Page|1
HEALTH INSURANCE FLORIDA 2-40
PRACTICE EXAM QUESTIONS #2 2026\2027
QUESTIONS AND ANSWERS.
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - CORRECT ANSWER Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a business
owner becomes disabled. Expenses such as rent, utilities, telephone,
equipment, employees' salaries, etc.)
All of the following are state or federal government programs that provide
health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - CORRECT ANSWER Medigap (Explanation:A Medigap policy
is a Medicare supplement insurance policy sold by private insurance
companies to fill "gaps" in Medicare Parts A and B.)
, Page|2
What type of health insurance is available to assist low-income individuals?
- CORRECT ANSWER Medicaid
What types of reserves are set aside and held by health insurance
companies? - CORRECT ANSWER Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides for
dividends or experience rating. What is the basis called? - CORRECT
ANSWER Participating (Explanation:Group plans written by mutual
companies provide for dividends while stock companies frequently issue
experiencerated plans.)
Which of the following is NOT TRUE regarding eligibility for subsidies for
families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - CORRECT ANSWER Can be eligible for
Medicaid
, Page|3
Which of the following operates as a corporation, society, or association to
provide life insurance primarily for the mutual benefit of its members, has a
lodge or social system with rituals and representative form of government?
A) Mutual companies
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - CORRECT ANSWER B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay
-Fixed premium whether or not plan is used
-Premium based on how often plan is used - CORRECT ANSWER Fixed
premium whether or not plan is used
Which of the following is correct about those who are eligible for Medicare
and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the Medicare
Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - CORRECT
ANSWER They must be told that'll be getting all the benefits from the
Medicare Advantage plan
, Page|4
Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce, EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - CORRECT ANSWER Coverage ends
after 18 months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each fiscal
year
-Must deposit $100,000 with the Rehabilitation Administration Expense
Fund
-Must be sold by agents licensed and appointed as health insurance agents
- CORRECT ANSWER Must deposit $100,000 with the Rehabilitation
Administration Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration Expense
Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
HEALTH INSURANCE FLORIDA 2-40
PRACTICE EXAM QUESTIONS #2 2026\2027
QUESTIONS AND ANSWERS.
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - CORRECT ANSWER Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to
reimburse a business for overhead expenses in the event a business
owner becomes disabled. Expenses such as rent, utilities, telephone,
equipment, employees' salaries, etc.)
All of the following are state or federal government programs that provide
health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - CORRECT ANSWER Medigap (Explanation:A Medigap policy
is a Medicare supplement insurance policy sold by private insurance
companies to fill "gaps" in Medicare Parts A and B.)
, Page|2
What type of health insurance is available to assist low-income individuals?
- CORRECT ANSWER Medicaid
What types of reserves are set aside and held by health insurance
companies? - CORRECT ANSWER Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides for
dividends or experience rating. What is the basis called? - CORRECT
ANSWER Participating (Explanation:Group plans written by mutual
companies provide for dividends while stock companies frequently issue
experiencerated plans.)
Which of the following is NOT TRUE regarding eligibility for subsidies for
families under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - CORRECT ANSWER Can be eligible for
Medicaid
, Page|3
Which of the following operates as a corporation, society, or association to
provide life insurance primarily for the mutual benefit of its members, has a
lodge or social system with rituals and representative form of government?
A) Mutual companies
B) Fraternal associations
C) Stock companies
-Fraternal benefit society - CORRECT ANSWER B) Fraternal associations
What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay
-Fixed premium whether or not plan is used
-Premium based on how often plan is used - CORRECT ANSWER Fixed
premium whether or not plan is used
Which of the following is correct about those who are eligible for Medicare
and wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the Medicare
Advantage plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - CORRECT
ANSWER They must be told that'll be getting all the benefits from the
Medicare Advantage plan
, Page|4
Joyce is totally disabled. Her HMO policy just terminated. All of the
following are correct regarding "extension of benefits" for Joyce, EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - CORRECT ANSWER Coverage ends
after 18 months
All of the following are correct regarding Florida regulation of HMOs,
EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each fiscal
year
-Must deposit $100,000 with the Rehabilitation Administration Expense
Fund
-Must be sold by agents licensed and appointed as health insurance agents
- CORRECT ANSWER Must deposit $100,000 with the Rehabilitation
Administration Expense Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration Expense
Fund.)
What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care
providers
