Pearson Vue National Health Insurance 51 Practice Test Questions And Answers

An insurer must provide claim forms to an insured within a MAXIMUM of how many days after receiving notice of an Accident & Health claim? A. Five B. Fifteen C. Twenty D. Thirty - ✔ ✔ b Under a group health plan, an employer may offer additional benefits to classes of employees on the basis of all of the following factors EXCEPT: A. length of employment B. gender C. salary grade D. job category - ✔ ✔ b Which of the following statemen ts is CORRECT about a Waiver of Premium provision in a Disability Income policy? A. It allows the insurer to deduct premiums due from the disabled insured's benefit payments. B. It allows the insurer to increase the amount of premium during the insured's time of disability. C. It allows the insured to extend the length of the Grace Period while disabled. D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums. - ✔ ✔ d Suicide, pre -existing conditions and self -inflicted injuries are dealt with in which of the following policy features? A. Extensions of coverage B. Benefits clause C. Riders D. Exclusions - ✔ ✔ d An insured becomes disabled three years after his Disability Income policy is issued. The disability is caused by a condition that existed prior to the policy issue date but was not specifically excluded from coverage. In this situation, the insurer will m ost likely take which of the following actions? A. Pay the full claim B. Pay the claim for a maximum of six months only C. Deny the claim on the basis of misrepresentation D. Deny the claim because it involves a pre -existing condition - ✔ ✔ a A health care plan that reimburses a flat fee for medical care it provides at a clinic it owns and operates is referred to as: A. Health Maintenance Organization B. Medicaid C. Medicare D. Multiple Employer Trust (MET) - ✔ ✔ a Which of the following laws requ ires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant? A. Uniform Provisions Law B. Freedom of Information Act