Accident and Health Insurance Exam Questions and answers graded A+ 2024.

Accident and Health Insurance Exam Questions and answers graded A+ 2024. H yhas ysuffered ya ycovered ydisability yaway yfrom yher yjob yand ywill yshortly ybegin ycollecting ybenefits. yThe yinsurer ysends ya yletter yto yH ystating ythat yshe ywill ynot yreceive yany ybenefit yamounts ygreater ythan yher yincome. yThis yclause yis yknown yas: A: yOver-insurance yclause B: yfree ylook C: yrelation yof yearning yto yinsurance D: yrelation yof yeconomic yvalue y- ycorrect yanswers. yC: yrelation yof yearning yto yinsurance The yinsured yshould ybe yaware yof ythe yissue ydate yupon ydelivery ya ypolicy yand ythe ydate yshould ybe ylisted yon: A: ythe ypolicy ysummary B: ythe yfirst ypage yof ythe ycontract C: ythe ydelivery yreceipt D: yupon yconditional yreceipt y- ycorrect yanswers. yB: ythe yfirst ypage yof ythe ycontract The ypolicy yhas yall yof ythe yfollowing yrights yEXCEPT: A: yRight yto ysolely yrenew ya yguaranteed yrenewable ypolicy. B: yRight yto yterminate ya ypolicy C: yUnilateral yright yto yrenew yan yOptionally yrenewable ypolicy D: yRight yto yassign ya ycontract y- ycorrect yanswers. yC: yUnilateral yright yto yrenew yan yOptionally yrenewable ypolicy The ypart yof ya ycontract ythat yspecifies ywhich yexpenses ymay yor ymay ynot ybe ycovered yis yknown yas ythe: A: yExclusion B: yEligible yExpense yprovision C: yInsuring yAgreement D: yConsideration yClause y- ycorrect yanswers. yB: yEligible yExpense yprovision Which yof ythe yfollowing yis yconsidered yto ybe ya ymandatory yprovision yin ya yhealth ypolicy? A: yTime yLimit yon yCertain yDefenses B: yChange yof yOccupation C: yIllegal yOccupation D: yIntoxicant/Narcotic yUsage y- ycorrect yanswers. yA: yTime yLimit yon yCertain yDefenses Which yof ythe yfollowing ymay ybe yconsidered yan yeligible yexpense yfound yin ya yhealth ypolicy? y A: yCosmetic ySurgery B: yPremium ypayment C: ycold ycream D: yBus yfare yto yreceive ytreatment yfor ya ycovered yloss y- ycorrect yanswers. yD: yBus yfare yto yreceive ytreatment yfor ya ycovered yloss K yhas ya ypolicy ythat ycovers ydoctors yvisits ybut ylimits ythe ynumber yof yvisits yper ycalendar yyear yand ypays ya ylimited yindemnification ylimit yper yvisit. yK yhas: A: yBasic yMedical yExpense B: yPhysician yNonsurgical yCoverage C: yBasic ySurgical yPolicy D: yBasic yHospital yCoverage y- ycorrect yanswers. yB: yPhysician yNonsurgical yCoverage All yof ythe yfollowing yare yCORRECT yabout yMedicare yEXCEPT: A: yAn yinsured ywho yis yage y30 ybut ycollecting ySocial ySecurity ydisability yfor ythe ylast ytwo yyears yis yeligible yfor yMedicare. B: yAn yinsured ywho yis yage y60 yand yis yat ythe yend ystage yof yrenal yfailure yis yeligible yfor yMedicare. C: yAn yinsured ywho yturns yage y65 yand yis ystill yemployed yis yeligible yfor yMedicare. D: yAn yinsured ywho yhas yMedicare yPart yA yis yeligible yto yenroll yfor yMedigap ypolicies ywithin ysix ymonths yof yenrolling yin yPart yA. y- ycorrect yanswers. yD: yAn yinsured ywho yhas yMedicare yPart yA yis yeligible yto yenroll yfor yMedigap ypolicies ywithin ysix ymonths yof yenrolling yin yPart yA. Under ythe yClaim yForms yprovision yin yan yAccident yand yHealth ypolicy, yan yinsurance ycompany ymust ysupply yan yinsured ywith yclaim yforms ywithin ya yMAXIMUM yof yhow ymany ydays yafter yreceiving ynotice yof ythe yloss? A: