NC - Health Insurance - Practice Exam
Questions and Answers 100% Solved
A brain surgeon has an accident and develops tremors in her right arm. Which disability
income policy definition of total disability will cover her for all losses?
a)"Any occupation" - more restrictive than other definitions
b)"Own occupation" - less restrictive than other definitions
c)"Own occupation" - more restrictive than other definitions
d)"Any occupation" - less restrictive than other definitions - ANSWER-b)"Own
occupation" - less restrictive than other definitions
In theory, the brain surgeon could find other work, but because her disability income
policy specifies that she is covered for her own occupation, she would be wholly
covered.
A client has a new individual disability income policy with a 20-day probationary period
and a 30-day elimination period. Ten days later, the client breaks their leg and is off
work for 45 days. How many days of disability benefits will the policy pay?
a)10 days
b)15 days
c)25 days
d)45 days - ANSWER-b)15 days
A probationary period refers to the amount of time that coverage is not available for
illness-related disabilities, so it would not apply to a broken leg. The elimination period,
however, is the time that must elapse between the onset of the disability and when
benefits will start being paid. In this case, the individual is considered disabled for 45
days, and the benefits will start to be paid after 30 days. So, the client will receive
benefits for 15 days.
A dentist is off work for 4 months due to a disability. His dental assistant's salary would
be covered by?
a). Business Overhead Insurance
b). Disability Income
c). Key Employee Disability
d). Partnership Disability - ANSWER-a). Business Overhead Insurance
Business overhead insurance is designed to pay the ongoing business expenses of a
small business owner while they are disabled and unable to work. It will provide the
funds needed to pay the salary of employees other than the owners and their ongoing
business expenses, such as rent.
,A husband and wife are insured under group health insurance plans at their own places
of employment, and as dependents under their spouse's coverage. If one of them incurs
hospital expenses, how will those expenses likely be paid?
a)Neither plan would pay.
b)Each plan will pay in equal shares.
c)The insured will have to select a plan from which to collect benefits.
d)The benefits will be coordinated. - ANSWER-d)The benefits will be coordinated.
Benefits will be coordinated when individuals are covered under two or more health
plans.
A man is an attorney when he applies for a health policy. He decides to become a
professional bungee jumper. He files a claim. What should happen?
a). His coverage will be dropped
b). The man's workers comp will pay the claim in full
c). The insurance company will not pay the claim
d). The insurance company will pay the claim according to the benefits available if the
correct premium has been paid - ANSWER-d). The insurance company will pay the
claim according to the benefits available if the correct premium has been paid
If the insured makes a change to a more hazardous occupation, upon claim, benefit will
be reduced to what premiums paid would have purchased assuming the more
hazardous occupation.
According to the Future Increase Option Rider (FIO), which of the following is NOT a
qualifying event to increase an insured's benefit level?
a)Death of a spouse
b)Age 40
c)Marriage
d)Birth of a child - ANSWER-a)Death of a spouse
The FIO rider allows insureds to increase their benefit levels to certain amounts at
specific times without proof of insurability. The following are the typical occasions when
an insurer allows for a benefit increase: ages 25, 28, 31, 34, 37 and 40; marriage; and
the birth of a child.
According to the PPACA rules, what percentage of health care costs will be covered
under a bronze plan?
a)10%
b)30%
c)40%
, d)60% - ANSWER-d)60%
Under the bronze plan, the health plan is expected to cover 60% of the cost for an
average population, and the participants would cover the remaining 40%
After appointing an agent, how long does an insurer have to file with the Commissioner
the form detailing the agent's name, address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - ANSWER-B) 30 days
Insurers have 30 days to file, in a form prescribed by the Commissioner, the names,
addresses, and other information required by the Commissioner for its newly appointed
agents.
All of the following are features of a health insurance plan purchased on the health
insurance marketplace EXCEPT
a). Coverage for emergency services
b). Coverage for pre-existing conditions
c). Dollar limits on essential benefits
d). Guaranteed renewability - ANSWER-c). Dollar limits on essential benefits
Health plans are restricted from applying a dollar limit on essential benefits, nor can
they establish a dollar limit on the amount of benefits paid during the course of an
insured's lifetime.
All of the following are true regarding Key Employee Disability Income insurance
EXCEPT
A) Premiums are not tax deductible for the employer.
B) Benefits are taxable to the employer.
C) The employer owns the policy.
D) Benefits are paid to the employer to retrain a new person. - ANSWER-B) Benefits
are taxable to the employer.
Key person disability income premiums are not deductible to the business, but the
benefits are received income tax free by the business.
All of the following are true regarding key person disability income insurance EXCEPT
a)The employee is the insured.
b)Premiums are tax deductible as a business expense.
c)The employer receives the benefits if the key person is disabled.
