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LOUISIANA LIFE AND HEALTH INSURANCE
EXAM ACTUAL PREP QUESTIONS AND WELL
REVISED ANSWERS - LATEST AND COMPLETE
UPDATE WITH VERIFIED SOLUTIONS –
ASSURES PASS
All of the following are correct about the required provisions of a health insurance
policy EXCEPT
A. The entire contract clause means the signed application, policy,
endorsements, and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWER: B.
A reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at
least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be
the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWER: B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
An insured has a primary group health plan and an excess plan, each covering
losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any
copayments or deductibles, how much will the excess plan pay?
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A. $10,000
B. $7,500
C. $5,000
D. $0 - ANSWER: C. $5,000
Once the primary plan has paid its full promised benefit, the insured submits the
claim to the secondary, or excess, provider for any additional benefits payable.
COBRA applies to employers with at least
A. 60 employees.
B. 50 employees.
C. 20 employees.
D. 80 employees. - ANSWER: C. 20 employees.
Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA),
any employer with 20 or more employees must extend group health coverage to
terminated employees and their families.
Which of the following long-term care benefits would provide coverage for care
for functionally impaired adults on a less than 24-hour basis?
A. Residential care
B. Assisted living
C. Home health care
D. Adult day care - ANSWER: D. Adult day care
Adult day care is designed for those who require assistance with various ADLs on
a daily basis, but not around the clock. Custodial care is usually the only service
provided by adult day care facilities.
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Medicaid provides all of the following benefits EXCEPT A. Family planning
services.
B. Income assistance for work-related injury.
C. Home health care services.
D. Eyeglasses. - ANSWER: B. Income assistance for work-related injury.
Medicaid covers a variety of medical costs, from eyeglasses to hospitalization.
Which of the following statements is correct?
A. HMOs do not pay for services covered by Medicare.
B. Medicare Advantage is Medicare provided by an approved Health
Maintenance Organization only.
C. All HMOs and PPOs charge premiums beyond what is paid by Medicare.
D. HMOs may pay for services not covered by Medicare. - ANSWER: D.
HMOs may pay for services not covered by Medicare.
The advantages of an HMO or PPO for a Medicare recipient may be that there are
no claims forms required, almost any medical problem is covered for a set fee so
health care costs can be budgeted, and the HMO or PPO may pay for services not
usually covered by Medicare or Medicare supplement policies, such as
prescriptions, eye exams, hearing aids, or dental care.
Which of the following is NOT an activity of daily living (ADL)?
A. Talking
B. Eating
C. Dressing
D. Bathing - ANSWER: A. Talking
The ability of a person to do activities of daily living (ADLs) is often used to
determine the extent of a person's disability. ADLs include basic activities such as
getting dressed, bathing, continence, transferring, and eating.
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What is the difference between the Medicare approved amount for a service or
supply and the actual charge?
A. Excess charge
B. Actual charge
C. Limiting charge
D. Coinsurance - ANSWER: A. Excess charge
Excess Charge is the difference between the Medicare approved amount for a
service or supply and the actual charge.
Which of the following Medicare supplement plans would be available to a
reasonably healthy 91year-old female?
A. K & L only
B. A only
C. A-C only
D. A-N - ANSWER: D. A-N
All Medicare supplement plans (A-N) must be made available to qualifying
applicants, regardless of age.
Question 11 of 15
An applicant for an individual health policy failed to complete the application
properly. Before being able to complete the application and pay the initial
premium, she is confined to a hospital. This will not be covered by insurance
because she has not met the conditions specified in the A. Insuring Clause.
B. Pre-existing Conditions Clause.
LOUISIANA LIFE AND HEALTH INSURANCE
EXAM ACTUAL PREP QUESTIONS AND WELL
REVISED ANSWERS - LATEST AND COMPLETE
UPDATE WITH VERIFIED SOLUTIONS –
ASSURES PASS
All of the following are correct about the required provisions of a health insurance
policy EXCEPT
A. The entire contract clause means the signed application, policy,
endorsements, and attachments constitute the entire contract.