y10 B: y15 C: y20 D: y30 y- ycorrect yanswers. yB: y15 The ypurpose yof ythe yFair yCredit yReporting yAct yis yto: A: yprotect ythe yconsumer yfrom yhaving yan yadverse yaction yagainst ythem ybased yof yobsolete ycredit yinformation B: yto yensure ythat ycredit yinformation yused yin yunderwriting yis yaccurate yand yupdated C: ymake ysure ythat yany yfinancial yinstitution yhandles yan yindividual's ycredit yin ya ycorrect, yproper ymanner D: yAll yof ythe yAbove y- ycorrect yanswers. yD: yAll yof ythe yAbove Most yAccident yand yHealth ypolicies yrequire ythat yclaims ymust ybe ypaid y_________ yupon ywritten yproof yof yloss. y A: y30 ydays B: yImmediately C: y60 ydays D: y90 ydays y- ycorrect yanswers. yB: yImmediately A yLTC ypolicy ythat ywill yonly ypay yfor yADL ygiven yoccasionally yby ya ylicensed yprofessional yis: A: ySkilled yCare B: yIntermediate yCare C: yCustodial yCare D: yNone yof ythe yAbove y- ycorrect yanswers. yC: yCustodial yCare Which yof ythe yfollowing ypolicy yprovisions yare yoptional yin ya yindividual yhealth ypolicy? A: yEntire yContract B: yChange yof yOccupation C: yEntire yContract D: yReinstatement y- ycorrect yanswers. yB: yChange yof yOccupation Which yof ythe yfollowing yelements yis ypart yof ythe yentire ycontract yclause? A: yThe yexchange yof yvalue ybetween ythe yparties B: yThe yagreement ybetween ythe ypolicyholder yand yinsurer C: yThe yamount yof ytime ythe yinsured yhas yto ysend ya ypolicy yback yfor ya yfull yrefund D: yNone yof ythe yAbove y- ycorrect yanswers. yD: yNone yof ythe yAbove All yof ythe yfollowing yare ytrue yregarding ySocial ySecurity ydisability yEXCEPT: A: yA yinsured ymust ywait y5 ymonths ybefore ycollecting ybenefits B: yTo yqualify yan yinsured ymust ybe yunable yto ydo yany yjob yin ythe yAmerican yeconomy C: yTo yqualify yan yinsured ymust ybe ydisabled yfor ya yyear yor ylonger yor ydie ywithin ya ytwo yyear yperiod. D: yThe yinsured ymust yhave ya ycertain yamount yof ySocial ySecurity ycredits ybased yoff yage. y- ycorrect yanswers. yC: yTo yqualify yan yinsured ymust ybe ydisabled yfor ya yyear yor ylonger yor ydie ywithin ya ytwo yyear yperiod. Health yCare yFSA ycontributions yare ylimited yto y_______ yper yyear. A: y$5,000 B: y$3,000 C: y$2,700 D: y$3,250 y- ycorrect yanswers. yC: y$2,700 A ynoncancelable ypolicy ymeans ythe ycompany A: ymay ynot yraise ythe ypremium yor yterminate ythe ypolicy yexcept yfor ynonpayment yof ypremium B: ymay ynot ycancel ybefore ythe yinsured yreaches yage y50 C: ymay ypay ylimited ybenefits yand ycannot ycancel yall ybenefits D: ycan yonly yterminate ycoverage yif ythe yinsured yswitches yoccupations y- ycorrect yanswers. yA: ymay ynot yraise ythe ypremium yor yterminate ythe ypolicy yexcept yfor ynonpayment yof ypremium The ymaximum ynumber yof yin-hospital ydays ycoverage yprovided yby yan yindividual ypolicy yunder yminimum ystandards yis: A: y30 ydays B: y45 ydays C: y90 ydays D: y180 ydays y- ycorrect yanswers. yD: y180 ydays If ythere yis ya ydispute yon ymedical ynecessity yunder ya yHMO, ythere ymust ybe ya ysystem yin yplace yfor ya ysecond yopinion. yIf ythe ysecond yopinion ydetermines ythat ya ycovered yservice yis yin yfact ymedically ynecessary, ythe yHMO ymust yprovide yservice. yThe yonly yway ythat ybenefits yare ypaid yfor yan yout-of-network yphysician yis: A: yif ya yreferral yis ygiven B: ystate ylaw ydictates ywhen ycoverage yout yof yarea