Accident and Health Insurance Final Exam with correct detailed answers

Accident and Health Insurance Final Exam
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with correct detailed answers
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Your |license |will |be |considered |to |be |inactive |when |you: |- |correct |answer |No |longer |have |any |
appointments



On |a |"participating" |health |insurance |policy |issued |by |a |mutual |insurance |company, |dividends |paid |to
|policy |holders |are: |- |correct |answer |Not |taxable |since |the |IRS |treats |them |as |a |refund |of |a |portion |of

|the |premium |paid




All |of |the |following |are |true |regarding |a |non-contributory |employer |group |medical |expense |insurance |
policy |EXCEPT: |- |correct |answer |Premiums |must |be |paid |entirely |by |the |employees



Which |two |of |the |following |are |considered |to |be |activities |of |daily |living |in |most |long-term |care |
policies: |- |correct |answer |Eating |and |dressing



The |Employee |Retirement |Income |Security |Act |(ERISA) |requires |that |employee |benefit |plans |be |
managed |for |the |benefit |of: |- |correct |answer |Participants |and |beneficiaries



Which |of |the |following |must |be |printed |on |every |licensee's |business |cards, |written |price |quotations |
and |printed |advertisements: |- |correct |answer |Their |insurance |license |number



At |age |65, |an |individual |would |be |eligible |for |which |of |the |following |at |no |charge |- |correct |answer |
Part |A |of |Medicare



Under |the |California |Insurance |Code |(CIC), |neither |party |to |a |contract |of |insurance |is |bound |to |
communicate |any |of |the |following |EXCEPT: |- |correct |answer |Information |known |to |be |material



The |enrollee |pays |what |percentage |of |the |premium |for |Medicare |Part |B? |- |correct |answer |100%

, When |an |insurer |voids |an |insurance |contract |due |to |an |intentionally |fraudulent |omission |by |the |
insured |of |a |material |fact, |it |is |known |as: |- |correct |answer |Rescission



When |can |a |representation |be |altered |or |withdrawn? |- |correct |answer |Before |the |insurance |is |
effected, |but |not |afterwards



Under |the |Patient |Protection |and |Affordable |Care |Act |(PPACA), |health |plans |cannot |limit |or |deny |
benefits |or |deny |coverage |for |a |child |younger |than |age |____ |because |the |child |has |a |pre-existing |
condition |that |developed |before |the |child |applied |to |join |the |plan: |- |correct |answer |19



Which |of |the |following |is |not |covered |in |a |long-term |care |policy? |- |correct |answer |Acute |care |in |the |
hospital



The |uncertainty |about |loss |that |exists |whenever |more |than |one |outcome |is |possible |is |called: |- |
correct |answer |Risk



The |hospice |benefit |under |a |long-term |care |policy |will |cover |all |of |the |following |EXCEPT: |- |correct |
answer |Rehabilitation |expenses



On |disability |income |insurance, |another |name |for |the |"waiting" |period |is |the |_______ |period: |- |
correct |answer |Elimination



Which |of |the |following |parts |of |Medicare |is |known |as |the |"managed |care" |option |- |correct |answer |
Part |C |- |Medicare |Advantage



The |Patient |Protection |and |Affordable |Care |Act |(PPACA) |requires |health |plans |to |provide |rebates |to |
consumers |for |the |amount |of |the |premiums |spent |on |clinical |services |and |quality |that |is |less |than |
____% |for |plans |in |the |individual |market |place: |- |correct |answer |80



Medical |expense |insurance |policies |often |contain |a |provision |which |states |that |during |the |first |12 |
months |after |the |policy's |effective |date, |there |is |no |coverage |for |a |pre-existing |sickness |that |recurs. |
This |provision |is |known |as: |- |correct |answer |A |probationary |period