sandra owns a Medical Expense Plan that contains a 60/40
Participation Provision (Coinsurance) after the deductible has been met.
If a claim was filed and $7,200 in costs remained after Sandra met the
$200 deductible?
A) The insurer would pay $2,880, and Sandra would pay $4,320.
B) The insurer would pay $4,440, and Sandra would pay $2,960.
C) The insurer would pay $2,960, and Sandra would pay $4,440.
D) The insurer would pay $4,320, and Sandra would pay $2,880..
Answer: The insurer would pay $4,320, and Sandra would pay $2,880.
⩥ A specified period before new coverage goes into effect for a specified
condition is known as which of the following?
, A) Waiting period
B) Exclusion
C) Probationary period
D) Morbidity table. Answer: Probationary period
(The question establishes a period before coverage goes into effect for
specified conditions, not a period before an employee is even eligible to
enroll for group benefits, which would be a waiting period.)
⩥ Beth has a contract stating she must be disabled for 3 months before
benefits will be paid. This is considered the?
A) Probationary Period
B) Elimination Period
C) Grace Period
D) Contingency Period. Answer: Elimination Period
(The Elimination Period is a period of time that must expire after onset
of an illness or occurrence of an accident before benefits will be
payable.)
⩥ Which is NOT a reason insurers limit disability income benefits to
70% or less of the insured's past earnings?
A) Insurers limit the benefits simply because it keeps their expenses
down.