NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
Typically, Long-Term Disability benefits are coordinated with which
benefit plan? - Social Security
The focus of major medical insurance is providing coverage for -
medical and hospitalization expenses
An insured under a Major Medical expense plan with a zero deductible
and 80/20 coinsurance provision files a $1,000 claim. How much of this
claim is the insured responsible for? - $200
because this policy has a zero deductible, the insures is only responsible
for the 20% coinsurance on this claim, or $200
An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The
insured incurs
$25,000 of covered losses. How much will the insured pay? - $5,000
Which type of plan would be the most appropriate for an individual on
Medicare and concerned that Medicare will NOT pay for charges exceeding
the approved amount? - Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health
Insurance Portability and Accountability Act (HIPAA)? - when contribution
or participation rules have been violated
What does the word "level: in Level Term describe? - the face amount
A non-contributory health insurance plan helps the insurer avoid - adverse
selection
because all eligible employees are usually covered, non-contributory plans
are desirable from an underwriting standpoint because adverse selection is
minimized.
To qualify for a resident producer license in the state of Michigan, an
individual - must complete the required pre-licensing education within 12
months of license application
Under an expense-incurred individual health policy, what is the MAXIMUM
length of time after issuance of the policy that an insurer can exclude
coverage for a pre-existing condition? - 12 months
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
pre-existing conditions may be excluded for a maximum of 12 months from
the date of enrollment.
An insured has a health plan that pays established amounts in accordance
with a list of injuries, surgical procedures, or other losses. This list is called a -
benefit schedule
benefits schedule set predetermined limits or maximums on how much
money and insured can be reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - Provider
Which of the following is NOT an illegal inducement? - Giving the insured
an article of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial
condition of an insurer is known as - defamation
Which of the following is NOT a required provision in an accident and health
insurance policy? - change of occupation
the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? - Funded by
federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by
each state.
All of these are considered key factors in underwriting life insurance
EXCEPT - Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an
accident and health policy? - legal actions
All of the following plans allow for employee contributions to be taken on a
pre-tax basis EXCEPT - Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's),
not employees.
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
Which of the following gifts from a producer would NOT be considered
rebating? - $5 pen
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
A producer quoting life insurance may give an applicant an article of
merchandise having an invoice value of $5.00 or less.
Written notice for a health claim must be given to the insurer
days after
the occurrence of the loss. - 20
Chris is an insured bricklayer who severed his left hand in an automobile
accident. Although his primary duty cannot be performed, Chris is also a
substitute high school teacher. He collects a full disability income check
every month. How does his policy define total disability? - own occupation
the "own occupation" definition of total disability requires that the insured
be unable to perform the insured's current occupation as a result of an
accident or sickness.
Which approach predicts a person's earning potential and determines how
much of that amount would be devoted to dependents? - Human life value
approach
The human life value approach predicts an individual's future earning
potential and determines how much of that amount would be devoted to
dependents.
Index whole life insurance contains a securities component that acts as
a(n) - hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the
benefits. Which of these benefit options would he choose? - Guaranteed
lifetime withdrawal benefit
The guaranteed lifetime withdrawal benefit normally requires a fee, but it
ensures that the income benefit will be paid for life without actually
annuitizing the contract.
Which of these factors would an insurer consider when determining whether
to accept a group life plan? - average age
and insurer would consider the average age when determining whether to
accept a group Life Plan.
This MANDATORY health policy provision states that the policy, including
endorsements and attached papers, constitutes - the entire insurance
contract between the parties
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
Typically, Long-Term Disability benefits are coordinated with which
benefit plan? - Social Security
The focus of major medical insurance is providing coverage for -
medical and hospitalization expenses
An insured under a Major Medical expense plan with a zero deductible
and 80/20 coinsurance provision files a $1,000 claim. How much of this
claim is the insured responsible for? - $200
because this policy has a zero deductible, the insures is only responsible
for the 20% coinsurance on this claim, or $200
An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The
insured incurs
$25,000 of covered losses. How much will the insured pay? - $5,000
Which type of plan would be the most appropriate for an individual on
Medicare and concerned that Medicare will NOT pay for charges exceeding
the approved amount? - Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health
Insurance Portability and Accountability Act (HIPAA)? - when contribution
or participation rules have been violated
What does the word "level: in Level Term describe? - the face amount
A non-contributory health insurance plan helps the insurer avoid - adverse
selection
because all eligible employees are usually covered, non-contributory plans
are desirable from an underwriting standpoint because adverse selection is
minimized.
To qualify for a resident producer license in the state of Michigan, an
individual - must complete the required pre-licensing education within 12
months of license application
Under an expense-incurred individual health policy, what is the MAXIMUM
length of time after issuance of the policy that an insurer can exclude
coverage for a pre-existing condition? - 12 months
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
pre-existing conditions may be excluded for a maximum of 12 months from
the date of enrollment.
An insured has a health plan that pays established amounts in accordance
with a list of injuries, surgical procedures, or other losses. This list is called a -
benefit schedule
benefits schedule set predetermined limits or maximums on how much
money and insured can be reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - Provider
Which of the following is NOT an illegal inducement? - Giving the insured
an article of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial
condition of an insurer is known as - defamation
Which of the following is NOT a required provision in an accident and health
insurance policy? - change of occupation
the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? - Funded by
federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by
each state.
All of these are considered key factors in underwriting life insurance
EXCEPT - Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an
accident and health policy? - legal actions
All of the following plans allow for employee contributions to be taken on a
pre-tax basis EXCEPT - Health reimbursement Arrangement plan
employers contribute to health reimbursement Arrangement planz (HRA's),
not employees.
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
Which of the following gifts from a producer would NOT be considered
rebating? - $5 pen
, NUCLMED N01A EXAM-HEALTH INSUARANCE
QUESTIONS WITH ANSWERS GRADED A+
2022/2023 UPDATE
A producer quoting life insurance may give an applicant an article of
merchandise having an invoice value of $5.00 or less.
Written notice for a health claim must be given to the insurer
days after
the occurrence of the loss. - 20
Chris is an insured bricklayer who severed his left hand in an automobile
accident. Although his primary duty cannot be performed, Chris is also a
substitute high school teacher. He collects a full disability income check
every month. How does his policy define total disability? - own occupation
the "own occupation" definition of total disability requires that the insured
be unable to perform the insured's current occupation as a result of an
accident or sickness.
Which approach predicts a person's earning potential and determines how
much of that amount would be devoted to dependents? - Human life value
approach
The human life value approach predicts an individual's future earning
potential and determines how much of that amount would be devoted to
dependents.
Index whole life insurance contains a securities component that acts as
a(n) - hedge against inflation
Phil is shopping for an annuity that guarantees he CANNOT outlive the
benefits. Which of these benefit options would he choose? - Guaranteed
lifetime withdrawal benefit
The guaranteed lifetime withdrawal benefit normally requires a fee, but it
ensures that the income benefit will be paid for life without actually
annuitizing the contract.
Which of these factors would an insurer consider when determining whether
to accept a group life plan? - average age
and insurer would consider the average age when determining whether to
accept a group Life Plan.
This MANDATORY health policy provision states that the policy, including
endorsements and attached papers, constitutes - the entire insurance
contract between the parties