B. A reinstated policy provides immediate coverage for an illness.
C. Policies become incontestable after being in force for 3 years.
D. A grace period of 31 days is found in an annual pay policy. - ANSWER: B.
A reinstated policy provides immediate coverage for an illness.
Accidental injury is covered immediately, but to protect the insurer against adverse
selection, losses resulting from sickness are covered only if the sickness occurs at
least 10 days after the reinstatement date.
An insured pays a monthly premium of $100 for health insurance. What would be
the duration of the grace period under the policy?
A. 15 days
B. 30 days
C. 60 days
D. 7 days - ANSWER: B. 30 days
The grace period is 30 days for all health insurance policies in Louisiana.
An insured has a primary group health plan and an excess plan, each covering
losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any
copayments or deductibles, how much will the excess plan pay?
,2|Page
A. $10,000
B. $7,500
C. $5,000
D. $0 - ANSWER: C. $5,000
Once the primary plan has paid its full promised benefit, the insured submits the
claim to the secondary, or excess, provider for any additional benefits payable.
COBRA applies to employers with at least
A. 60 employees.
B. 50 employees.
C. 20 employees.
D. 80 employees. - ANSWER: C. 20 employees.
Under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA),
any employer with 20 or more employees must extend group health coverage to
terminated employees and their families.
Which of the following long-term care benefits would provide coverage for care
for functionally impaired adults on a less than 24-hour basis?
A. Residential care
B. Assisted living
C. Home health care
D. Adult day care - ANSWER: D. Adult day care
Adult day care is designed for those who require assistance with various ADLs on
a daily basis, but not around the clock. Custodial care is usually the only service
provided by adult day care facilities.
,3|Page
Medicaid provides all of the following benefits EXCEPT A. Family planning
services.
B. Income assistance for work-related injury.
C. Home health care services.
D. Eyeglasses. - ANSWER: B. Income assistance for work-related injury.
Medicaid covers a variety of medical costs, from eyeglasses to hospitalization.
Which of the following statements is correct?
A. HMOs do not pay for services covered by Medicare.
B. Medicare Advantage is Medicare provided by an approved Health
Maintenance Organization only.
C. All HMOs and PPOs charge premiums beyond what is paid by Medicare.
D. HMOs may pay for services not covered by Medicare. - ANSWER: D.
HMOs may pay for services not covered by Medicare.
The advantages of an HMO or PPO for a Medicare recipient may be that there are
no claims forms required, almost any medical problem is covered for a set fee so
health care costs can be budgeted, and the HMO or PPO may pay for services not
usually covered by Medicare or Medicare supplement policies, such as
prescriptions, eye exams, hearing aids, or dental care.
Which of the following is NOT an activity of daily living (ADL)?
A. Talking
B. Eating
C. Dressing
D. Bathing - ANSWER: A. Talking
The ability of a person to do activities of daily living (ADLs) is often used to
determine the extent of a person's disability. ADLs include basic activities such as
getting dressed, bathing, continence, transferring, and eating.
, 4|Page
What is the difference between the Medicare approved amount for a service or
supply and the actual charge?
A. Excess charge
B. Actual charge
C. Limiting charge
D. Coinsurance - ANSWER: A. Excess charge
Excess Charge is the difference between the Medicare approved amount for a
service or supply and the actual charge.
Which of the following Medicare supplement plans would be available to a
reasonably healthy 91year-old female?
A. K & L only
B. A only
C. A-C only
D. A-N - ANSWER: D. A-N
All Medicare supplement plans (A-N) must be made available to qualifying
applicants, regardless of age.
Question 11 of 15
An applicant for an individual health policy failed to complete the application
properly. Before being able to complete the application and pay the initial
premium, she is confined to a hospital. This will not be covered by insurance
because she has not met the conditions specified in the A. Insuring Clause.
B. Pre-existing Conditions Clause.