yexists C: yif yit yis yan yemergency D: yNone yof ythe yAbove y- ycorrect yanswers. yA: yif ya yreferral yis ygiven Which yof ythe yfollowing ycircumstances ymay ylead yto ythe yrenewal yof ya yproducer ylicense ywithout ythe yrequirement yof ycompleting ycontinuing yeducation yrequirements? y A: yThere yare yno yexceptions yto ythe ycontinuing yeducation ylaw. B: yThe yproducer ysuffers ya ystroke yand yis yincapable yof ycompleting yany ycoursework. C: yThe yproducer yis ycalled yup yto ymilitary yduty yand ysecures ya ymilitary ywaiver. D: yOnce ya yproducer yhas ybeen ylicensed yfor ymore ythan y30 yconsecutive yyears yand yis yat yleast y65 yyears yof yage, ythey yare yexempt yfrom ycontinuing yeducation yrequirements. y- ycorrect yanswers. yC: yThe yproducer yis ycalled yup yto ymilitary yduty yand ysecures ya ymilitary ywaiver. Renewability yof ya yLong yTerm yCare ypolicy ymust ybe yat yleast: A: yNoncancelable B: yGuaranteed yRenewable C: yCancellable D: yA yand yB yonly y- ycorrect yanswers. yD: yA yand yB yonly Under yminimum ystandards, ythe yprobationary ywaiting yperiod yfor yillness ymay ynot yexceed A: y10 ydays B: y20 ydays C: y30 ydays D: y40 ydays y- ycorrect yanswers. yC: y30 ydays If ya ypolicy yowner yof ya yMedicare ySupplement ybecomes yeligible yfor yMedicaid, ya ysupplement ycan ybe ysuspended yfor yup yto y______ yas ylong yas ythey ygive ythe yinsurer ynotice ywithin y90 ydays yof ybeing yeligible yfor yMedicaid. y A: y6 ymonths B: y12 ymonths C: y24 ymonths D: y36 ymonths y- ycorrect yanswers. yC: y24 ymonths H yhas yhad ygroup yLTC ycoverage yfor ythe ylast y5 ymonths. yH yhas ydecided yto yleave yhis yjob yand yfind ya ynew ycareer. yUpon yleaving yhis ygroup, yH ywould ylike yto yconvert yhis ygroup yLTC ypolicy yto yan yindividual yplan. yThe yinsurer yis ymost ylikely yto: A: ydeny yconversion B: yallow yconversion C: yallow yconversion, ybut ythey ymay yincrease ythe ypremium D: yallow yconversion yas ylong yas yH yconverts ywithin y30 ydays yof yleaving ythey ygroup y- ycorrect yanswers. yA: ydeny yconversion If yan yinsurance ycompany yissues ydeceptive ystatements yabout yits yassets, ythis yaction yis A: yfalse yadvertising. B: yan yunfair ytrade ypractice. C: yunfair ydiscrimination. D: yfalsification. y- ycorrect yanswers. yB: yan yunfair ytrade ypractice. Other ythan ywhen yan yagent yor yinsurer ysells ya ysupplement ynot yapproved yby ythe ydirector, yall yother yviolations ymay yincur ya ymaximum yfine yof: A: y$500 B: y$1,000 C: y$5,000 D: y$10,000 y- ycorrect yanswers. yC: y$5,000 If yan yinsurer ydiscontinues ya ygroup ypolicy ythey yare yonly yliable yfor: A: ytheir yextent yof ybenefits yunder ythe yold ycontract B: yhalf yof ythe ynew ycarrier's ycovered ylosses C: ynothing D: yall ylosses yup yto ya yyear y- ycorrect yanswers. yA: ytheir yextent yof ybenefits yunder ythe yold ycontract N yhas ya ymajor ymedical ypolicy ythrough yan yinsolvent yinsurer. yThe ymaximum ythe yGuarantee yAssociation ywill ypay yon yN's ylosses yis: A: y$500,000 B: y$300,000 C: y$200,000 D: y$100,000 y- ycorrect yanswers. yA: y$500,000 On yMarch y1 yC, ywho yholds yan yIllinois ynon-resident ylicense ymoves yfrom yIdaho yto yIowa. yBy ywhich ydate ymust yC ynotify ythe yIllinois yDirector yof yInsurance yabout ythis ymove? A: yBy yMarch y31 B: yC ydoes ynot yhave yto ynotify yIllinois ysince yhe ywas ya ynon-resident ylicense yholder. C: yBy yMay