COMPREHENSIVE STUDY GUIDE 2026 HEALTH
INSURANCE PRINCIPLES AND POLICY
STRUCTURES
◉ Group health insurance specifies that what percentage of eligible
individuals MUST be offered coverage under a noncontributory
plan?
-25
-50
-75
-100.
Answer: 100
◉ Under an Accidental Death and Dismemberment (AD&D) policy,
insurable interest must exist at which of the following times?
-When a change of beneficiary is requested
-At the inception of the policy
-When a beneficiary other than a relative is named
-At the time a claim is submitted.
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:
-month
-three months
-six months
-year.
Answer: month
◉ M and N own a small interior design studio that employs six
people. The owners are concerned about the financial continuation
of the business if either of them should become permanently
disabled. In this situation, a producer would MOST likely
recommend which of the following types of contracts?
-Basic Hospital
-Disability Buy-Out
-Comprehensive Major Medical
-Short-Term Disability Income.
Answer: Disability Buy-Out
◉ Which of the following health policies requires a beneficiary
designation?
-Travel Accident
-Medicare Supplement
, -Blanket
-Long Term Care.
Answer: Travel Accident
◉ Suicide, pre-existing conditions and self-inflicted injuries are dealt
with in which of the following policy features?
-Extensions of coverage
-Benefits clause
-Riders
-Exclusions.
Answer: Exclusions
◉ 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?
-Cancel the policy and refund one year's premiums
-Settle the claim according to what the premiums would have
purchased under the more hazardous occupation
-Pay the claim in full and then cancel the policy
-Pay the claim after deducting an extra one-year premium payment.
Answer: Settle the claim according to what the premiums would
have purchased under the more hazardous occupation