Health and Accident Insurance Questions With
Complete Solutions
During the underwriting process for a group health policy, it was discovered that
15 out of 50 members of the group have major health issues. How would the
insurer handle this?
Accept or reject the whole group
When a claim has coverage under more than one health plan, which group
medical plan provision applies?
Coordination of benefits
What percentage of eligible employees must participate in a noncontributory
group health plan before it can be put in effect?
100%
Who is financially liable for the payment of covered claims in a fully insured
group health plan?
Insurer
Buy-Sell Plans are typically funded by which two types of insurance?
Life insurance and Disability insurance
In regards to a group health insurance plan, which statement is CORRECT?
A non-contributory group health plan must cover all eligible members
Which of the following is NOT typically covered under vision care insurance?
Eye Surgery
An eligible individual who would like to obtain group health insurance without
providing evidence of insurability must?
Enroll within a specified eligibility period
Coverage is limited for vision and dental insurance in all of the following ways,
EXCEPT?
, Specific dollar amount for examinations
The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to
employers who employ at least?
20 employees
The problem of overinsurance is addressed in which health insurance provision?
Coordination of benefits
Minimum participation standards exist for group health insurance plans in order
to
prevent adverse selection
In an employer-sponsored group accident and health plan, a master contract is
issued to the?
Employer
Which of the following does Coordination of Benefits allow?
Allows the secondary payor to reduce their benefit payments so no more than 100% of
the claim is paid.
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the
Employee's waiting period for coverage of a preexisting condition can be reduced under
the new employer's health plan
Credit Accident and Health plans are designed to?
Help pay off existing loans during periods of disability
Health insurance involves two perils, accident and _________.
sickness.
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.
Mark continues working after the age of 65 and is covered through his employer's
group health plan. Which of the following statements is TRUE?
Medicare is the secondary payer.
The election of COBRA for continuation of health coverage will...
Maintain the same coverage and increase premium.
Complete Solutions
During the underwriting process for a group health policy, it was discovered that
15 out of 50 members of the group have major health issues. How would the
insurer handle this?
Accept or reject the whole group
When a claim has coverage under more than one health plan, which group
medical plan provision applies?
Coordination of benefits
What percentage of eligible employees must participate in a noncontributory
group health plan before it can be put in effect?
100%
Who is financially liable for the payment of covered claims in a fully insured
group health plan?
Insurer
Buy-Sell Plans are typically funded by which two types of insurance?
Life insurance and Disability insurance
In regards to a group health insurance plan, which statement is CORRECT?
A non-contributory group health plan must cover all eligible members
Which of the following is NOT typically covered under vision care insurance?
Eye Surgery
An eligible individual who would like to obtain group health insurance without
providing evidence of insurability must?
Enroll within a specified eligibility period
Coverage is limited for vision and dental insurance in all of the following ways,
EXCEPT?
, Specific dollar amount for examinations
The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to
employers who employ at least?
20 employees
The problem of overinsurance is addressed in which health insurance provision?
Coordination of benefits
Minimum participation standards exist for group health insurance plans in order
to
prevent adverse selection
In an employer-sponsored group accident and health plan, a master contract is
issued to the?
Employer
Which of the following does Coordination of Benefits allow?
Allows the secondary payor to reduce their benefit payments so no more than 100% of
the claim is paid.
Under the Health Insurance Portability and Accountability Act (HIPAA), the
employee's new Group Health Plan will verify Creditable Coverage so that the
Employee's waiting period for coverage of a preexisting condition can be reduced under
the new employer's health plan
Credit Accident and Health plans are designed to?
Help pay off existing loans during periods of disability
Health insurance involves two perils, accident and _________.
sickness.
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.
Mark continues working after the age of 65 and is covered through his employer's
group health plan. Which of the following statements is TRUE?
Medicare is the secondary payer.
The election of COBRA for continuation of health coverage will...
Maintain the same coverage and increase premium.