y1 D: yBy yMarch y16 y- ycorrect yanswers. yA: yBy yMarch y31 V yhas yan yHMO ywho yhas ybeen yfinancial yimpaired, ythe ymost ythe yHMO yGuarantee yAssociation ywill ypay yfor yV's yclaims yis: A: y$100,000 B: y$250,000 C: y$300,000 D: y$500,000 y- ycorrect yanswers. yD: y$500,000 What yaction ywould ybe yrequired yof ya yproducer ywho yfails yto yreinstate ya ylapsed yproducer ylicense ywithin ythe ystatutory yallowed ytime yperiod? A: yThe yperson yis ybarred yfrom yentering ythe yinsurance ybusiness yfor y5 yyears. B: yThe yperson yis ybarred yfrom yentering ythe yinsurance ybusiness yfor ylife. C: yThe yperson ywould ybe yrequired yto ytake ya ycertified yprelicensing ycourse yand ystate yexam yfor yeach yline yor yauthority ysought yand ythen yto ysubmit yan yapplication ywith ythe ypayment yof ya y$180 ylicense yfee. D: yThe yperson ywould ybe yrequired yto ytake ya ycertified yprelicensing ycourse yand ystate yexam yfor yeach yline yor yauthority ysought yand ythen yto ysubmit yan yapplication ywith ythe ypayment yof ya y$360 ylicense yfee. y- ycorrect yanswers. yC: yThe yperson ywould ybe yrequired yto ytake ya ycertified yprelicensing ycourse yand ystate yexam yfor yeach yline yor yauthority ysought yand ythen yto ysubmit yan yapplication ywith ythe ypayment yof ya y$180 ylicense yfee. T yhas yrecently yreplaced yher yMedicare ySupplement ypolicy ywhich ywas yin yforce yfor y7 ymonths. yThe ycontract yhas ya yprobationary ywaiting yperiod yon yall yillness yrelated ylosses yfor ythe yfirst yten ydays yof ycoverage. yOn yday y5, yT ysuffers yan yillness. yThe yreplacing yinsurer yis ymost ylikely yto: A: ycover ythe yloss B: ydeny ythe yclaim C: yrequire yT ypay ymore ypremium yto ycover ythe yloss D: yNone yof ythe yAbove y- ycorrect yanswers. yA: ycover ythe yloss Another yname yfor ya yBinder yis: A: yConditional yReceipt B: yUnconditional yReceipt C: yTemporary yCoverage yBinder D: yPre-Conditional yReceipt y- ycorrect yanswers. yB: yUnconditional yReceipt When yan yagent ysells yan yAccident yand yHealth ypolicy, yhe/she yshould ydo ywhich yof ythe yfollowing ywith ythe yapplication? A: yComplete yit yand yhave ythe yapplicant yreview yand ysign yit B: yThe yagent yshould yinitial yany yand yall ychanges yhe/she ymay ymake ylater C: yHave ythe yapplicant ysign yand ythen ycarefully yput yin ythe yrequired yinformation yin yas ythoroughly yand yaccurately ya ymanner yas ypossible D: yAdvise ythe yapplicant yto yprovide yinformation yin ysuch ya ymanner yto ymake ycertain ythe ypolicy ywill ybe yissued ywithout yrestrictions y- ycorrect yanswers. yA: yComplete yit yand yhave ythe yapplicant yreview yand ysign yit G yhad yhis ypolicy yreinstated yon yAugust y1. yOn yAugust y5, yG yfalls yill yand yneeds yto yspend ya yfew ynights yin ythe yhospital. yWhich yof ythe yfollowing yis ymost ylikely yto yhappen? A: yThe yinsurer ywill ypay yfull ybenefits yfor yG's yloss B: yThe yinsurer ywill ynot ypay yfor yG's yloss C: yG ywill yhave yto ypay ymore ypremium yto yhave ythe yloss ycovered D: yNone yof ythe yAbove y- ycorrect yanswers. yB: yThe yinsurer ywill ynot ypay yfor yG's yloss Which yof ythe yrights yof yrenewable ywill yguarantee ypremiums yremain ylevel? A: yGuaranteed yRenewable B: yCancelable C: yNoncan D: yNone yof ythe yAbove y- ycorrect yanswers. yC: yNoncan Under ythe yClaim yForms yprovision yin yan yAccident yand yHealth ypolicy, yan yinsurance ycompany