ARKANSAS HEALTH INSURANCE PRACTICE
EXAM QUESTIONS AND ANSWERS (VERIFIED
ANSWERS GRADED A+)
Why do HMOs encourage members to get regular checkups? - ANSWER-To help catch
health problems early when treatment has the greatest chance for success (i.e.
preventive care)
Who chooses a primary care physician in an HMO plan? - ANSWER-The individual
member
What is a fee-for-service health plan? - ANSWER-Under a fee-for-service plan,
providers receive payments for each service provided
What are the three types of basic medical expense insurance? - ANSWER-Hospital,
surgical, and medical
What is the capital sum in Accidental Death and Dismemberment (AD&D) coverage? -
ANSWER-A percentage of the principle sum
What is the main principle of an HMO plan? - ANSWER-Preventive care
In health insurance, what is considered a sickness? - ANSWER-An illness that first
arises while the policy is in force
What do individual insureds receive as proof of their group health coverage? -
ANSWER-Certificate of insurance
In what type of health plans are providers paid for services in advance, regardless of the
services provided? - ANSWER-Prepaid plans
In health insurance, the policy itself and the insurance application form what? -
ANSWER-The entire contract
If an insurer decides to obtain medical information from different sources in order to
determine the insurability of an applicant, who must be notified of the investigation? -
ANSWER-The applicant
Who must sign a health insurance application? - ANSWER-The policyowner, the
insured (if different), and the agent
If an underwriter requires extensive information about the applicant's medical history,
what report will best serve this purpose? - ANSWER-Attending Physicians statement
, Who is responsible for paying the cost of a medical examination required in the process
of underwriting? - ANSWER-Insurer
Whose responsibility is it to inform an applicant for health insurance about the insurer's
information gathering practices? - ANSWER-The agent
If an agent makes a correction on the application for health insurance, who must initial
the correct answer? - ANSWER-The applicant
What is the term used for a written request for an insurer to issue an insurance contract
based on the provided information? - ANSWER-Application
What information are the members of the Medical Information Bureau required to
report? - ANSWER-Adverse medical information about the applicants or insured.
When should an agent obtain a Statement of Good Health from the insured? -
ANSWER-When the premium was paid upon policy delivery and not the time of
application.
What is the entire contract in health insurance underwriting? - ANSWER-The application
and policy issued.
What entities make up the Medical Information Bureau? - ANSWER-Insurers
What is the best way to make a change on an application for insurance? - ANSWER-
Start over with a fresh application
What type of hospital policy pays a fixed amount each day that the insured is in the
hospital? - ANSWER-Hospital indemnity
What is the term for a period of time immediately following a disability during which
benefits are not payable? - ANSWER-Elimination period
What is the primary purpose of disability income insurance? - ANSWER-To replace
income lost due to a disability
Who are the parties in a group health contract? - ANSWER-The employer and the
insurer
Under what type of care do insurers negotiate contracts with health care providers to
allow subscribers have access to health care services at a favorable cost? - ANSWER-
Preferred Provider Organization (PPO)
How are HMO territories typically divided? - ANSWER-geographic areas
EXAM QUESTIONS AND ANSWERS (VERIFIED
ANSWERS GRADED A+)
Why do HMOs encourage members to get regular checkups? - ANSWER-To help catch
health problems early when treatment has the greatest chance for success (i.e.
preventive care)
Who chooses a primary care physician in an HMO plan? - ANSWER-The individual
member
What is a fee-for-service health plan? - ANSWER-Under a fee-for-service plan,
providers receive payments for each service provided
What are the three types of basic medical expense insurance? - ANSWER-Hospital,
surgical, and medical
What is the capital sum in Accidental Death and Dismemberment (AD&D) coverage? -
ANSWER-A percentage of the principle sum
What is the main principle of an HMO plan? - ANSWER-Preventive care
In health insurance, what is considered a sickness? - ANSWER-An illness that first
arises while the policy is in force
What do individual insureds receive as proof of their group health coverage? -
ANSWER-Certificate of insurance
In what type of health plans are providers paid for services in advance, regardless of the
services provided? - ANSWER-Prepaid plans
In health insurance, the policy itself and the insurance application form what? -
ANSWER-The entire contract
If an insurer decides to obtain medical information from different sources in order to
determine the insurability of an applicant, who must be notified of the investigation? -
ANSWER-The applicant
Who must sign a health insurance application? - ANSWER-The policyowner, the
insured (if different), and the agent
If an underwriter requires extensive information about the applicant's medical history,
what report will best serve this purpose? - ANSWER-Attending Physicians statement
, Who is responsible for paying the cost of a medical examination required in the process
of underwriting? - ANSWER-Insurer
Whose responsibility is it to inform an applicant for health insurance about the insurer's
information gathering practices? - ANSWER-The agent
If an agent makes a correction on the application for health insurance, who must initial
the correct answer? - ANSWER-The applicant
What is the term used for a written request for an insurer to issue an insurance contract
based on the provided information? - ANSWER-Application
What information are the members of the Medical Information Bureau required to
report? - ANSWER-Adverse medical information about the applicants or insured.
When should an agent obtain a Statement of Good Health from the insured? -
ANSWER-When the premium was paid upon policy delivery and not the time of
application.
What is the entire contract in health insurance underwriting? - ANSWER-The application
and policy issued.
What entities make up the Medical Information Bureau? - ANSWER-Insurers
What is the best way to make a change on an application for insurance? - ANSWER-
Start over with a fresh application
What type of hospital policy pays a fixed amount each day that the insured is in the
hospital? - ANSWER-Hospital indemnity
What is the term for a period of time immediately following a disability during which
benefits are not payable? - ANSWER-Elimination period
What is the primary purpose of disability income insurance? - ANSWER-To replace
income lost due to a disability
Who are the parties in a group health contract? - ANSWER-The employer and the
insurer
Under what type of care do insurers negotiate contracts with health care providers to
allow subscribers have access to health care services at a favorable cost? - ANSWER-
Preferred Provider Organization (PPO)
How are HMO territories typically divided? - ANSWER-geographic areas
