HURM 4640 EXAM 3 QUESTIONS AND ANSWERS
All of the following are contract provisions common to various types of medical expense benefits
EXCEPT:
A. the amounts set for co-pays and deductibles.
B. eligibility provisions.
C. claims provisions.
D. coordination of benefit provisions. - CORRECT ANSWER✅✅A. the amounts set for co-pays and
deductibles.
What dependents are ineligible for coverage under a medical expense plan?
A. Spouses of those covered employees
B. Children of these covered employees (under the
age of 23)
C. Children of covered employees unable to earn
their own living due to physical or mental infirmity.
D. Those dependents of employees not covered. - CORRECT ANSWER✅✅D. Those dependents of
employees not covered.
Which of the following is usually eligible for coverage as a dependent under a major medical expense
plan?
A. A spouse who is legally separated, but not divorced from the employee.
B. Dependent, unmarried stepchildren under age 19.
C. Dependent parents over age 65.
D. Dependent, married children up to age 25 if full-time college students. - CORRECT ANSWER✅✅B.
Dependent, unmarried stepchildren under age 19.
,All of the following statements concerning the portability provisions of the Health Insurance Portability
and Accountability Act are correct EXCEPT:
A. They apply only to insured health plans of employers with 50 or more employees.
B. They require an employer to give persons losing group coverage a certificate that specifies the period
of creditable coverage under the plan they are leaving.
C. They allow a late enrollee in a plan to be subject to a pre-existing conditions period of 18 months.
D. They require any waiting period for coverage to run concurrently with any preexisting conditions
period. - CORRECT ANSWER✅✅A. They apply only to insured health plans of employers with 50 or
more employees.
The term Domestic Partner Benefits refer to what type of relationship to the subscriber?
A. Partners of the same sex that is financially independent
B. Both same and opposite sex partners who can prove interdependence
C. Married persons with a roommate
D. Only those domestic partners with dependent - CORRECT ANSWER✅✅B. Both same and opposite
sex partners who can prove interdependence
If dependent coverage is contributory, duplicate coverage may arise in all instances EXCEPT:
A. an employee has two jobs.
B. children are covered under both a parent's and a step parent's plan.
C. an individual has coverage under a group plan that is not provided by an employer.
D. All of the above
E. None of the above - CORRECT ANSWER✅✅E. None of the above
Which of the following statements concerning the usual coordination-of-benefits provision is (are)
correct?
,I. When two plans both have the provision and the parents are neither separated nor divorced, a
father's coverage is primary for male children and a mother's coverage is primary for female children.
II. When two plans both have the provision, coverage as an employee is primary to coverage as a
dependent.
A. I only
B. II only
C. Both I and II
D. Neither I nor II - CORRECT ANSWER✅✅B. II only
Most employees and their dependents will be eligible for Medicare upon reaching age:
A. 60
B. 65
C. 62
D. 55 - CORRECT ANSWER✅✅B. 65
Which of the following statements concerning Medicare carve-outs and supplements is (are) correct?
I. Under a Medicare carve-out, Medicare benefits are reduced by the amount of any benefits paid by an
employer's medical expense plan.
II. Medical supplements can be provided only to active employees who are covered by Medicare.
A. I only
B. II only
C. Both I and II
D. Neither I nor II - CORRECT ANSWER✅✅D. Neither I nor II
, How many employees does an employer have to have for COBRA to apply to them?
A. 10
B. 15
C. 25
D. 20 - CORRECT ANSWER✅✅D. 20
Ignoring any provision for the continuing of coverage, an employee's coverage under a medical expense
plan will generally cease in all of the following cases EXCEPT:
A. the employee reaches age 65.
B. the master contract terminates.
C. the date on which employment terminates.
D. the employee receives the maximum overall benefit payable under the policy. - CORRECT
ANSWER✅✅A. the employee reaches age 65.
COBRA requires that group health plans allow employees and certain beneficiaries to elect to have their
current health insurance coverage extended at group rates for up to how many months following a 1st
qualifying event that results in the loss of coverage for a qualified beneficiary?
A. 12 months
B. 18 months or 36 months depending on the situation
C. 24 months
D. 26 months - CORRECT ANSWER✅✅B. 18 months or 36 months depending on the situation
Who has to comply with COBRA?
A. Local, State, and Federal agencies and contractors working with the government whose contracts
exceed $50,000 in one year.