ymust ysupply yan yinsured ywith yclaim yforms ywithin ya yMAXIMUM yof yhow ymany ydays yafter yreceiving ynotice yof ythe yloss? A: y10 B: y15 C: y20 D: y30 y- ycorrect yanswers. yB: y15 A yCORRECT ystatement yabout ybenefits ypayable yunder ya yDisability yBuy-Out ypolicy ythat yis yowned yby ya ybusiness yentity yis ythat ythey yare: A: yrelated ydirectly yto ysalary B: ypaid yin yinstallments C: ypaid yto ythe ycorporation D: ypaid ydirectly yto ythe yemployee y- ycorrect yanswers. yC: ypaid yto ythe ycorporation The yrider ythat yan yinsurer yuses yto yspecifically yname yand yexclude ya ypreexisting ycondition yfrom ycoverage yis yknown yas: A: yExclusionary yRider B: yPreexisting yCondition yRider C: yImpairment yRider D: yExclusion yRider y- ycorrect yanswers. yC: yImpairment yRider Lifetime, yPer yCause, yand yAnnual ymaximums yare yall yexamples yof: A: yBenefit yExclusions B: yBenefit yLimits C: yOut yof yPocket yExpenses D: yContractual yLosses y- ycorrect yanswers. yB: yBenefit yLimits If ythe ycarrier yhas ya yreasonable ycharge ythat yis ybelow ythe yproviders ycontractual yreasonable ycharge, ythe yinsured ymay ybe yresponsible yfor ythe ydifference yof ymedical ycost, ythis yis yknown yas: A: yBalance yBilling B: yReasonable yCharges C: yUsual yCharges D: yCustomary yCharge y- ycorrect yanswers. yA: yBalance yBilling Which yof ythe yfollowing yrights yof yrenewability ystipulate ythat ythe yinsured yhas ythe ysole yright yto yend ycoverage? A: yPeriod yof yTime B: yNoncancelable C: yCancelable D: yConditionally yRenewable y- ycorrect yanswers. yB: yNoncancelable All yof ythe yfollowing ystatements yare ytrue yabout ya yspecified ydisease yplan yEXCEPT: A: yCancer ymay ybe ycovered yup yto ya yfixed ydollar ybenefit yamount. B: yA yspecified ydisease yplan yis ya ygood ysubstitute yfor ya ymajor ymedical ypolicy ybecause yit yis ycheaper ypremiums. C: yA yspecified ydisease yplan ywill yonly ycover yone yspecific yloss. D: yNo ypolicy ywill ycover ya yspecified ydisease yif ydiagnosed yoccurred ybefore ythe ypolicy ywas yapplied yfor. y- ycorrect yanswers. yB: yA yspecified ydisease yplan yis ya ygood ysubstitute yfor ya ymajor ymedical ypolicy ybecause yit yis ycheaper ypremiums. Which yof ythe yfollowing yare yexclusions yunder ya yhealth ypolicy? y A: yan yannual yeye yexam B: ya ybiannual ydental ycheck-up C: ya yworker ythat yis yinjured ywhile yworking yon ythe yjob D: yAll yof ythe yAbove y- ycorrect yanswers. yD: yAll yof ythe yAbove The ymandatory yprovision ythat ystipulates ythe yinsurer's yrights yduring yunderwriting yand yproving yfraud yis ythe: A: yProof yof yLoss yprovision B: yPhysical yExamination yand yAutopsy C: yEntire yContract yProvision D: yLegal yAction yProvision y- ycorrect yanswers. yB: yPhysical yExamination yand yAutopsy What yis ya ycontract's ygrace yperiod yif ya ypremium yis ypaid yon ya yquarterly ybasis? A: y7 ydays B: y10 ydays C: y31 ydays D: y90 ydays y- ycorrect yanswers. yC: y31 ydays Doctors yin ya yPreferred yProvider yOrganization yare ypaid: A: yCapitation B: yFee yfor yService C: ySalary D: yReimbursement y- ycorrect yanswers. yB: yFee yfor yService In ya yhealth ypolicy, ythe yprobationary yperiod ybegins: A: yupon yissuance yof ya ypolicy B: yupon ydelivery yof ya ypolicy C: ywhen yunderwriting ytakes yplace D: yupon ypayment yof yfirst ypremium y- ycorrect yanswers. yA: yupon yissuance yof ya ypolicy Which