ALABAMA LIFE HEALTH 2026 QUESTIONS AND
ANSWERS SURE A+
✔✔Under Optional Provision 'Unpaid Premiums', when premiums are unpaid at the time
a claim is submitted, the insurer may: - ✔✔Deduct unpaid premiums from benefits
before paying the claim
✔✔Required Provision 'Reinstatement' addresses reinstatement of a lapsed policy.
According to this provision, when an insured applies for reinstatement and receives a
conditional receipt, how long does the insurer have to approve or deny reinstatement
before the policy will be automatically reinstated? - ✔✔45 days from the date of the
conditional receipt
✔✔The Time Limit on Certain Defenses (Incontestable) period is _____ years under
individual health and disability contracts. - ✔✔2
✔✔Under the Legal Actions Mandatory Uniform Provision, an insured must wait at least
_____ days after providing proof of loss before he or she can take legal action against
the insurer. - ✔✔60 days
, ✔✔John has had his individual Health and Disability Income policies for many years.
While intoxicated, he was injured as the driver in a single car accident. Who covers the
medical expenses for John? - ✔✔John is liable for all expenses
According to the Intoxicants and Narcotics Provision (an Optional Uniform Provision),
the insurer may deny coverage for John's injuries, making John liable for all expenses.
✔✔An insured should receive necessary claim forms within _____ days after notice of
claim. - ✔✔15
✔✔Which of the following is not a Mandatory Uniform Provision of an Accident and
Health policy? - ✔✔Waiver of Premium
✔✔Precertification, Mandatory Second Surgical Opinion, and Concurrent Review are
provisions in health insurance policies known as: - ✔✔Case Management Provisions
✔✔Managed Health Care attempts to contain costs by controlling the behavior of
participants in all of the following ways, except: - ✔✔Partial Case Management
✔✔Which statement concerning individual A&H policy renewal provisions is most
correct from the perspective of the insured? - ✔✔The more favorable the renewal
provision to the insured, the higher the cost
The more favorable a renewal provision is to the insured, the higher the premium will
be. A Noncancellable policy will cost the most because its premium may not be
changed in the future.
✔✔Which of these is a Mandatory Uniform Provision? - ✔✔Legal Actions
✔✔The Coordination of Benefits Provision is designed to: - ✔✔Give insureds as much
coverage as possible while eliminating overinsurance
✔✔Which of the following statements is NOT true concerning a coordination of benefits
situation? - ✔✔Where children are involved, the primary group insurer is the insurer for
the parent who is oldest by age at the time of claim
When double coverage exists, the coordination of benefits provision simply steps in and
stipulates which insurer pays and when. The insured's plan is always primary, the
spouses plan is secondary, the parent whose birthday comes first in the calendar year
is primary for the children, not who is oldest. The purpose of this provision is to provide
the most possible coverage without allowing any overinsurance from occurring.
✔✔A plan in which employees select health benefits from a variety of coverage options,
based on their individual coverage needs is a: - ✔✔Cafeteria Plan
ANSWERS SURE A+
✔✔Under Optional Provision 'Unpaid Premiums', when premiums are unpaid at the time
a claim is submitted, the insurer may: - ✔✔Deduct unpaid premiums from benefits
before paying the claim
✔✔Required Provision 'Reinstatement' addresses reinstatement of a lapsed policy.
According to this provision, when an insured applies for reinstatement and receives a
conditional receipt, how long does the insurer have to approve or deny reinstatement
before the policy will be automatically reinstated? - ✔✔45 days from the date of the
conditional receipt
✔✔The Time Limit on Certain Defenses (Incontestable) period is _____ years under
individual health and disability contracts. - ✔✔2
✔✔Under the Legal Actions Mandatory Uniform Provision, an insured must wait at least
_____ days after providing proof of loss before he or she can take legal action against
the insurer. - ✔✔60 days
, ✔✔John has had his individual Health and Disability Income policies for many years.
While intoxicated, he was injured as the driver in a single car accident. Who covers the
medical expenses for John? - ✔✔John is liable for all expenses
According to the Intoxicants and Narcotics Provision (an Optional Uniform Provision),
the insurer may deny coverage for John's injuries, making John liable for all expenses.
✔✔An insured should receive necessary claim forms within _____ days after notice of
claim. - ✔✔15
✔✔Which of the following is not a Mandatory Uniform Provision of an Accident and
Health policy? - ✔✔Waiver of Premium
✔✔Precertification, Mandatory Second Surgical Opinion, and Concurrent Review are
provisions in health insurance policies known as: - ✔✔Case Management Provisions
✔✔Managed Health Care attempts to contain costs by controlling the behavior of
participants in all of the following ways, except: - ✔✔Partial Case Management
✔✔Which statement concerning individual A&H policy renewal provisions is most
correct from the perspective of the insured? - ✔✔The more favorable the renewal
provision to the insured, the higher the cost
The more favorable a renewal provision is to the insured, the higher the premium will
be. A Noncancellable policy will cost the most because its premium may not be
changed in the future.
✔✔Which of these is a Mandatory Uniform Provision? - ✔✔Legal Actions
✔✔The Coordination of Benefits Provision is designed to: - ✔✔Give insureds as much
coverage as possible while eliminating overinsurance
✔✔Which of the following statements is NOT true concerning a coordination of benefits
situation? - ✔✔Where children are involved, the primary group insurer is the insurer for
the parent who is oldest by age at the time of claim
When double coverage exists, the coordination of benefits provision simply steps in and
stipulates which insurer pays and when. The insured's plan is always primary, the
spouses plan is secondary, the parent whose birthday comes first in the calendar year
is primary for the children, not who is oldest. The purpose of this provision is to provide
the most possible coverage without allowing any overinsurance from occurring.
✔✔A plan in which employees select health benefits from a variety of coverage options,
based on their individual coverage needs is a: - ✔✔Cafeteria Plan
