Health Insurance Florida QUESTIONS AND ANSWERS
WITH VERIFIED ANSWERS 22025/2026 Q&A |INSTANT
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1. Which of the following is considered a “health maintenance organization”
(HMO)?
A. A plan where you can visit any doctor without referral
B. A plan that requires you to choose a primary care physician and get referrals
C. A plan with no network restrictions
D. A catastrophic insurance plan
Correct Answer: B – HMOs require members to select a primary care physician and
obtain referrals for specialist care.
2. Which entity regulates health insurance in Florida?
A. Centers for Medicare & Medicaid Services (CMS)
B. Florida Department of Insurance
C. Florida Office of Insurance Regulation (OIR)
D. National Association of Insurance Commissioners (NAIC)
Correct Answer: C – The Florida OIR regulates health insurance policies and
insurers in Florida.
3. Which of the following is a mandated benefit in Florida health insurance
policies?
A. Cosmetic surgery
B. Mammography screening
C. Fertility treatments
D. Alternative medicine
,Correct Answer: B – Florida law requires coverage for mammography screenings
as a preventive service.
4. What is the purpose of a “waiting period” in health insurance?
A. To delay payment of premiums
B. To prevent fraud
C. To specify the time before certain benefits are covered
D. To reduce deductible amounts
Correct Answer: C – A waiting period delays coverage of certain benefits after
enrollment.
5. Which of the following is true about Florida’s “small employer” health
insurance rules?
A. Applies to employers with 2–50 employees
B. Only applies to employers with 1 employee
C. Requires coverage for all employees automatically
D. Exempts employers from state regulation
Correct Answer: A – Small employer rules in Florida cover businesses with 2–50
employees.
6. What is a “preexisting condition” in health insurance terms?
A. A condition diagnosed after enrollment
B. A condition diagnosed before enrollment
C. A condition caused by accidents
D. A preventive service
Correct Answer: B – A preexisting condition is any medical condition diagnosed
before the policy starts.
, 7. Which type of Florida health insurance plan typically has lower premiums but
limited provider choice?
A. PPO
B. HMO
C. POS
D. Indemnity plan
Correct Answer: B – HMOs usually offer lower premiums with a restricted network
of providers.
8. Florida law requires insurers to provide coverage for:
A. Chiropractic care for all policies
B. Emergency services regardless of network
C. Cosmetic procedures
D. Experimental treatments
Correct Answer: B – Emergency services must be covered even if provided outside
the plan network.
9. Which of the following is a characteristic of a Preferred Provider Organization
(PPO)?
A. Requires referrals for specialists
B. Members can see any doctor but get higher benefits in-network
C. Only allows in-network services
D. Does not cover preventive care
Correct Answer: B – PPOs provide flexibility to see any provider, with better
coverage for in-network care.
10. Florida health insurers cannot deny coverage to children under:
A. Age 10
B. Age 19
WITH VERIFIED ANSWERS 22025/2026 Q&A |INSTANT
DOWNLOAD PDF
1. Which of the following is considered a “health maintenance organization”
(HMO)?
A. A plan where you can visit any doctor without referral
B. A plan that requires you to choose a primary care physician and get referrals
C. A plan with no network restrictions
D. A catastrophic insurance plan
Correct Answer: B – HMOs require members to select a primary care physician and
obtain referrals for specialist care.
2. Which entity regulates health insurance in Florida?
A. Centers for Medicare & Medicaid Services (CMS)
B. Florida Department of Insurance
C. Florida Office of Insurance Regulation (OIR)
D. National Association of Insurance Commissioners (NAIC)
Correct Answer: C – The Florida OIR regulates health insurance policies and
insurers in Florida.
3. Which of the following is a mandated benefit in Florida health insurance
policies?
A. Cosmetic surgery
B. Mammography screening
C. Fertility treatments
D. Alternative medicine
,Correct Answer: B – Florida law requires coverage for mammography screenings
as a preventive service.
4. What is the purpose of a “waiting period” in health insurance?
A. To delay payment of premiums
B. To prevent fraud
C. To specify the time before certain benefits are covered
D. To reduce deductible amounts
Correct Answer: C – A waiting period delays coverage of certain benefits after
enrollment.
5. Which of the following is true about Florida’s “small employer” health
insurance rules?
A. Applies to employers with 2–50 employees
B. Only applies to employers with 1 employee
C. Requires coverage for all employees automatically
D. Exempts employers from state regulation
Correct Answer: A – Small employer rules in Florida cover businesses with 2–50
employees.
6. What is a “preexisting condition” in health insurance terms?
A. A condition diagnosed after enrollment
B. A condition diagnosed before enrollment
C. A condition caused by accidents
D. A preventive service
Correct Answer: B – A preexisting condition is any medical condition diagnosed
before the policy starts.
, 7. Which type of Florida health insurance plan typically has lower premiums but
limited provider choice?
A. PPO
B. HMO
C. POS
D. Indemnity plan
Correct Answer: B – HMOs usually offer lower premiums with a restricted network
of providers.
8. Florida law requires insurers to provide coverage for:
A. Chiropractic care for all policies
B. Emergency services regardless of network
C. Cosmetic procedures
D. Experimental treatments
Correct Answer: B – Emergency services must be covered even if provided outside
the plan network.
9. Which of the following is a characteristic of a Preferred Provider Organization
(PPO)?
A. Requires referrals for specialists
B. Members can see any doctor but get higher benefits in-network
C. Only allows in-network services
D. Does not cover preventive care
Correct Answer: B – PPOs provide flexibility to see any provider, with better
coverage for in-network care.
10. Florida health insurers cannot deny coverage to children under:
A. Age 10
B. Age 19