ypolicy yrider ywould yoffer yan yinsured ythe yoption yto yincrease ytheir ybenefits yof ythe yoriginal ypolicy? y A: yImpairment yRider B: yGuaranteed yInsurability yRider C: yWaiver yof yPremium D: yNone yof ythe yAbove y- ycorrect yanswers. yB: yGuaranteed yInsurability yRider C yhas ya yLTC ypolicy ythat ycannot ybe yterminated yand yhas yguaranteed ypremiums. yC yhas ywhich yof ythe yfollowing yrights yof yrenewability? A: yNoncancelable B: yGuaranteed yRenewable C: yCancelable D: yPeriod yof yTime y- ycorrect yanswers. yA: yNoncancelable Consideration yfor ythe yinsurer yis yto: A: yguarantee ycoverage B: ycover ylosses ythat yare yexcluded C: ypay ycovered ylosses D: yshare yin ypremium ypayment y- ycorrect yanswers. yC: ypay ycovered ylosses All yof ythe yfollowing ybenefits ymay yrequire ya yreferral yEXCEPT: A: yA ydoctor yseen yin-network yunder ya yPPO B: yA ysubscriber yuses ytheir ypoint yof yservice yplan yfor ya ycovered yspecialist C: yA ysubscriber yutilizes ytheir yHMO ycoverage yfor ya ycardiologist. D: yNone yof ythe yAbove y- ycorrect yanswers. yA: yA ydoctor yseen yin-network yunder ya yPPO T yhas yjust yreturned yback yto ywork yafter ya ytotal ydisability ybut yis yonly yable yto ywork yhalf ythe yday. yT's ypolicy ypays ythe ydifference ybetween ywhat ythe yemployer ypays yT yand ywhat yT yearned yprior yto ydisability. yT yhas: A: yOwn yOccupation B: yResidual yDisability C: yPartial yDisability D: yAny yOccupation y- ycorrect yanswers. yB: yResidual yDisability If yan yagent yhas ycompleted ythe yinitial ycontinuing yeducation yfor ylong yterm ycare, ynext yrenewal ythey ymust ycomplete yongoing yeducation ythat yis y____ yof ycontinuing yeducation. A: y4 yhours B: y8 yhours C: y12 yhours D: y24 yhours y- ycorrect yanswers. yA: y4 yhours Which yof ythe yfollowing yis ynot ytrue yregarding yMedicare ySupplement yminimum ystandards? A: ySupplements ycan yonly yexclude yillness yor ytreatment ythat yare yexcluded yunder yMedicare. B: yIf ya ygroup ySupplement ywas yterminated, ythe yinsurer ydoes ynot yhave yto yoffer ycertificate yholders ya yright yto yconvert yto yan yindividual ypolicy. C: ySupplements ycannot ybase ypayments yon ystandards ysuch yas yreasonable yand ycustomary. D: yA ypreexisting ycondition yis ylimited yto y6 ymonths ybefore yeffective ydate yof ycoverage. y- ycorrect yanswers. yB: yIf ya ygroup ySupplement ywas yterminated, ythe yinsurer ydoes ynot yhave yto yoffer ycertificate yholders ya yright yto yconvert yto yan yindividual ypolicy. Which yof ythe yfollowing yis yan ya yexample yof ya yunfair ytrade ypractice? A: ya ycompany yrates yan yindividual ybased yon ypartial yblindness B: ya ycompany yrates yan yindividual ywith ya ydisability C: yan yagent ydiscriminates ya yclient ybecause yof ythey yare ytotally yblind D: yAll yof ythe yAbove y- ycorrect yanswers. yD: yAll yof ythe yAbove A yproducer yviolates ythe ywritten yorder yfrom ythe yDirector ypertaining yto ytheir ymarket yconduct yactivities. yWhat yis ythe ymaximum ycivil ypenalty ythat ycan ybe yassessed yby ythe yDirector yagainst ya yproducer yin ythis ycircumstance? A: y$10,000 B: y$20,000 C: y$50,000 D: y$100,000 y- ycorrect yanswers. yB: y$20,000 If yan yinsured yhas ya ylimited ygroup yplan yand ythe ycarrier ydiscontinues ygroup ybenefits, yas ylong yas ythe yinsured yhas ynot yused yup yall yof ytheir ybenefits yunder ythe ypolicy, yin ythe ycase yof