Questions and Answers 100% Solved
A brain surgeon has an accident and develops tremors in her right arm. Which disability
income policy definition of total disability will cover her for all losses?
a)"Any occupation" - more restrictive than other definitions
b)"Own occupation" - less restrictive than other definitions
c)"Own occupation" - more restrictive than other definitions
d)"Any occupation" - less restrictive than other definitions - ANSWER-b)"Own
occupation" - less restrictive than other definitions
In theory, the brain surgeon could find other work, but because her disability income
policy specifies that she is covered for her own occupation, she would be wholly
covered.
A client has a new individual disability income policy with a 20-day probationary period
and a 30-day elimination period. Ten days later, the client breaks their leg and is off
work for 45 days. How many days of disability benefits will the policy pay?
a)10 days
b)15 days
c)25 days
d)45 days - ANSWER-b)15 days
A probationary period refers to the amount of time that coverage is not available for
illness-related disabilities, so it would not apply to a broken leg. The elimination period,
however, is the time that must elapse between the onset of the disability and when
benefits will start being paid. In this case, the individual is considered disabled for 45
days, and the benefits will start to be paid after 30 days. So, the client will receive
benefits for 15 days.
A dentist is off work for 4 months due to a disability. His dental assistant's salary would
be covered by?
a). Business Overhead Insurance
b). Disability Income
c). Key Employee Disability
d). Partnership Disability - ANSWER-a). Business Overhead Insurance
Business overhead insurance is designed to pay the ongoing business expenses of a
small business owner while they are disabled and unable to work. It will provide the
funds needed to pay the salary of employees other than the owners and their ongoing
business expenses, such as rent.
,A husband and wife are insured under group health insurance plans at their own places
of employment, and as dependents under their spouse's coverage. If one of them incurs
hospital expenses, how will those expenses likely be paid?
a)Neither plan would pay.
b)Each plan will pay in equal shares.
c)The insured will have to select a plan from which to collect benefits.
d)The benefits will be coordinated. - ANSWER-d)The benefits will be coordinated.
Benefits will be coordinated when individuals are covered under two or more health
plans.
A man is an attorney when he applies for a health policy. He decides to become a
professional bungee jumper. He files a claim. What should happen?
a). His coverage will be dropped
b). The man's workers comp will pay the claim in full
c). The insurance company will not pay the claim
d). The insurance company will pay the claim according to the benefits available if the
correct premium has been paid - ANSWER-d). The insurance company will pay the
claim according to the benefits available if the correct premium has been paid
If the insured makes a change to a more hazardous occupation, upon claim, benefit will
be reduced to what premiums paid would have purchased assuming the more
hazardous occupation.
According to the Future Increase Option Rider (FIO), which of the following is NOT a
qualifying event to increase an insured's benefit level?
a)Death of a spouse
b)Age 40
c)Marriage
d)Birth of a child - ANSWER-a)Death of a spouse
The FIO rider allows insureds to increase their benefit levels to certain amounts at
specific times without proof of insurability. The following are the typical occasions when
an insurer allows for a benefit increase: ages 25, 28, 31, 34, 37 and 40; marriage; and
the birth of a child.
According to the PPACA rules, what percentage of health care costs will be covered
under a bronze plan?
a)10%
b)30%
c)40%
, d)60% - ANSWER-d)60%
Under the bronze plan, the health plan is expected to cover 60% of the cost for an
average population, and the participants would cover the remaining 40%
After appointing an agent, how long does an insurer have to file with the Commissioner
the form detailing the agent's name, address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - ANSWER-B) 30 days
Insurers have 30 days to file, in a form prescribed by the Commissioner, the names,
addresses, and other information required by the Commissioner for its newly appointed
agents.
All of the following are features of a health insurance plan purchased on the health
insurance marketplace EXCEPT
a). Coverage for emergency services
b). Coverage for pre-existing conditions
c). Dollar limits on essential benefits
d). Guaranteed renewability - ANSWER-c). Dollar limits on essential benefits
Health plans are restricted from applying a dollar limit on essential benefits, nor can
they establish a dollar limit on the amount of benefits paid during the course of an
insured's lifetime.
All of the following are true regarding Key Employee Disability Income insurance
EXCEPT
A) Premiums are not tax deductible for the employer.
B) Benefits are taxable to the employer.
C) The employer owns the policy.
D) Benefits are paid to the employer to retrain a new person. - ANSWER-B) Benefits
are taxable to the employer.
Key person disability income premiums are not deductible to the business, but the
benefits are received income tax free by the business.
All of the following are true regarding key person disability income insurance EXCEPT
a)The employee is the insured.
b)Premiums are tax deductible as a business expense.
c)The employer receives the benefits if the key person is disabled.
