Florida Insurance Exam (2-15) questions and answers 2024

A Supplementary Medical Expense policy combines the benefits of what two types of plans? - ANSWERS Basic Medical and Major Medical Which of the following is not correct concerning Health Maintenance Organizations? - ANSWERS They mandate enrollment for groups of 25 or more. Which is not true concerning a Hospital Fixed-Rate plan? - ANSWERS Benefits are paid directly to the hospital When benefits are paid to a policyowner covered under a Hospital Expense policy, the policy is considered to be which of the following? - ANSWERS Fixed-Rate plan Which of the following about Health Reimbursement Accounts HRA's is/are correct? - ANSWERS HRA's are established by the employer Which of the following statements is true about Basic Hospital, Medical, and Surgical Expense Policies? - ANSWERS They usually have a stated limit for specific expenses. Which of the following plans used with High Deductible Health Plans is employee owned? - ANSWERS Health Savings Accounts (HSAs) 6. Which of the following service providers allows for a primary care physician as well as out-of-network care? - ANSWERS Point of Service Plan (POS) Which of the following is true about coinsurance? - ANSWERS It helps control overutilization of benefits. In a Basic Surgical policy, which of the following pays per point? - ANSWERS Relative Value The type of health care provider that provides both the health care services and the health care financing is a: - ANSWERS Health Maintenance Organization Which of the following non-insurance entities are NOT involved with self-insured plans? - ANSWERS Actuaries Which of the following policies would cover a student pilot taking flying lessons? - ANSWERS Special Risk An applicant for insurance may pay the initial premium and receive a document from the agent indicating that if the policy is issued as requested coverage begins on the date of the documents. What is this document called? - ANSWERS Conditional receipt How does a basic medical plan avoid small claims and keep the cost of premiums down? - ANSWERS by imposing benefit limits A limited risk policy will pay for dread diseases : - ANSWERS such as cancer Stagmite purchases a major medical policy with a $100 annual deductible, 80/20 coinsurance and a maximum out-of-pocket of $5000. If Stagmite were to incur covered expenses of $10,100, how much would Stag be out of pocket? - ANSWERS $2100 If all or part of a $500 deductible is offset by a Basic Medical policy, what type of deductible applies? - ANSWERS Integrated In a Basic Hospital Expense policy, the miscellaneous expense limits are a multiple of what factor? - ANSWERS Daily room and board What is the agreement between an HMO and subscriber or group? - ANSWERS Health maintenance contract HMOs are a distinct form of health provider because: - ANSWERS They provide financing for the health care plus the health care itself Which of the following is the most common type of co-insurance in a major medical policy? - ANSWERS 20-25% Which statement concerning commercial companies is not true? - ANSWERS They are not debit companies Another term used for Home Service insurers is: - ANSWERS Debit insurers Basic Medical expense policies do not generally provide coverage for: - ANSWERS Lost income HMO's are known for stressing - ANSWERS preventive medicine and early treatment Which of the following companies can sell health insurance? I. Mono-Line II. Home Service/Industrial III. Property/Casualty IV. Multi-Lines Company - ANSWERS All of the above Which of the following statements regarding workers' compensation plans is correct? - ANSWERS Benefits may be financed by private insurers, state funds or self-insurance Health insurance may be written by all the following types of companies except: - ANSWERS surety Many major medical policies include a provision whereby when expenses reach a certain dollar amount, the insured no longer shares in the cost of expenses: the insurer pays 100% of remaining covered charges. This is referred to as the: - ANSWERS stoploss limit What term describes the concept that the insurer and the insured share in the cost of medical expenses, with the insurer bearing the greater share? - ANSWERS Coinsurance All of the following statements concerning Social Security disability benefits are true except: - ANSWERS Benefits are retroactive to the time of disability An insured has a basic hospital expense policy with a $10,000 limit for benefits, coordinated with a major medical policy with a $500 corridor deductible and 80/20 coinsurance provision. If she incurs a loss of $20,000, how much will the insurer pay? - ANSWERS $17,600 A Health Savings Account does not allow: - ANSWERS Tax free non-qualified withdrawals What is included under the miscellaneous expense benefit? - ANSWERS Anesthesia The term FIRST DOLLAR often is used to describe benefits payable by which type of policy? - ANSWERS A Hospital Indemnity policy Which of the following statements is true regarding Multiple Employer Trusts ? . - ANSWERS The Multiple Employer Trust, not the employer, is the contract holder Rose Bud receives a hospital bill for $9,500 after being released from the hospital. Her Major Medical policy has a $500 deductible and an 80% - 20% continuous coinsurance feature. Of the total expense, how much will Rose have to pay? - ANSWERS 2,300 Blue Cross and Blue Shield subscribers pay a set fee, usually each month, for medical services covered under the plan. This is describing: - ANSWERS Prepaid plan Social Security was started in what year? - ANSWERS 1935 How long is the waiting period before a person may file a claim for Social Security Disability benefits? - ANSWERS 5 Months