ytotal ydisability, ycoverage yapplies yup yto y______ yafter ydiscontinuation yor yend yof ydisability, ywhichever yoccurs yfirst. y A: y30 ydays B: y60 ydays C: y90 ydays D: y12 ymonths y- ycorrect yanswers. yC: y90 ydays A yproducer ytells yhis yclient ythat yhis ydisability yincome ypolicy ywill ypay yfor yall yof yhis ymedical ybills yif ydisabled. yThe yproducer yis yguilty yof A: yTwisting B: yMisrepresentation C: yDefamation D: yFalse yAdvertising y- ycorrect yanswers. yB: yMisrepresentation On yMarch y1 ythe yDirector ymailed ya ynotice yof yproducer ylicense ysuspension yto yR ywhich yhe yreceived yon yMarch y4. yIf yR ywishes yto yrequest ya yhearing yon ythe ymatter, yby ywhich ydate ymust yR ymake ythis ydemand yin ywriting? A: y24-Mar B: y30-Mar C: y31-Mar D: y3-Apr y- ycorrect yanswers. yC: y31-Mar Under ylaw, ya yLTC ypolicy ymust yprovide yconsecutive ycoverage yfor yat yleast: A: y6 ymonths B: y12 ymonths C: y24 ymonths D: y36 ymonths y- ycorrect yanswers. yB: y12 ymonths Company yA yhas ydecided yto ycease ygroup ycoverage yin yIL. yOn yAugust y1, yCompany yA ynotifies yall ygroup ycontract yholders yof ydiscontinuation. yHow ymany ydays ydoes ythe ycontract yholder yhave yto ynotify yenrollees? A: y10 ydays B: y20 ydays C: y30 ydays D: y31 ydays y- ycorrect yanswers. yA: y10 ydays Each yof ythe yfollowing yis ytrue yregarding ya ycancelable ypolicy yEXCEPT: A: yThe yinsured ycan ycancel yfor yany yreason B: yThe yinsurer ycan ycancel ythe ypolicy yat yanytime C: yThe yinsurer ycan yonly yterminate ybecause yof ynonpayment yof ypremium D: yCancelable yis yusually ythe ymost yinexpensive yrenewability yoption. y- ycorrect yanswers. yC: yThe yinsurer ycan yonly yterminate ybecause yof ynonpayment yof ypremium The ypurpose yof ypreventing yan yinsured yfrom ycollecting ytwice yon ylosses ythat yare ySubrogated yis yto: A: yreinforce yindemnity B: yto yhinder ythe yinsured's yrights C: yto yallow ythe yinsurer yto ycollect ytwice D: yNone yof ythe yAbove y- ycorrect yanswers. yA: yreinforce yindemnity N yhas ya ydisability ypolicy yand ysuffers ya ycovered yloss. yAfter yelimination, ywhat yis ythe ymaximum ytime ythe yinsurer yhas yto ymake ya yclaim ypayment yunder ythe yTime yPayment yof yClaims yprovision? A: yImmediately B: y15 ydays C: y20 ydays D: y30 ydays y- ycorrect yanswers. yD: y30 ydays The yinsured ymust ywait yto yfile ya ylawsuit yagainst yan yinsurer yhowever, ythe yinsurer yhas y______ yfrom yproof yof yloss yto yfile ythe ylawsuit. y A: y30 ydays B: y60 ydays C: y2 yyears D: y3 yyears y- ycorrect yanswers. yD: y3 yyears All yof ythe yfollowing yprovisions yfound yin ya yhealth ypolicy yare yoptional yEXCEPT: A: yChange yof yOccupation B: yIllegal yOccupation C: yIntoxicant yand yNarcotic yUsage D: yNone yof ythe yAbove y- ycorrect yanswers. yD: yNone yof ythe yAbove J yhas ymedical ybenefits ythat yprovide ya yfirst ydollar ycoverage ybut ythen yalso yapplies ya ydeductible yand ycoinsurance yfor ymajor ybenefits. yJ yhas: A: yComprehensive yMajor yMedical B: yCombined yMedical yPolicy C: yComparative yMedical D: yMajor yMedical y- ycorrect yanswers. yA: yComprehensive yMajor yMedical All yof ythe yfollowing yare yrequired ydisclosure yforms yat yapplication yEXCEPT: A: yHIPAA B: yHIV C: yMIB D: yNone yof ythe yAbove y- ycorrect yanswers. yC: yMIB A ybusiness ycan yprovide ygroup yinsurance yto ytheir yemployees yif: A: ythe ypurchase yof