2-40 Health and Accident Insurance State Exam Prep|
103 QUESTIONS| WITH COMPLETE SOLUTION
Multiple Employer Welfare Arrangement (MEWA) provides what type of benefits? Correct
Answer: Insurance
XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of
eligible employees that must be covered is Correct Answer: 100%
In Major Medical Expense policies, what is the intent of Stop Loss provision? Correct Answer:
Limits an insured's out-of-pocket medical expenses
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a
$100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this
claim? Correct Answer: $2,100
Omitting information that affects the issuance or the rate of an insurance contract is called
Correct Answer: concealment
Florida requires that coverage for newborns begins "from the moment of birth" and continues for
Correct Answer: 18 months
In order to establish a Health Reimbursement Arrangement (HRA), it MUST Correct Answer:
be established by the employer
Which provision allows a portion of any used medical benefits to be restored following a
particular amount of benefits has been used, or after the policy has been in effect for a particular
period of time? Correct Answer: Restoration of used benefit
Disability policies do NOT normally pay for disabilities arising from which of the following?
Correct Answer: War
According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare
Supplement applicant? Correct Answer: At the time of application
An agent selling Medicare Supplement policies must provide every applicant with a(n) Correct
Answer: Suitability form
One definition of replacement is "the act of replacing an existing insurance policy with another".
Replacement is Correct Answer: closely regulated and requires full disclosure
Who makes the legally enforceable promises in a unilateral insurance policy? Correct Answer:
insurance company
, Which of the following acts is an agent NOT authorized to do on behalf of an insurer? Correct
Answer: Authorize claim payments
Which of the following BEST describes a Hospital Indemnity policy? Correct Answer:
Coverage that pays a stated amount PER DAY of a covered hospitalization
What is required in the Florida Employee Health Care Access Act? Correct Answer: Small
group benefit plan are to be issued on a "guarantee-issue" basis
The waiting period for a pre-existing condition under a Medicare Supplement policy may NOT
go beyond Correct Answer: 6 months
J purchased a Disability Income Policy that ONLY J can terminate and on which the rates will
never increase above those illustrated in the policy. Which of the following types of policies did
J purchase? Correct Answer: Noncancelable
What is the elimination period of an individual disability policy? Correct Answer: Time period a
disabled person must wait before benefits are paid
This type of deductible provision waives the deductible for all family members after some of
them have satisfied individual deductibles within the same year Correct Answer: Family
maximum deductible
Under an Individual Disability policy in Florida, what is the minimum schedule of time in which
claims must be made to an insured? Correct Answer: Monthly
Under a Long Term Care policy, which benefit would be typically excluded or limited? Correct
Answer: Alcohol rehabilitation
P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from
participating in a carjacking. How will the insurer most likely handle this claim? Correct
Answer: Claim will be denied
A mutual insurance company and a stock insurance company have one main difference between
them. What is the Major contrast? Correct Answer: Stock company is owned by its
shareholders.
Mutual company is owned by its policyholders.
Upon reaching the limiting age, a handicapped child can extend their health insurance coverage
as a dependent Correct Answer: only if the child is incapable of employment and chiefly
dependent on the policyowner
Which Unfair Trade Practice involves an agent suggesting that an insurance policy is like a share
of stock? Correct Answer: Misrepresentation
103 QUESTIONS| WITH COMPLETE SOLUTION
Multiple Employer Welfare Arrangement (MEWA) provides what type of benefits? Correct
Answer: Insurance
XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of
eligible employees that must be covered is Correct Answer: 100%
In Major Medical Expense policies, what is the intent of Stop Loss provision? Correct Answer:
Limits an insured's out-of-pocket medical expenses
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical policy with a
$100 deductible and 80/20 coinsurance. How much will Q be responsible for paying on this
claim? Correct Answer: $2,100
Omitting information that affects the issuance or the rate of an insurance contract is called
Correct Answer: concealment
Florida requires that coverage for newborns begins "from the moment of birth" and continues for
Correct Answer: 18 months
In order to establish a Health Reimbursement Arrangement (HRA), it MUST Correct Answer:
be established by the employer
Which provision allows a portion of any used medical benefits to be restored following a
particular amount of benefits has been used, or after the policy has been in effect for a particular
period of time? Correct Answer: Restoration of used benefit
Disability policies do NOT normally pay for disabilities arising from which of the following?
Correct Answer: War
According to Florida law, when must an agent deliver the Outline of Coverage to a Medicare
Supplement applicant? Correct Answer: At the time of application
An agent selling Medicare Supplement policies must provide every applicant with a(n) Correct
Answer: Suitability form
One definition of replacement is "the act of replacing an existing insurance policy with another".
Replacement is Correct Answer: closely regulated and requires full disclosure
Who makes the legally enforceable promises in a unilateral insurance policy? Correct Answer:
insurance company
, Which of the following acts is an agent NOT authorized to do on behalf of an insurer? Correct
Answer: Authorize claim payments
Which of the following BEST describes a Hospital Indemnity policy? Correct Answer:
Coverage that pays a stated amount PER DAY of a covered hospitalization
What is required in the Florida Employee Health Care Access Act? Correct Answer: Small
group benefit plan are to be issued on a "guarantee-issue" basis
The waiting period for a pre-existing condition under a Medicare Supplement policy may NOT
go beyond Correct Answer: 6 months
J purchased a Disability Income Policy that ONLY J can terminate and on which the rates will
never increase above those illustrated in the policy. Which of the following types of policies did
J purchase? Correct Answer: Noncancelable
What is the elimination period of an individual disability policy? Correct Answer: Time period a
disabled person must wait before benefits are paid
This type of deductible provision waives the deductible for all family members after some of
them have satisfied individual deductibles within the same year Correct Answer: Family
maximum deductible
Under an Individual Disability policy in Florida, what is the minimum schedule of time in which
claims must be made to an insured? Correct Answer: Monthly
Under a Long Term Care policy, which benefit would be typically excluded or limited? Correct
Answer: Alcohol rehabilitation
P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from
participating in a carjacking. How will the insurer most likely handle this claim? Correct
Answer: Claim will be denied
A mutual insurance company and a stock insurance company have one main difference between
them. What is the Major contrast? Correct Answer: Stock company is owned by its
shareholders.
Mutual company is owned by its policyholders.
Upon reaching the limiting age, a handicapped child can extend their health insurance coverage
as a dependent Correct Answer: only if the child is incapable of employment and chiefly
dependent on the policyowner
Which Unfair Trade Practice involves an agent suggesting that an insurance policy is like a share
of stock? Correct Answer: Misrepresentation
