Accident and Health Insurance
Agent/Broker Practice Exam
A basic medical plan will usually cover all of the following losses EXCEPT:
1.Monthly income from disability
2.Physician charges
3.Private duty nursing
4.Daily room and board - ANS-.Monthly income from disability
A change of occupation provision will allow the insurance company to do any of the following at
the time of claim EXCEPT:
1.Increase the premiums for that individual
2.Pay a reduced benefit for a higher risk occupation
3.Pay the benefits stated in the policy
4.Require a doctor's statement confirming disability - ANS-Increase the premiums for that
individual
A contract that heavily restricts one party while leaving the other free (as some standard form
printed contracts), and implies inequality in bargaining power is:
A contract of adhesion
A conditional contract
An aleatory contract
A unilateral contract - ANS-A contract of adhesion
A hazard is best defined as:
a peril.
a loss.
something that increases the chance of loss.
a legal hazard. - ANS-something that increases the chance of loss
A health insurance underwriter may deny coverage for which of the following reasons?
1.The applicant's history of alcohol abuse
2.The applicant's marital status
3.The sex or gender of the applicant
4.Genetic traits of the applicant - ANS-The applicant's history of alcohol abuse
A health policy will be issued with an outline of coverage. All of the following will be listed in the
outline of coverage EXCEPT:
,1.Contractual governing provisions
2.An outline of benefits and coverage
3.Principal exclusions and limitations
4.Renewal and cancellation provisions - ANS-Contractual governing provisions
A health policy will be issued with an outline of coverage. All of the following will be listed in the
outline of coverage EXCEPT:
Contractual governing provisions
Renewal and cancellation provisions
Principal exclusions and limitations
An outline of benefits and coverage - ANS-Contractual governing provisions
A Medicare supplement plan (Medigap) is designed to provide benefits for all of the following
services EXCEPT:
1.A portion of the surgeon's bill not paid in full by Medicare
2.Hospital Deductibles
3.A portion of lab and x-ray tests not paid in full by Medicare
4.Custodial care facility - ANS-Custodial care facility
A Medicare Supplement policy is issued with a "Free Look" period. This is usually a minimum of:
10 days
45 days
30 days
20 days - ANS-30 days
A reimbursement contract will contain which of the following features:
1.Payment for daily hospital room & board and for surgical procedures.
2.None of the Above
3.Payment of lost income
4.Payment for travel expenses to and from medical facility. - ANS-Payment for daily hospital
room & board and for surgical procedures.
A unilateral contract is:
1.A contract that makes a promise or promises in exchange for a performance
2.Insures that both parties are bound to perform
3.Implies inequality of bargaining power
4.Allows the "little guy" some rights over the person writing the contract. - ANS-A contract that
makes a promise or promises in exchange for a performance
A variety of types of care are provided under a long-term care policy. All of the following are
types of care generally provided EXCEPT:
1.Home health care
2.Intensive care
3.Custodial care
, 4.Skilled care - ANS-Intensive care
Abraham is reviewing the outline of coverage contained in his health policy. He will find all of the
following in this outline EXCEPT:
Future policy value
Limitations and exclusions
Renewal provisions
Benefits - ANS-Future policy value
Adrian is a producer with a poor work ethic. He has been known to misrepresent the terms of a
policy, make false or misleading statements regarding dividends or other benefits paid and
misrepresents the insurer's financial condition or reserves. The state of Maryland has a term for
this activity:
Conflict of interest
Prohibited practices
Diminished trust
Fiduciary unaccountability - ANS-Prohibited practices
Advertisements may be:
Truthful
Misleading and false
Unclear regarding waiting periods
All of the Above - ANS-Truthful
After an adverse determination has been deemed to be denied, the Patient Protection and
Affordable Care Act requires an external review process at what level?
Federal or state
State only
Federal only
Federal, state or county - ANS-Federal or state
All long-term care policies are guaranteed renewable. Some long-term policies are called
noncancellable. Which of the following is true about a noncancellable policy.
1.Policy cannot be cancelled as long as premiums are paid
2.Provisions of the policy can be changed
3.The insurer can decline to renew
4.The insurer can change the policy premium - ANS-Policy cannot be cancelled as long as
premiums are paid
All of the following acts are considered unfair trade practices EXCEPT:
1.replacement.
2.misrepresentation
3.coercion.
