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Arizona Health Insurance Exam Mastery Toolkit: 584 Proven Practice Questions & Expert Solutions

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Under the Legal Actions Provision, the insured must wait __________, but not later than __________ after proof of loss, before legal action can be brought against the company. - Correct Answer ️️60 days/2 years Change of Beneficiary Provision - Correct Answer ️️stipulates that the policy owner may change the beneficiary at any time by providing a written request to the insurer, unless the beneficiary is designated as irrevocable. When changing the beneficiary on a plan, the consent of the __________ is not required. - Correct Answer ️️beneficiary The Affordable Care Act requires that all health care plans include the following essential benefits: - Correct Answer ️️- ambulatory patient services - emergency services - hospitalization - maternity and newborn care- mental health and substance use disorder services, including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services, including oral and vision care Optional Change of Occupation Provision - Correct Answer ️️a provision that allows the insurer to adjust benefits if the insured changes occupations, because the occupation of the insured is an important underwriting consideration

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2024/2025
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Arizona Health Insurance 584 Exam
Questions

Under the Legal Actions Provision, the insured must wait __________, but not

later than __________ after proof of loss, before legal action can be brought

against the company. - Correct Answer ✔️✔️60 days/2 years


Change of Beneficiary Provision - Correct Answer ✔️✔️stipulates that the

policy owner may change the beneficiary at any time by providing a written

request to the insurer, unless the beneficiary is designated as irrevocable.


When changing the beneficiary on a plan, the consent of the __________ is not

required. - Correct Answer ✔️✔️beneficiary


The Affordable Care Act requires that all health care plans include the following

essential benefits: - Correct Answer ✔️✔️- ambulatory patient services


- emergency services


- hospitalization


- maternity and newborn care

,- mental health and substance use disorder services, including behavioral health

treatment


- prescription drugs


- rehabilitative and habilitative services and devices


- laboratory services


- preventive and wellness services and chronic disease management


- pediatric services, including oral and vision care


Optional Change of Occupation Provision - Correct Answer ✔️✔️a

provision that allows the insurer to adjust benefits if the insured changes

occupations, because the occupation of the insured is an important

underwriting consideration


Optional Misstatement of Age/Sex Provision - Correct Answer ✔️✔️if the

insured misstated their age or gender at the time of the application, the

benefits paid under the policy would be adjusted to what the premium paid

would have been purchased at the correct age/gender

,If the insured has 2 or more policies from different companies that provide

benefits on an __________, and the policies cover the same expenses, and if the

insurance companies were not notified that the other coverage existed, then

each insurer will pay a proportionate share of any claim. - Correct Answer ✔

️✔️expense-incurred basis


The insurer may cancel an accident and health policy by providing at least

__________ written notice. - Correct Answer ✔️✔️30 days


If the policy has been continued beyond its original term, the __________ may

cancel the policy at any time- effective on receipt of written notice. In these

situations, the insurer will return any unearned premiums. - Correct Answer

✔️✔️insured


Optional Conformity with State Statutes Provision - Correct Answer ✔️✔

️states that any provision of the policy which, on its effective date, is in

conflict with the statutes of the state in which the insured resides on that date,

is automatically amended to conform to the minimum requirement of the

statutes. Although this is an optional provision, most states require that it be

included in every health insurance contract issued.

, Optional Intoxicants and Narcotics Provision - Correct Answer ✔️✔

️excludes coverage of any injury or sickness that results from the insured's

intoxication (except in the case of drugs administered by a physician)


Free-Look/Right to Examine Provision - Correct Answer ✔️✔️allows the

insured a period of several days to look over the policy, and if dissatisfied for

any reason, return it for a full refund


How long is a typical free-look/right to examine period? - Correct Answer ✔

️✔️10 days from the date the policy is delivered, but may vary for different

types of policies


Insuring Clause - Correct Answer ✔️✔️a general statement that identifies

the basic agreement between the insurance company and the insured and

states what kind of loss (peril) is covered, usually located on the first page


Consideration Clause - Correct Answer ✔️✔️makes it clear that both

parties to the contract must give some valuable consideration; the payment of

the premium and the statements in the application are the consideration given

by the applicant, the insurers consideration is the promise to pay in accordance

with the contract terms

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