1 | Page
NC - HEALTH INSURANCE QUESTIONS WITH
100% CORRECT SOLUTIONS | GUARANTEED
SUCCESS.
All of the following are true regarding Key Employee Disability
Income insurance EXCEPT
A) Premiums are not tax deductible for the employer.
B) Benefits are taxable to the employer.
C) The employer owns the policy.
D) Benefits are paid to the employer to retrain a new person. -
correct answer- B) Benefits are taxable to the employer.
Key person disability income premiums are not deductible to
the business, but the benefits are received income tax free by
the business.
How is emergency care covered for a member of an HMO?
A) A member of an HMO can receive care in or out of the HMO
service area, but care is preferred in the service area.
B) A member of an HMO may receive care at any emergency
facility, at the same cost as if in his or her own service area.
C) HMOs have salaried member physicians, but they do not
cover emergency care.
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D) An HMO emergency specialist will cover the patient. -
correct answer- A. A member of an HMO can receive care in or
out of the HMO service area, but care is preferred in the service
area.
Emergency care must be provided for the member in or out of
the HMO's service area. If emergency care is being provided
for a member outside the service area, the HMO will be eager
to get the member back into the service area so that care can
be provided by salaried member physicians.
After appointing an agent, how long does an insurer have to file
with the Commissioner the form detailing the agent's name,
address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - correct answer- B) 30 days
Insurers have 30 days to file, in a form prescribed by the
Commissioner, the names, addresses, and other information
required by the Commissioner for its newly appointed agents.
Bethany studies in England for a semester. While she is there,
she is involved in a train accident that leaves her disabled. If
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Bethany owns a general disability policy, what will be the extent
of benefits that she receives? - correct answer- None
Which of the following are the main factors taken into account
when calculating residual disability benefits?
a)Present earnings and earnings prior to disability
b)Earnings prior to disability and the length of disability
c)Employee's full-time status and length of disability
d)Present earnings and standard cost of living - correct answer-
a)Present earnings and earnings prior to disability
Residual disability will help pay for loss of earnings by making
up the difference between the employee's present earnings and
what they were earning prior to disability.
How can a new physician be added to the PPO's approved list?
a)Fill out the appropriate paperwork and wait the 12 month pre-
certification period.
b)Pay an annual fee for being on the PPO list.
c)New physicians are only added once a year, and are selected
by the PPO's Board of Directors.
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d)Agree to follow the PPO standards and charge the
appropriate fees. - correct answer- d)Agree to follow the PPO
standards and charge the appropriate fees.
Any physician or hospital that qualifies for and agrees to follow
the PPO's standards and charges the established fees can be
added to the PPO's approved list at any time. The providers
may withdraw their name from the list at any time, as well.
Under the uniform required provisions, proof of loss under a
health insurance policy normally should be filed within
a)90 days of a loss.
b)20 days of a loss.
c)30 days of a loss.
d)60 days of a loss. - correct answer- a)90 days of a loss.
Under the Uniform Required Provisions, proof of loss under a
health insurance policy normally should be filed within 90 days
of a loss.
Which of the following must an insurer obtain in order to
transact insurance within a given state?
a)Business entity license
NC - HEALTH INSURANCE QUESTIONS WITH
100% CORRECT SOLUTIONS | GUARANTEED
SUCCESS.
All of the following are true regarding Key Employee Disability
Income insurance EXCEPT
A) Premiums are not tax deductible for the employer.
B) Benefits are taxable to the employer.
C) The employer owns the policy.
D) Benefits are paid to the employer to retrain a new person. -
correct answer- B) Benefits are taxable to the employer.
Key person disability income premiums are not deductible to
the business, but the benefits are received income tax free by
the business.
How is emergency care covered for a member of an HMO?
A) A member of an HMO can receive care in or out of the HMO
service area, but care is preferred in the service area.
B) A member of an HMO may receive care at any emergency
facility, at the same cost as if in his or her own service area.
C) HMOs have salaried member physicians, but they do not
cover emergency care.
,2 | Page
D) An HMO emergency specialist will cover the patient. -
correct answer- A. A member of an HMO can receive care in or
out of the HMO service area, but care is preferred in the service
area.
Emergency care must be provided for the member in or out of
the HMO's service area. If emergency care is being provided
for a member outside the service area, the HMO will be eager
to get the member back into the service area so that care can
be provided by salaried member physicians.
After appointing an agent, how long does an insurer have to file
with the Commissioner the form detailing the agent's name,
address, and other needed information?
A) 15 days
B) 30 days
C) 45 days
D) 60 days - correct answer- B) 30 days
Insurers have 30 days to file, in a form prescribed by the
Commissioner, the names, addresses, and other information
required by the Commissioner for its newly appointed agents.
Bethany studies in England for a semester. While she is there,
she is involved in a train accident that leaves her disabled. If
,3 | Page
Bethany owns a general disability policy, what will be the extent
of benefits that she receives? - correct answer- None
Which of the following are the main factors taken into account
when calculating residual disability benefits?
a)Present earnings and earnings prior to disability
b)Earnings prior to disability and the length of disability
c)Employee's full-time status and length of disability
d)Present earnings and standard cost of living - correct answer-
a)Present earnings and earnings prior to disability
Residual disability will help pay for loss of earnings by making
up the difference between the employee's present earnings and
what they were earning prior to disability.
How can a new physician be added to the PPO's approved list?
a)Fill out the appropriate paperwork and wait the 12 month pre-
certification period.
b)Pay an annual fee for being on the PPO list.
c)New physicians are only added once a year, and are selected
by the PPO's Board of Directors.
, 4 | Page
d)Agree to follow the PPO standards and charge the
appropriate fees. - correct answer- d)Agree to follow the PPO
standards and charge the appropriate fees.
Any physician or hospital that qualifies for and agrees to follow
the PPO's standards and charges the established fees can be
added to the PPO's approved list at any time. The providers
may withdraw their name from the list at any time, as well.
Under the uniform required provisions, proof of loss under a
health insurance policy normally should be filed within
a)90 days of a loss.
b)20 days of a loss.
c)30 days of a loss.
d)60 days of a loss. - correct answer- a)90 days of a loss.
Under the Uniform Required Provisions, proof of loss under a
health insurance policy normally should be filed within 90 days
of a loss.
Which of the following must an insurer obtain in order to
transact insurance within a given state?
a)Business entity license
