PEARSON VUE NATIONAL
HEALTH INSURANCE PRACTICE
TEST
M and N own a small interior design studio that employs six
people. The owners are concerned about the financial
continuation of the business if either of them should become
permanently disabled. In this situation, a producer would MOST
likely recommend which of the following types of contracts?
A. Basic Hospital
B. Disability Buy-Out
C. Comprehensive Major Medical
D. Short-Term Disability Income
b
Which of the following definitions of disability would cover a
permanent partial disability?
A. Own occupation
B. Any occupation
C. Residual disability
D. Presumptive disability
,c
Group health insurance specifies that what percentage of eligible
individuals MUST be offered coverage under a noncontributory
plan?
A. 25
B. 50
C. 75
D. 100
d
An Eligible Expenses provision in a comprehensive major medical
policy commonly identifies all of the following types of covered
health care services EXCEPT:
A. professional services of doctors and other medical practitioners
B. hospital charges for semi-private room and board
C. experimental and investigative services
D. pre-approved home health care
c
Which of the following provisions explains that a producer does
not have the authority to waive the provisions of an insurance
contract?
A. Legal actions
, B. Reinstatement
C. Time limit on certain defenses
D. Entire Contract
d
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:
A. expect a full refund of all premiums paid plus interest
B. submit the claim in any form, which must be accepted by the
company as adequate proof of loss
C. request the Department of Insurance mediate the claim
settlement
D. wait for the claim form to arrive
b
The Coordination of Benefits clause found in group health master
contracts is used to:
A.integrate Disability Income benefits with Major Medical
benefits
A. integrate Disability Income benefits with Major Medical
benefits
B. avoid double payment of benefits to an insured who has
duplicate group coverages
HEALTH INSURANCE PRACTICE
TEST
M and N own a small interior design studio that employs six
people. The owners are concerned about the financial
continuation of the business if either of them should become
permanently disabled. In this situation, a producer would MOST
likely recommend which of the following types of contracts?
A. Basic Hospital
B. Disability Buy-Out
C. Comprehensive Major Medical
D. Short-Term Disability Income
b
Which of the following definitions of disability would cover a
permanent partial disability?
A. Own occupation
B. Any occupation
C. Residual disability
D. Presumptive disability
,c
Group health insurance specifies that what percentage of eligible
individuals MUST be offered coverage under a noncontributory
plan?
A. 25
B. 50
C. 75
D. 100
d
An Eligible Expenses provision in a comprehensive major medical
policy commonly identifies all of the following types of covered
health care services EXCEPT:
A. professional services of doctors and other medical practitioners
B. hospital charges for semi-private room and board
C. experimental and investigative services
D. pre-approved home health care
c
Which of the following provisions explains that a producer does
not have the authority to waive the provisions of an insurance
contract?
A. Legal actions
, B. Reinstatement
C. Time limit on certain defenses
D. Entire Contract
d
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:
A. expect a full refund of all premiums paid plus interest
B. submit the claim in any form, which must be accepted by the
company as adequate proof of loss
C. request the Department of Insurance mediate the claim
settlement
D. wait for the claim form to arrive
b
The Coordination of Benefits clause found in group health master
contracts is used to:
A.integrate Disability Income benefits with Major Medical
benefits
A. integrate Disability Income benefits with Major Medical
benefits
B. avoid double payment of benefits to an insured who has
duplicate group coverages
