QUESTIONS WITH VERIFIED ANSWERS. / ALREADY GRADED A+
Reinstatement of an individual health insurance plan requires?
payment of premium without proof of insurability
If an employee contributes 50% toward the disability plan premium provided by an employer, what
would be considered the taxable income of a $1,000 monthly disability benefit?
$500
A beneficiary change can occur
normally at any time during the policy term
When are group disability benefits considered to be tax-free to the insured?
When the recipient pays the premiums
The election of COBRA for continuation of health coverage will
maintain the same coverage and increase premium
Jerry voluntarily terminated his producer's license. If he changes his mind, his license may be
reinstated during the same license period IF
He completes a new license application
An insured has a stop-loss limit of $5,000, a deductible of $500, and an 80/20 coinsurance. The
insured incurs $25,000 of covered losses. How much will the insured have to pay?
$5,000
A common exclusion with Vision plans is
lasik surgery
Which of the following is NOT a required provision in an accident and health insurance policy?
legal actions
grace period
change of occupation
reinstatement
change of occupation
All advertisements for health insurance shall make clear the identity of the
Insurer
, A policyholder has a major medical plan with a 80%/20% coinsurance and a deductible of $75. If the
insured has previously met her deductible and receives a bill for $175, how much will the insurer pay?
$140 Because the insured has previously met her deductible, the eligible expenses for a claim is the
entire $175. The insurance company pays 80% of $175, or $140.
An agent is required to keep replacement forms on file for at LEAST ____ years
5
An insurance company needs to obtain personal information from a third party concerning an
applicant. Which law do all insurers and their producers need to comply with?
Fair credit reporting act
The law that established insurance transactions should be regulated by the states is called the
McCarran-Ferguson Act
An accident and health insurer has just received written proof of loss from one of its insureds. The
insured must now wait 60 days before
Bringing legal action against the insurer
A branch office registration form is required to be filed at least ___ days before selling insurance out
of that branch
30
In New Jersey, an insurer is required to maintain files of all published and printed advertisements for?
5 years from the date of last use
Disability Income plans which require that the insurer can NEVER change or alter premium rates are
usually considered
Noncancellable
Medicare Part A does not pay for medical benefits provided for the treatment in a skilled nursing
facility beyond
100 days
According to HIPAA, when an insured individual leaves an employer and immediately begins working
for a new company that offers group health insurance, the individual
Is eligible for coverage upon hire
An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a
notice of claim.
15 days
Which of the following is MANDATORY coverage for all group health care service contracts?