Agent/Broker Practice Exam
A basic medical plan will usually cover all of the following losses EXCEPT:
1.Monthly income from disability
2.Physician charges
3.Private duty nursing
4.Daily room and board - ANS-.Monthly income from disability
A change of occupation provision will allow the insurance company to do any of the following at
the time of claim EXCEPT:
1.Increase the premiums for that individual
2.Pay a reduced benefit for a higher risk occupation
3.Pay the benefits stated in the policy
4.Require a doctor's statement confirming disability - ANS-Increase the premiums for that
individual
A contract that heavily restricts one party while leaving the other free (as some standard form
printed contracts), and implies inequality in bargaining power is:
A contract of adhesion
A conditional contract
An aleatory contract
A unilateral contract - ANS-A contract of adhesion
A hazard is best defined as:
a peril.
a loss.
something that increases the chance of loss.
a legal hazard. - ANS-something that increases the chance of loss
A health insurance underwriter may deny coverage for which of the following reasons?
1.The applicant's history of alcohol abuse
2.The applicant's marital status
3.The sex or gender of the applicant
4.Genetic traits of the applicant - ANS-The applicant's history of alcohol abuse
A health policy will be issued with an outline of coverage. All of the following will be listed in the
outline of coverage EXCEPT:
,1.Contractual governing provisions
2.An outline of benefits and coverage
3.Principal exclusions and limitations
4.Renewal and cancellation provisions - ANS-Contractual governing provisions
A health policy will be issued with an outline of coverage. All of the following will be listed in the
outline of coverage EXCEPT:
Contractual governing provisions
Renewal and cancellation provisions
Principal exclusions and limitations
An outline of benefits and coverage - ANS-Contractual governing provisions
A Medicare supplement plan (Medigap) is designed to provide benefits for all of the following
services EXCEPT:
1.A portion of the surgeon's bill not paid in full by Medicare
2.Hospital Deductibles
3.A portion of lab and x-ray tests not paid in full by Medicare
4.Custodial care facility - ANS-Custodial care facility
A Medicare Supplement policy is issued with a "Free Look" period. This is usually a minimum of:
10 days
45 days
30 days
20 days - ANS-30 days
A reimbursement contract will contain which of the following features:
1.Payment for daily hospital room & board and for surgical procedures.
2.None of the Above
3.Payment of lost income
4.Payment for travel expenses to and from medical facility. - ANS-Payment for daily hospital
room & board and for surgical procedures.
A unilateral contract is:
1.A contract that makes a promise or promises in exchange for a performance
2.Insures that both parties are bound to perform
3.Implies inequality of bargaining power
4.Allows the "little guy" some rights over the person writing the contract. - ANS-A contract that
makes a promise or promises in exchange for a performance
A variety of types of care are provided under a long-term care policy. All of the following are
types of care generally provided EXCEPT:
1.Home health care
2.Intensive care
3.Custodial care
, 4.Skilled care - ANS-Intensive care
Abraham is reviewing the outline of coverage contained in his health policy. He will find all of the
following in this outline EXCEPT:
Future policy value
Limitations and exclusions
Renewal provisions
Benefits - ANS-Future policy value
Adrian is a producer with a poor work ethic. He has been known to misrepresent the terms of a
policy, make false or misleading statements regarding dividends or other benefits paid and
misrepresents the insurer's financial condition or reserves. The state of Maryland has a term for
this activity:
Conflict of interest
Prohibited practices
Diminished trust
Fiduciary unaccountability - ANS-Prohibited practices
Advertisements may be:
Truthful
Misleading and false
Unclear regarding waiting periods
All of the Above - ANS-Truthful
After an adverse determination has been deemed to be denied, the Patient Protection and
Affordable Care Act requires an external review process at what level?
Federal or state
State only
Federal only
Federal, state or county - ANS-Federal or state
All long-term care policies are guaranteed renewable. Some long-term policies are called
noncancellable. Which of the following is true about a noncancellable policy.
1.Policy cannot be cancelled as long as premiums are paid
2.Provisions of the policy can be changed
3.The insurer can decline to renew
4.The insurer can change the policy premium - ANS-Policy cannot be cancelled as long as
premiums are paid
All of the following acts are considered unfair trade practices EXCEPT:
1.replacement.
2.misrepresentation
3.coercion.
