Final Exam Cram complete questions and answers

Disability income provide disabled individuals with periodic income while they cannot work Except for direct response policies, when must a Medicare supplement policy outline of coverage must be delivered to an applicant? Select one: a. Prior to the presentation b. At the time of application c. When the policy is delivered d. Within 3 days of the policy delivery Except for direct response policies, a Medicare supplement policy outline of coverage must be delivered at the time of application. The correct answer is: At the time of application 00:00 Marshall wants to reinstate his life policy and to do so he need not do which of the following? Select one: a. Make a collateral assignment to the insurance company. b. Provide evidence of insurability. c. Pay back interest on his outstanding policy loan. d. Pay past due premiums He must do all except make a collateral assignment. The correct answer is: Make a collateral assignment to the insurance company. Tim was injured in an accident, how many day does he have to provide proof of loss? Select one: a. 15 days b. 7 days c. 45 days d. 90 days An insured has 90 days from the time of loss to provide the insurer proof of loss. The correct answer is: 90 days What consist of 2 or more employers or labor unions seeking group health insurance coverage by joining together to form a larger group? Select one: a. PLHSO b. DMPO c. EPO d. MEWA Multiple Employer Welfare Arrangements (MEWAs) consist of 2 or more employers or labor unions seeking group health insurance coverage by joining together to form a larger group. The correct answer is: MEWA Which care program requires the insured to select a primary care physician? Select one: a. HMO b. PPO c. POS d. FSA HMO's require the insured to select a primary care physician. The correct answer is: HMO What are the taxes imposed on a key person disability income policy? Select one: a. Premiums are not taxed. b. Benefits are taxable. c. Premiums are paid with after-tax dollars. d. Premiums and benefits are tax-free. Premiums for a key person disability income policy are not tax-deductible as a business expense, but benefits are received tax-free. The correct answer is: Premiums are paid with after-tax dollars. What type of rating method are small employer health policy carriers in Florida required to use for establishing premium rates? Select one: a. Extended individual rating b. Modified community rating c. Effective community rating d. Historical rating Small employer health policy carriers in Florida must use a _modified community rating_ method for establishing premium rates. The correct answer is: Modified community rating Who must sign the notice regarding replacement? Select one: a. The applicant only b. The producer only c. The applicant and the producer d. The applicant, the producer and the insurer Applicants replacing a life insurance policy must receive a notice regarding replacement. The notice will be signed by both the applicant and the producer. The correct answer is: The applicant and the producer Which of the following is NOT an unfair claim practice? Select one: a. Knowingly misrepresenting to claimants pertinent facts b. Asking for further information c. Offering to settle claims for an amount less than the amount reasonably due d. Failing to affirm or deny coverage of claims Any of the following acts, if committed without just cause and performed frequently, constitute improper and unfair claim practices: knowingly misrepresenting to claimants pertinent facts, failing to affirm or deny coverage of claims, offering to settle claims for an amount less than the amount reasonably due and many others. The correct answer is: Asking for further information What is a medical provider who has negotiated with healthcare professionals to accept a discounted fee at the time the service is performed? Select one: a. EPO b. DMPO c. MEWA d. PLHSO Discount Medical Plan Organizations (DMPOs) are medical providers who have negotiated with healthcare professionals to accept a discounted fee at the time the service is performed. The correct answer is: DMPO Medicare Advantage Plans include all the following, EXCEPT: Select one: a. HMOs b. PPOs c. EPOs d. Private Fee-for-Service Plans Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. The correct answer is: EPOs