Aflac Study Pre Cert. Practice Exam with
Complete Solutions
What is covered under a limited accident and health insurance policy?
A. Losses that occur only in limited occupations
B. Limited pre-existing conditions
C. Losses that occur only in limited age groups
D. Limited perils and amounts Correct Ans-D. Limited perils and amounts
In long-term care insurance, what is the length of time for which claims will be paid?
A. Benefit period
B. Free-look period
C. Grace period
D. Elimination period Correct Ans-A. Benefit period
After joining a health maintenance organization (HMO), a subscriber will typically select a(n)
A. capitation level
B. primary care physician
C. closed panel
,D. deductible level Correct Ans-B. primary care physician
Which of the following can be defined as a cause of a loss?
A. Adversity
B. Risk
C. Hazard
D. Peril Correct Ans-D. Peril
Which of the following accurately describes the "time limit on certain defenses"?
A. After a stated period of time, claims cannot be denied due to material misrepresentation on
the application
B. All claims can be disputed after two years
C. An insured cannot file a lawsuit within 90 days of the claim being filed
D. The right to return an accident and health policy must be within 10 days of policy delivery
Correct Ans-A. After a stated period of time, claims cannot be denied due to material
misrepresentation on the application
A significant difference between HICs and private commercial accident and health insurers is
that
,A. Private commercial insurers do NOT offer group coverage
B. HICs are limited to providing coverage for nonprofit organizations
C. HICs combine medical care delivery and funding in one organization
D. Private commercial insurers will NOT offer coverage to nonprofit organizations Correct
Ans-C. HICs combine medical care delivery and funding in one organization
What is a prosthodontics dental procedure?
A. A filling
B. A root canal
C. Bridgework
D. Teeth cleaning Correct Ans-C. Bridgework
Quality care in HIC specialty plans is evidenced by all of the following EXCEPT
A. The buildings and equipment are in good repair
B. The plan's service area is unlimited
C. The providers provide accurate diagnosis and treatment
D. The participants experience improved health Correct Ans-B. The plan's service area is
unlimited
An Ohio agent's license to sell insurance may be revoked for all of the following reasons EXCEPT
, A. Rebating or twisting
B. Misrepresenting contract provisions
C. Being convicted of a felony
D. Sharing commissions with licensed agents Correct Ans-D. Sharing commissions with
licensed agents
An example of illegal inducement would be
A. Announcing the opening of a new agency
B. Publishing guaranteed dividend rates on a new type of policy
C. Delaying payment on a claim because of an incomplete accident report
D. Advertising that your agency can provide policies with competitive rates Correct Ans-B.
Publishing guaranteed dividend rates on a new type of policy
Under the Affordable Care Act (ACA), what is the proportion of premium revenues spent on
clinical services and quality improvements?
A. Medical loss ratio
B. Minimum essential coverage
C. Issue rebate
D. Market rate reform Correct Ans-A. Medical loss ratio
Complete Solutions
What is covered under a limited accident and health insurance policy?
A. Losses that occur only in limited occupations
B. Limited pre-existing conditions
C. Losses that occur only in limited age groups
D. Limited perils and amounts Correct Ans-D. Limited perils and amounts
In long-term care insurance, what is the length of time for which claims will be paid?
A. Benefit period
B. Free-look period
C. Grace period
D. Elimination period Correct Ans-A. Benefit period
After joining a health maintenance organization (HMO), a subscriber will typically select a(n)
A. capitation level
B. primary care physician
C. closed panel
,D. deductible level Correct Ans-B. primary care physician
Which of the following can be defined as a cause of a loss?
A. Adversity
B. Risk
C. Hazard
D. Peril Correct Ans-D. Peril
Which of the following accurately describes the "time limit on certain defenses"?
A. After a stated period of time, claims cannot be denied due to material misrepresentation on
the application
B. All claims can be disputed after two years
C. An insured cannot file a lawsuit within 90 days of the claim being filed
D. The right to return an accident and health policy must be within 10 days of policy delivery
Correct Ans-A. After a stated period of time, claims cannot be denied due to material
misrepresentation on the application
A significant difference between HICs and private commercial accident and health insurers is
that
,A. Private commercial insurers do NOT offer group coverage
B. HICs are limited to providing coverage for nonprofit organizations
C. HICs combine medical care delivery and funding in one organization
D. Private commercial insurers will NOT offer coverage to nonprofit organizations Correct
Ans-C. HICs combine medical care delivery and funding in one organization
What is a prosthodontics dental procedure?
A. A filling
B. A root canal
C. Bridgework
D. Teeth cleaning Correct Ans-C. Bridgework
Quality care in HIC specialty plans is evidenced by all of the following EXCEPT
A. The buildings and equipment are in good repair
B. The plan's service area is unlimited
C. The providers provide accurate diagnosis and treatment
D. The participants experience improved health Correct Ans-B. The plan's service area is
unlimited
An Ohio agent's license to sell insurance may be revoked for all of the following reasons EXCEPT
, A. Rebating or twisting
B. Misrepresenting contract provisions
C. Being convicted of a felony
D. Sharing commissions with licensed agents Correct Ans-D. Sharing commissions with
licensed agents
An example of illegal inducement would be
A. Announcing the opening of a new agency
B. Publishing guaranteed dividend rates on a new type of policy
C. Delaying payment on a claim because of an incomplete accident report
D. Advertising that your agency can provide policies with competitive rates Correct Ans-B.
Publishing guaranteed dividend rates on a new type of policy
Under the Affordable Care Act (ACA), what is the proportion of premium revenues spent on
clinical services and quality improvements?
A. Medical loss ratio
B. Minimum essential coverage
C. Issue rebate
D. Market rate reform Correct Ans-A. Medical loss ratio