B. Employers with 10 or more employees.
All of the following are contract provisions common to various types of medical expense benefits
EXCEPT:
A. the amounts set for co-pays and deductibles.
B. eligibility provisions.
C. claims provisions.
D. coordination of benefit provisions. - CORRECT ANSWER✅✅A. the amounts set for co-pays and
deductibles.
What dependents are ineligible for coverage under a medical expense plan?
A. Spouses of those covered employees
B. Children of these covered employees (under the
age of 23)
C. Children of covered employees unable to earn
their own living due to physical or mental infirmity.
D. Those dependents of employees not covered. - CORRECT ANSWER✅✅D. Those dependents of
employees not covered.
Which of the following is usually eligible for coverage as a dependent under a major medical expense
plan?
A. A spouse who is legally separated, but not divorced from the employee.
B. Dependent, unmarried stepchildren under age 19.
C. Dependent parents over age 65.
D. Dependent, married children up to age 25 if full-time college students. - CORRECT ANSWER✅✅B.
Dependent, unmarried stepchildren under age 19.
,All of the following statements concerning the portability provisions of the Health Insurance Portability
and Accountability Act are correct EXCEPT:
A. They apply only to insured health plans of employers with 50 or more employees.
B. They require an employer to give persons losing group coverage a certificate that specifies the period
of creditable coverage under the plan they are leaving.
C. They allow a late enrollee in a plan to be subject to a pre-existing conditions period of 18 months.
D. They require any waiting period for coverage to run concurrently with any preexisting conditions
period. - CORRECT ANSWER✅✅A. They apply only to insured health plans of employers with 50 or
more employees.
The term Domestic Partner Benefits refer to what type of relationship to the subscriber?
A. Partners of the same sex that is financially independent
B. Both same and opposite sex partners who can prove interdependence
C. Married persons with a roommate
D. Only those domestic partners with dependent - CORRECT ANSWER✅✅B. Both same and opposite
sex partners who can prove interdependence
If dependent coverage is contributory, duplicate coverage may arise in all instances EXCEPT:
A. an employee has two jobs.
B. children are covered under both a parent's and a step parent's plan.
C. an individual has coverage under a group plan that is not provided by an employer.
D. All of the above
E. None of the above - CORRECT ANSWER✅✅E. None of the above
Which of the following statements concerning the usual coordination-of-benefits provision is (are)
correct?
,I. When two plans both have the provision and the parents are neither separated nor divorced, a
father's coverage is primary for male children and a mother's coverage is primary for female children.
II. When two plans both have the provision, coverage as an employee is primary to coverage as a
dependent.
A. I only
B. II only
C. Both I and II
D. Neither I nor II - CORRECT ANSWER✅✅B. II only
Most employees and their dependents will be eligible for Medicare upon reaching age:
A. 60
B. 65
C. 62
D. 55 - CORRECT ANSWER✅✅B. 65
Which of the following statements concerning Medicare carve-outs and supplements is (are) correct?
I. Under a Medicare carve-out, Medicare benefits are reduced by the amount of any benefits paid by an
employer's medical expense plan.
II. Medical supplements can be provided only to active employees who are covered by Medicare.
A. I only
B. II only
C. Both I and II
D. Neither I nor II - CORRECT ANSWER✅✅D. Neither I nor II
, How many employees does an employer have to have for COBRA to apply to them?
A. 10
B. 15
C. 25
D. 20 - CORRECT ANSWER✅✅D. 20
Ignoring any provision for the continuing of coverage, an employee's coverage under a medical expense
plan will generally cease in all of the following cases EXCEPT:
A. the employee reaches age 65.
B. the master contract terminates.
C. the date on which employment terminates.
D. the employee receives the maximum overall benefit payable under the policy. - CORRECT
ANSWER✅✅A. the employee reaches age 65.
COBRA requires that group health plans allow employees and certain beneficiaries to elect to have their
current health insurance coverage extended at group rates for up to how many months following a 1st
qualifying event that results in the loss of coverage for a qualified beneficiary?
A. 12 months
B. 18 months or 36 months depending on the situation
C. 24 months
D. 26 months - CORRECT ANSWER✅✅B. 18 months or 36 months depending on the situation
Who has to comply with COBRA?
A. Local, State, and Federal agencies and contractors working with the government whose contracts
exceed $50,000 in one year.
B. Employers with 10 or more employees.
