1|Page
Michigan Accident & Health Insurance Exam TEST FINAL EXAM
AND PRACTICE EXAM 20262027 BANK 2 VERSIONS
QUESTIONS WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% CORRECT
ANSWERS A+ GRADED
The act of _________ insurance does NOT require an individual to hold
an insurance producer license.
-soliciting
-negotiating
-underwriting
-selling - ANSWERS--Underwriting
XYZ Company has applied for group health insurance for its employees.
What information would the insurer's underwriters likely use to
determine the appropriate coverage and final premium rate given to
the group?
-Arrest reports
-AM Best rating
-Experience rating
-Credit reports - ANSWERS--Experience rating
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Who is financially liable for the payment of covered claims in a fully
insured group health plan?
-Insurer
-Health provider
-Guaranty Association
-Group member - ANSWERS--Insurer
Which of the following types of employee welfare plans is specifically
exempt from regulation under ERISA?
-Blue Cross-Blue Shield plans
-Accident plans
-Hospital benefit plans
-Church plans - ANSWERS--Church plans
Which of the following statements about COBRA is CORRECT?
-The premium for continued group medical coverage may be up to
102% of the premium that would otherwise be charged.
-The employer must pay the cost of the continued group coverage.
-The schedule of benefits during the continuation period may be
different than those provided under the group plan.
-COBRA permits an employee to convert a group certificate to an
individual policy. - ANSWERS--The premium for continued group
medical coverage may be up to 102% of the premium that would
otherwise be charged.
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Which of the following is the purpose of medical cost management?
-To influence hospital charges and doctors' fees
-To discourage individuals from utilizing health care services
-To control health claim expenses
-To encourage individuals to seek medical help only as a last resort -
ANSWERS--To control health claim expenses
Which of the following is considered to be a point of service (POS) plan?
-Managed care plan
-Preferred provider organization
-Protected care provider
-Restricted provider organization - ANSWERS--Managed care plan
Which of the following best describes the characteristics of Preferred
Provider Organizations (PPOs)?
-PPOs are generally public in nature rather than private
-If service is obtained outside the PPO, benefits are reduced and costs
increase
-PPOs operate like an HMO on a prepaid basis
-Health care providers themselves are barred from forming a PPO due
to conflict of interest - ANSWERS--If service is obtained outside the
PPO, benefits are reduced and costs increase
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When comparing an HMO to a PPO, the PPO
-always requires service in a network
-always requires a referral to specialists
-is a prepaid medical service plan
-provides a greater choice of providers - ANSWERS--provides a greater
choice of providers
When a preferred provider organization (PPO) insured goes out-of-
network, which of the following actions occur?
-The benefits are taxable
-The insured will pay a reduced amount
-The insured has lower out-of-pocket expenses
-The insurer will pay a reduced amount - ANSWERS--The insurer will
pay a reduced amount
What is the name of a health care delivery system involving private
insurers who contract with doctors and hospitals to provide services at
set prices and allows insureds to choose among designated doctors and
hospitals when medical treatment and care is needed?
-Health Insuring Corporation
-Administrative services organization
-Preferred provider organization
Michigan Accident & Health Insurance Exam TEST FINAL EXAM
AND PRACTICE EXAM 20262027 BANK 2 VERSIONS
QUESTIONS WITH DETAILED VERIFIED ANSWERS EXAM
QUESTIONS WILL COME FROM HERE (100% CORRECT
ANSWERS A+ GRADED
The act of _________ insurance does NOT require an individual to hold
an insurance producer license.
-soliciting
-negotiating
-underwriting
-selling - ANSWERS--Underwriting
XYZ Company has applied for group health insurance for its employees.
What information would the insurer's underwriters likely use to
determine the appropriate coverage and final premium rate given to
the group?
-Arrest reports
-AM Best rating
-Experience rating
-Credit reports - ANSWERS--Experience rating
,2|Page
Who is financially liable for the payment of covered claims in a fully
insured group health plan?
-Insurer
-Health provider
-Guaranty Association
-Group member - ANSWERS--Insurer
Which of the following types of employee welfare plans is specifically
exempt from regulation under ERISA?
-Blue Cross-Blue Shield plans
-Accident plans
-Hospital benefit plans
-Church plans - ANSWERS--Church plans
Which of the following statements about COBRA is CORRECT?
-The premium for continued group medical coverage may be up to
102% of the premium that would otherwise be charged.
-The employer must pay the cost of the continued group coverage.
-The schedule of benefits during the continuation period may be
different than those provided under the group plan.
-COBRA permits an employee to convert a group certificate to an
individual policy. - ANSWERS--The premium for continued group
medical coverage may be up to 102% of the premium that would
otherwise be charged.
,3|Page
Which of the following is the purpose of medical cost management?
-To influence hospital charges and doctors' fees
-To discourage individuals from utilizing health care services
-To control health claim expenses
-To encourage individuals to seek medical help only as a last resort -
ANSWERS--To control health claim expenses
Which of the following is considered to be a point of service (POS) plan?
-Managed care plan
-Preferred provider organization
-Protected care provider
-Restricted provider organization - ANSWERS--Managed care plan
Which of the following best describes the characteristics of Preferred
Provider Organizations (PPOs)?
-PPOs are generally public in nature rather than private
-If service is obtained outside the PPO, benefits are reduced and costs
increase
-PPOs operate like an HMO on a prepaid basis
-Health care providers themselves are barred from forming a PPO due
to conflict of interest - ANSWERS--If service is obtained outside the
PPO, benefits are reduced and costs increase
, 4|Page
When comparing an HMO to a PPO, the PPO
-always requires service in a network
-always requires a referral to specialists
-is a prepaid medical service plan
-provides a greater choice of providers - ANSWERS--provides a greater
choice of providers
When a preferred provider organization (PPO) insured goes out-of-
network, which of the following actions occur?
-The benefits are taxable
-The insured will pay a reduced amount
-The insured has lower out-of-pocket expenses
-The insurer will pay a reduced amount - ANSWERS--The insurer will
pay a reduced amount
What is the name of a health care delivery system involving private
insurers who contract with doctors and hospitals to provide services at
set prices and allows insureds to choose among designated doctors and
hospitals when medical treatment and care is needed?
-Health Insuring Corporation
-Administrative services organization
-Preferred provider organization
