PEARSON VUE NATIONAL HEALTH INSURANCE
ACTUAL EXAM PAPER 2026 GRADED A+
◉ Health insurance policies are offered on a "take it or leave it" basis
and referred to as which of the following types of contracts? Answer:
Contracts of Adhesion
◉ Under the Claims Forms provision of a health policy, if the
insurance company fails to send claim forms within the time period
required, the insured should: Answer: Submit the claim in any form,
which must be accepted by the company as adequate proof of loss
◉ In an Accidental Death and Dismemberment (AD&D) policy,
capital sum refers to: Answer: A lump sum payment made for an
accidental dismemberment
◉ The Coordination of Benefits clause found in group health master
contracts is used to: Answer: Avoid double payment of benefits to an
insured who has duplicate group coverages
◉ Which of the following definitions MOST accurately describes the
Probationary Period? Answer: The waiting period a new hire must
satisfy prior to becoming eligible for group health coverage
,◉ A Health Maintenance Organization (HMO) differs from a
traditional insurer in that an HMO: Answer: Emphasizes preventive
medicine
◉ A married insured has an Accidental Death and Dismemberment
(AD&D) policy that names their sibling as the primary beneficiary
and their child as the contingent beneficiary. If the insured and their
sibling are both killed instantly in a train accident, the policy
proceeds would be paid to which of the following? Answer: The
insured's child
◉ The Social Security program provides all of the following benefits
EXCEPT: Answer: Workers compensation
◉ Under a Guaranteed Renewable Accident & Health policy, an
insurer retains the right to: Answer: Increase the premium rate for
an entire class of insureds
◉ A Disability Income policy may provide benefits for which of the
following losses? Answer: Residual Disability
◉ Which of the following statements about the Medicare program is
CORRECT? Answer: It is a federally sponsored program.
,◉ A child has a physical impairment, attends school, and is
incapable of self-sustaining employment and/or self care. Which of
the following statements is CORRECT about the child's medical
coverage under their parent's group plan? Answer: The child's
coverage continues as long as they are continually incapacitated and
financially dependent on their parent.
◉ Suicide, pre-existing conditions and self-inflicted injuries are dealt
with in which of the following policy features? Answer: Exclusions
◉ The PRIMARY purpose of Medicaid is to: Answer: Provide Medical
Expense coverage to persons below certain minimum income
requirements
◉ Which of the following provisions designates to whom claim
payments are made? Answer: Payment of Claims
◉ Under an Accidental Death and Dismemberment (AD&D) policy,
insurable interest must exist at which of the following times?
Answer: At the inception of the policy
◉ When periodic claim payments are required under a long-term
disability income policy, an insurer MUST make payments to an
insured at least once every: Answer: Month
, ◉ A 68 year-old employee that is covered by a group medical
insurance plan has medical expenses. The employee's company
health plan is the: Answer: Secondary payor
◉ An insured whose Disability Income policy contains a Change of
Occupation clause takes a new job in a more hazardous occupation
and fails to notify the insurer of the change. One year later, the
insured becomes disabled. The insurer will most likely take which of
the following actions? Answer: Settle the claim according to what
the premiums would have purchased under the more hazardous
occupation
◉ The purpose of the Medical Information Bureau (MIB) is to:
Answer: Share medical data among member companies
◉ Which of the following laws requires an insurer to notify an
applicant in writing that an investigative consumer report may be
made on the applicant? Answer: D. Fair Credit Reporting Act
(Insurance Information and Privacy Protection Act)
◉ Which of the following statements is CORRECT about a Waiver of
Premium provision in a Disability Income policy? Answer: D. It
allows the insured to maintain a policy in force while disabled and
unable to pay premiums.
ACTUAL EXAM PAPER 2026 GRADED A+
◉ Health insurance policies are offered on a "take it or leave it" basis
and referred to as which of the following types of contracts? Answer:
Contracts of Adhesion
◉ Under the Claims Forms provision of a health policy, if the
insurance company fails to send claim forms within the time period
required, the insured should: Answer: Submit the claim in any form,
which must be accepted by the company as adequate proof of loss
◉ In an Accidental Death and Dismemberment (AD&D) policy,
capital sum refers to: Answer: A lump sum payment made for an
accidental dismemberment
◉ The Coordination of Benefits clause found in group health master
contracts is used to: Answer: Avoid double payment of benefits to an
insured who has duplicate group coverages
◉ Which of the following definitions MOST accurately describes the
Probationary Period? Answer: The waiting period a new hire must
satisfy prior to becoming eligible for group health coverage
,◉ A Health Maintenance Organization (HMO) differs from a
traditional insurer in that an HMO: Answer: Emphasizes preventive
medicine
◉ A married insured has an Accidental Death and Dismemberment
(AD&D) policy that names their sibling as the primary beneficiary
and their child as the contingent beneficiary. If the insured and their
sibling are both killed instantly in a train accident, the policy
proceeds would be paid to which of the following? Answer: The
insured's child
◉ The Social Security program provides all of the following benefits
EXCEPT: Answer: Workers compensation
◉ Under a Guaranteed Renewable Accident & Health policy, an
insurer retains the right to: Answer: Increase the premium rate for
an entire class of insureds
◉ A Disability Income policy may provide benefits for which of the
following losses? Answer: Residual Disability
◉ Which of the following statements about the Medicare program is
CORRECT? Answer: It is a federally sponsored program.
,◉ A child has a physical impairment, attends school, and is
incapable of self-sustaining employment and/or self care. Which of
the following statements is CORRECT about the child's medical
coverage under their parent's group plan? Answer: The child's
coverage continues as long as they are continually incapacitated and
financially dependent on their parent.
◉ Suicide, pre-existing conditions and self-inflicted injuries are dealt
with in which of the following policy features? Answer: Exclusions
◉ The PRIMARY purpose of Medicaid is to: Answer: Provide Medical
Expense coverage to persons below certain minimum income
requirements
◉ Which of the following provisions designates to whom claim
payments are made? Answer: Payment of Claims
◉ Under an Accidental Death and Dismemberment (AD&D) policy,
insurable interest must exist at which of the following times?
Answer: At the inception of the policy
◉ When periodic claim payments are required under a long-term
disability income policy, an insurer MUST make payments to an
insured at least once every: Answer: Month
, ◉ A 68 year-old employee that is covered by a group medical
insurance plan has medical expenses. The employee's company
health plan is the: Answer: Secondary payor
◉ An insured whose Disability Income policy contains a Change of
Occupation clause takes a new job in a more hazardous occupation
and fails to notify the insurer of the change. One year later, the
insured becomes disabled. The insurer will most likely take which of
the following actions? Answer: Settle the claim according to what
the premiums would have purchased under the more hazardous
occupation
◉ The purpose of the Medical Information Bureau (MIB) is to:
Answer: Share medical data among member companies
◉ Which of the following laws requires an insurer to notify an
applicant in writing that an investigative consumer report may be
made on the applicant? Answer: D. Fair Credit Reporting Act
(Insurance Information and Privacy Protection Act)
◉ Which of the following statements is CORRECT about a Waiver of
Premium provision in a Disability Income policy? Answer: D. It
allows the insured to maintain a policy in force while disabled and
unable to pay premiums.