yinsurance yis yincidental yto ythe ybusiness B: ythe ypurchase yof yinsurance yis yentirely ymade yby ythe yemployer C: ythe ypurchase yof yinsurance yis ymade yregardless yof ybusiness yownership D: yNone yof ythe yAbove y- ycorrect yanswers. yA: ythe ypurchase yof yinsurance yis yincidental yto ythe ybusiness Y yis yinjured ywhile yrobbing ya ybank yand yhis yclaim yis ydenied. yWhich yof ythe yfollowing yprovisions ywould ydeny yY's yclaim? y A: yChange yof yOccupation B: yIllegal yOccupation C: yFelony yExclusion D: yIllegal yAction y- ycorrect yanswers. yB: yIllegal yOccupation Z yhas ya yMajor yMedical ypolicy yand yincurs yher yfirst ycovered yloss yof ythe yyear. yZ ymust ypay: A: ythe yDeductible B: ythe yDeductible yplus yany yremaining yrequired yco-pay yon ythe yloss C: yany yCo-Insurance D: ythe yDeductible yplus yany yremaining yrequired yco-insurance yon ythe yloss. y- ycorrect yanswers. yD: ythe yDeductible yplus yany yremaining yrequired yco-insurance yon ythe yloss. Which yof ythe yfollowing ydefines ya ypotential ydefinition yof ya ytotal ydisability? A: yAny yOccupation B: yResidual C: yPartial D: ySocial ySecurity yDisability y- ycorrect yanswers. yA: yAny yOccupation Part yA yof yMedicare ycovers: A: yHospital yCare B: yInpatient yskilled ynursing yand yhome yhealth yvisits C: ydoctor yvisit D: yOnly yAnswers yA yand yB y- ycorrect yanswers. yD: yOnly yAnswers yA yand yB The yparty ythat ydictates ywhat ya yreasonable yor ycustomary ycharge yis yfor ya yhealth ypolicy yis ythe: A: yinsured B: yinsurer C: yDepartment yof yInsurance D: yfederal ygovernment y- ycorrect yanswers. yB: yinsurer N yhas ya yHMO yand yhas ya yterrible ysinus yinfection. yN ydecides yto ygo ystraight yto yan yEar, yNose yand yThroat yspecialist yfor yan yoffice yvisit. yWhich yof ythe yfollowing yis ymost ylikely yto yoccur? y A: yThe yHMO ywill ycover ythe ydoctor yvisit yfully. B: yThe yHMO ywill ypay yhalf yof ythe yvisit ybecause yit yis yout yof yservice yarea. C: yThe yHMO ywill ypay ythe yclaim yif yN ypays yextra ypremium. D: yN ywill ybe ydeclined yto ybe yseen yby ythe yspecialist yfor ythis yoffice yvisit. y- ycorrect yanswers. yD: yN ywill ybe ydeclined yto ybe yseen yby ythe yspecialist yfor ythis yoffice yvisit. K yhas ya ypolicy ythat ywill ypay ya ylump ysum ytax yfree ybenefit yif yhe yis ydiagnosed yand ythen ysurvives ycancer. yK yhas ya: A: yCritical yIllness yPolicy B: ySpecified yDisease yPlan C: yCancer yPolicy D: yMajor yMedical y- ycorrect yanswers. yA: yCritical yIllness yPolicy J ylet ytheir yhealth ypolicy ylapse. yTo yreinstate ythe ycontract, ythe yinsurer yis yrequiring yJ yto yreapply. yJ ypays ya ynew ypremium ywith ythe yhope ythat yshe ywill yget yher ypolicy yback yinto yforce. yThe yinsurer yhas y______ ydays yfrom yreceipt yto ydeny yreinstatement. y A: y7 B: y10 C: y31 D: y45 y- ycorrect yanswers. yD: y45 Which yof ythe yfollowing ylosses yare yexcluded yunder yminimum ystandard ylaw? A: yhospitalization B: yaccidental yinjuries C: yeye ycare D: yNone yof ythe yAbove y- ycorrect yanswers. yC: yeye ycare If yan yinsured yis ypurchasing ya yLTC ypolicy, yan youtline yof ycoverage ymust ybe ydelivered yby ythe yagent yat: A: ytime yof ysolicitation B: yunderwriting C: ydelivery D: yAny yof ythe yabove y- ycorrect yanswers. yA: ytime yof ysolicitation To ysell ya yLHSO yplan, ya yproducer ymust ybe ylicensed yin: A: yAccident yand yHealth yinsurance