Colorado Life & Health Insurance
Exam Questions with Accurate
Answers
utilization review correct answer a set of formal techniques to monitor the use or clinical necessity of
health care, determining the application of exclusions, and the medical necessity of treatment.
30 days for electronic; 45 days for paper correct answer With a clean claim, the insured has ? days for
paying or denying electronic and ? days for paper claims.
Enforces correct answer The Commissioner ______ laws and does not create them.
5 years correct answer Every ____ years, a licensed insurer must be examined by the state
commissioner.
Adverse selection correct answer What is a major concern for Underwriters, especially during the open
enrollment period?
Conversion privilege correct answer Allows individual policy conversion upon plan group termination
Non-taxable correct answer Benefits are taxable or non-taxable (?) to employees.
20 correct answer Employers with ___ + employees are required to offer COBRA for up to 18 months
after an employee is terminated.
Master policy correct answer In group health insurance a ______ type of policy is issued to the group
sponsor.
Impairment rider correct answer Temporary or permanent rider added to a policy that includes specific
conditions which would normally cause a policy to be declined.
, Free Look Period correct answer The period of time for the insured to look over a policy after it is issued
(10 days for health insurance, 15 for life)
Class correct answer The guaranteed renewable provision states that premiums can only be increased
by _________.
Legal Actions Provision correct answer The ___________ states that one has 60 days after proof of loss
with a 2-year limit on certain defenses.
Insurers correct answer The insuring clause includes ____________'s promise to pay benefits.
Proof of loss provision correct answer This provision states that the insured must provide proof of loss
within 90 days, up to a 1-year maximum.
elimination period correct answer waiting period after a loss occurs before benefit period begins (30, 90
days, up to 1 year)
Part C correct answer Medicare Advantage plan, substitution for original benefits (A & B)
Medicare Part A correct answer Hospital insurance, covers inpatient and hospice
Medicare Part B correct answer Outpatient treatment, ER treatment, preventive care is looped under
Part ___
Supplement Part A correct answer Also known as Medigap, this part covers core benefits, including
hospice care; premiums vary.
Guaranteed Insurability Rider correct answer Optional rider that enables the policyowner to purchase
additional amounts of coverage at predetermined times without proof of insurability
Accidental Death Benefit Rider correct answer doubles the face amount of life insurance if death occurs
as a result of an accident
Exam Questions with Accurate
Answers
utilization review correct answer a set of formal techniques to monitor the use or clinical necessity of
health care, determining the application of exclusions, and the medical necessity of treatment.
30 days for electronic; 45 days for paper correct answer With a clean claim, the insured has ? days for
paying or denying electronic and ? days for paper claims.
Enforces correct answer The Commissioner ______ laws and does not create them.
5 years correct answer Every ____ years, a licensed insurer must be examined by the state
commissioner.
Adverse selection correct answer What is a major concern for Underwriters, especially during the open
enrollment period?
Conversion privilege correct answer Allows individual policy conversion upon plan group termination
Non-taxable correct answer Benefits are taxable or non-taxable (?) to employees.
20 correct answer Employers with ___ + employees are required to offer COBRA for up to 18 months
after an employee is terminated.
Master policy correct answer In group health insurance a ______ type of policy is issued to the group
sponsor.
Impairment rider correct answer Temporary or permanent rider added to a policy that includes specific
conditions which would normally cause a policy to be declined.
, Free Look Period correct answer The period of time for the insured to look over a policy after it is issued
(10 days for health insurance, 15 for life)
Class correct answer The guaranteed renewable provision states that premiums can only be increased
by _________.
Legal Actions Provision correct answer The ___________ states that one has 60 days after proof of loss
with a 2-year limit on certain defenses.
Insurers correct answer The insuring clause includes ____________'s promise to pay benefits.
Proof of loss provision correct answer This provision states that the insured must provide proof of loss
within 90 days, up to a 1-year maximum.
elimination period correct answer waiting period after a loss occurs before benefit period begins (30, 90
days, up to 1 year)
Part C correct answer Medicare Advantage plan, substitution for original benefits (A & B)
Medicare Part A correct answer Hospital insurance, covers inpatient and hospice
Medicare Part B correct answer Outpatient treatment, ER treatment, preventive care is looped under
Part ___
Supplement Part A correct answer Also known as Medigap, this part covers core benefits, including
hospice care; premiums vary.
Guaranteed Insurability Rider correct answer Optional rider that enables the policyowner to purchase
additional amounts of coverage at predetermined times without proof of insurability
Accidental Death Benefit Rider correct answer doubles the face amount of life insurance if death occurs
as a result of an accident
