CA LIFE AND HEALTH INSURANCE EXAM 2 LATEST VERSIONS (VERSION A AND B) ACTUAL EXAM 2 50 QUESTIONS AND C ORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A Supplemental insurance u sed to pay for hospital confinement to treat cancer is also known as: A. Specified medical B. Urgent stay C. Dread disease D. Temporary major medical - ....ANSWER...C A health maintenance organization (HMO) plan contains costs by promoting: A. After -hours care B. Generic care C. Preventative care D. Fee for service care - ....ANSWER...C In HMOs, the use of a primary care physician is common as part of the: A. Group model B. Captivation arranegment C. Open enrollment D. Gatekeeper system - ....ANSWER...D Under an HMO, when physicians receive a flat monthly payment from the HMO for every member without regard to actual services provided by the physician, known as: A. Capitiation fee B. Excess insurance payments C. Over insurance D. A good de al - ....ANSWER...A HMOs are required to provide for all of the following except: A. Preventive care B. Physician services C. Emergency services D. Prescription drugs - ....ANSWER...D Who would be considered a claimant on a disability income policy? A. Beneficiary B. Insured C. Insurer D. None of above - ....ANSWER...B An insured's disability income policy defines total disability as the insured's inability to perform the duties of any occupation for which he is reasonably qualified by education, training, or experience. This definition is known as the - ....ANSWER..." Any occupation" definition and is more restrictive than other definitions A disability income policy would do which of the following? A. Replace a partial portion of income if you were disabled B. Replace your full income if you were disabled C. Would Re place all income if you were disabled D. Is never used in conjunction with social security - ....ANSWER...A During the disability income elimination period: A. Residual benefits are payable B. Occupational claims are payable C. No benefits are payable D. All claims are payable - ....ANSWER...C The commonly used 30,60,90 and 180 days in disability terminology refers to the: - ....ANSWER... Number of days for which no benefits are payable An elimination period is also known as: A. Benefit period B. waitin g period C. Incontestability period D. Any of above - ....ANSWER...B In a disability income policy, if the insured chooses a 90 -day elimination period, when would the first check be issued by the insurance company? A. 90th day B. 91st day C. 121st day D. Immediately - ....ANSWER...C To be classified as accidental under a disability income insurance policy, the following criteria must be used: - ....ANSWER... The cause may be intentional, but the result must be accidental What is the tax treatment for individual disability income policies? - ....ANSWER... Non-
deductuble premiums and tax -free benefits A disability policy described as "guaranteed renewable" is one where the insurance company: - ....ANSWER... Surrenders the rig ht to change any of its terms but may change the premiums Under an individual guaranteed renewable health contract, the insurer has the right to: - ....ANSWER... Change premiums for a class of insureds In a disability income insurance policy, an insured i s eligible for a waiver of premium benefit: - ....ANSWER... After the first three to 6 months of disability Which or the following is true about the PPACA? A. It provides affordable life insurance to individuals B. It allows individuals to purchase health insurance through the exchange if insurance is not affordable C. It allows the insurance company to deny coverage for any pre -existing conditions D. All of above - ....ANSWER...B Under PPACA, coverage for young adults was extended until what age? A.27 B. 25 C. 26 D. 24 - ....ANSWER...C Under the ACA, the maximum out of pocket expense limit for any individual marketplace plan in 2020 can be no more than how much? A. $6150 B. $7k C. $8k D. $8150 - ....ANSWER...D Which metal tier health plan has an actua rial value of 70%? A. Bronze B. Gold C. Silver D. Platinum - ....ANSWER...C Which metal tier health plan has an actuarial value of 80%? A. Bronze B. Gold C. Silver D. Platinum - ....ANSWER...B Which of the following would qualify for the AIM (access for infants and mothers) program? A. Must have a private insurance company B. Must make over $100k in annual income
deductuble premiums and tax -free benefits A disability policy described as "guaranteed renewable" is one where the insurance company: - ....ANSWER... Surrenders the rig ht to change any of its terms but may change the premiums Under an individual guaranteed renewable health contract, the insurer has the right to: - ....ANSWER... Change premiums for a class of insureds In a disability income insurance policy, an insured i s eligible for a waiver of premium benefit: - ....ANSWER... After the first three to 6 months of disability Which or the following is true about the PPACA? A. It provides affordable life insurance to individuals B. It allows individuals to purchase health insurance through the exchange if insurance is not affordable C. It allows the insurance company to deny coverage for any pre -existing conditions D. All of above - ....ANSWER...B Under PPACA, coverage for young adults was extended until what age? A.27 B. 25 C. 26 D. 24 - ....ANSWER...C Under the ACA, the maximum out of pocket expense limit for any individual marketplace plan in 2020 can be no more than how much? A. $6150 B. $7k C. $8k D. $8150 - ....ANSWER...D Which metal tier health plan has an actua rial value of 70%? A. Bronze B. Gold C. Silver D. Platinum - ....ANSWER...C Which metal tier health plan has an actuarial value of 80%? A. Bronze B. Gold C. Silver D. Platinum - ....ANSWER...B Which of the following would qualify for the AIM (access for infants and mothers) program? A. Must have a private insurance company B. Must make over $100k in annual income
