Pearson Vue National Health Insurance Practice
Test Study with Complete Solutions 2026
An insurer must provide claim forms to an insured within a MAXIMUM of how
many days after receiving notice of an Accident & Health claim?
A. Five
B. Fifteen
C. Twenty
D. Thirty -Correct Answer ✔-b
Under a group health plan, an employer may offer additional benefits to classes of
employees on the basis of all of the following factors EXCEPT:
A. length of employment
B. gender
C. salary grade
D. job category -Correct Answer ✔-b
Which of the following statements is CORRECT about a Waiver of Premium
provision in a Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's
benefit payments.
B. It allows the insurer to increase the amount of premium during the insured's
time of disability.
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C. It allows the insured to extend the length of the Grace Period while disabled.
D. It allows the insured to maintain a policy in force while disabled and unable to
pay premiums. -Correct Answer ✔-d
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of
the following policy features?
A. Extensions of coverage
B. Benefits clause
C. Riders
D. Exclusions -Correct Answer ✔-d
An insured becomes disabled three years after his Disability Income policy is
issued. The disability is caused by a condition that existed prior to the policy issue
date but was not specifically excluded from coverage. In this situation, the insurer
will most likely take which of the following actions?
A. Pay the full claim
B. Pay the claim for a maximum of six months only
C. Deny the claim on the basis of misrepresentation
D. Deny the claim because it involves a pre-existing condition -Correct Answer ✔-a
A health care plan that reimburses a flat fee for medical care it provides at a clinic
it owns and operates is referred to as:
A. Health Maintenance Organization
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B. Medicaid
C. Medicare
D. Multiple Employer Trust (MET) -Correct Answer ✔-a
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?
A. Uniform Provisions Law
B. Freedom of Information Act
C. Medical Information Bureau Disclosure Act
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) -
Correct Answer ✔-d
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the
right to:
A.increase the premium rate for one insured without increasing the rate for others
in the same class
A. increase the premium rate for one insured without increasing the rate for
others in the same class
B. increase the premium rate for an entire class of insureds
C. increase the benefits for an individual insured
D. decrease benefits for one insured without decreasing benefits for others in the
same class -Correct Answer ✔-d
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