Colorado Health Licensing Exam Questions and Answers(GRADED A+)
The PRIMARY purpose of medicaid is to: - ANSWER-provide medical expense coverage to persons meeting certain minimum income requirements
A disability income policy may provide benefits for which of the following losses? - ANSWER-residual disability
the elimination period in most disability income policies applies: - ANSWER-to each separate disability
On June 1, S purchased a Major Medical policy and paid the initial premium to Producer
T. On July 1, Producer T received the policy from the insurance company. The policy contained a Ten-Day Free Look provision. On July 3, Producer T attempted to deliver the policy but found that S was not at home. On July 5, Producer T was able to deliver the policy to S. on July 7, S decided he did not want the policy. S had 10 days from which of the following dates to return the policy to the company and obtain a full premium refund? - ANSWER-July 5
An insured whose disability income policy contains a change of occupation clause takes
a new job in a more hazardous occupation and fails to notify the insurer of the change. One year later, the insured becomes disabled. The insurer will most likely take which of the following actions? - ANSWER-Settle the claim according to what the premiums would have purchased under the more hazardous occupation.
Which of the following reports may include information obtained by telephone call to the proposed insured? - ANSWER-inspection report
J has a physical impairment, attends school, and is incapable of self-sustaining employer and/or self care. which of the following statements is CORRECT about J's medical coverage under J's father's group plan? - ANSWER-J's coverage continues as long as J is continually incapacitated and is financially dependent on J's father.
The Social Security program provides all of the following benefits EXCEPT - ANSWER-
workers compensation
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 most likely take which of the following actions? - ANSWER-pay the full claim Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy features. - ANSWER-exclusions
Which of the following definitions MOST accurately describes the Probationary Period? - ANSWER-the waiting period a new hire must satisfy prior to becoming eligible for group health coverage.
In which of the following health policies are both the renewability and the premiums guaranteed? - ANSWER-noncancellable
Medicare Part A covers which of the following expenses. - ANSWER-Hospital room and
board
When delivering a policy to a client, a producer should take all of the following actions EXCEPT: - ANSWER-keep the policy in the producer's office for safe-keeping on behalf
of the client
Which of the following provisions explains that a producer does not have the authority to
waive the provisions of an insurance contract? - ANSWER-entire contract
a precertification review prior to a nonemergency hospitalization is an example of: - ANSWER-managed care
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: - ANSWER-a Health Maintenance Organization
Under the Claims Forms provision of a health policy, if the insurance company fails to send claim forms within the time period required, the insured should: - ANSWER-submit
the claim in any form, which must be accepted by the company as adequate proof of loss
A married insured has an Accidental Death and Dismemberment (AD&D) policy that names his brother as the primary beneficiary and his son as the contingent beneficiary. If the insured and his brother are both killed instantly in a train accident, the policy proceeds would be paid to which of the following? - ANSWER-the insured's son
an Accident and Health policy Notice of Claim provision requires that an insured give written notice to the insurer within a MAXIMUM of how many days after the loss? - ANSWER-20
Which of the following statements is CORRECT about coinsurance? - ANSWER-It helps
control overutilization of benefits
The Consideration clause in an accident and health policy states the - ANSWER-the applicant pays the initial premium
The PRIMARY purpose of medicaid is to: - ANSWER-provide medical expense coverage to persons meeting certain minimum income requirements
A disability income policy may provide benefits for which of the following losses? - ANSWER-residual disability
the elimination period in most disability income policies applies: - ANSWER-to each separate disability
On June 1, S purchased a Major Medical policy and paid the initial premium to Producer
T. On July 1, Producer T received the policy from the insurance company. The policy contained a Ten-Day Free Look provision. On July 3, Producer T attempted to deliver the policy but found that S was not at home. On July 5, Producer T was able to deliver the policy to S. on July 7, S decided he did not want the policy. S had 10 days from which of the following dates to return the policy to the company and obtain a full premium refund? - ANSWER-July 5
An insured whose disability income policy contains a change of occupation clause takes
a new job in a more hazardous occupation and fails to notify the insurer of the change. One year later, the insured becomes disabled. The insurer will most likely take which of the following actions? - ANSWER-Settle the claim according to what the premiums would have purchased under the more hazardous occupation.
Which of the following reports may include information obtained by telephone call to the proposed insured? - ANSWER-inspection report
J has a physical impairment, attends school, and is incapable of self-sustaining employer and/or self care. which of the following statements is CORRECT about J's medical coverage under J's father's group plan? - ANSWER-J's coverage continues as long as J is continually incapacitated and is financially dependent on J's father.
The Social Security program provides all of the following benefits EXCEPT - ANSWER-
workers compensation
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 most likely take which of the following actions? - ANSWER-pay the full claim Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following policy features. - ANSWER-exclusions
Which of the following definitions MOST accurately describes the Probationary Period? - ANSWER-the waiting period a new hire must satisfy prior to becoming eligible for group health coverage.
In which of the following health policies are both the renewability and the premiums guaranteed? - ANSWER-noncancellable
Medicare Part A covers which of the following expenses. - ANSWER-Hospital room and
board
When delivering a policy to a client, a producer should take all of the following actions EXCEPT: - ANSWER-keep the policy in the producer's office for safe-keeping on behalf
of the client
Which of the following provisions explains that a producer does not have the authority to
waive the provisions of an insurance contract? - ANSWER-entire contract
a precertification review prior to a nonemergency hospitalization is an example of: - ANSWER-managed care
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: - ANSWER-a Health Maintenance Organization
Under the Claims Forms provision of a health policy, if the insurance company fails to send claim forms within the time period required, the insured should: - ANSWER-submit
the claim in any form, which must be accepted by the company as adequate proof of loss
A married insured has an Accidental Death and Dismemberment (AD&D) policy that names his brother as the primary beneficiary and his son as the contingent beneficiary. If the insured and his brother are both killed instantly in a train accident, the policy proceeds would be paid to which of the following? - ANSWER-the insured's son
an Accident and Health policy Notice of Claim provision requires that an insured give written notice to the insurer within a MAXIMUM of how many days after the loss? - ANSWER-20
Which of the following statements is CORRECT about coinsurance? - ANSWER-It helps
control overutilization of benefits
The Consideration clause in an accident and health policy states the - ANSWER-the applicant pays the initial premium
