LIFE, ACCIDENT AND HEALTH OR SICKNESS EXAMINATION
LATEST ACTUAL EXAM
What is the feature that limits the amount of money that an insured has to pay out
of pocket once he has paid a certain amount under the coinsurance clause? -
ANSWER: Stop Loss
The deductible that an insured has to pay before benefits begin to be paid by the
insurer in a major medical policy is known as the - ANSWER: Initial Deductible
How is coinsurance in an individual health policy regulated?
a. The insured can change the rates as long as they wish
b. There are no regulations
c. The insurer can change the rates as long as they don't exceed 25%
d. The insurer must leave the rate after the first year but not to exceed 25% -
ANSWER: b. There are no regulations
Group medical expense policies must cover all of the following except:
a. Maternity benefits
b. Chemical dependency
c. Mental illness
d. Work related injuries covered under Workers' Compensation - ANSWER: d. Work
related injuries covered under Workers' Compensation
Regardless of your expenses, this policy pays a flat amount per day in the hospital.
What is it called?
a. Major Medical
b. Hospital Expense Plan
c. Universal Life
d. Hospital Indemnity or Hospital Income Plan - ANSWER: d. Hospital Indemnity or
Hospital Income Plan
Pre-admission certification is a cost control method which is one of the ways that an
insurer can contain premium costs under what type of provisions?
a. Gate Keeping
b. Subrogation
c. Case Management
d. Closed Panel - ANSWER: c. Case Management
What is the feature found in a major medical policy that replaces a certain amount of
coverage each year lost as a result of a claim?
a. Stop-Loss
b. Family Deductible
c. Cost of Living
d. Restoration of benefits - ANSWER: d. Restoration of benefits
, Which of the following is usually covered as a basic hospital miscellaneous expense?
a. Doctor visits
b. Home health care
c. Surgical expense
d. Operating room charges - ANSWER: d. Operating room charges
A major medical insurance policy would cover expenses for all of the following
except:
a. Doctor's fees for an operation
b. Charges covered under Workers' Compensation Insurance
c. Hospital room and board charges
d. Charges for cosmetic surgery necessitated by an accident - ANSWER: b. Charges
covered under Workers' Compensation Insurance
In a major medical policy, what limits the amount of total deductible on a per person
deductible policy?
a. Coinsurance
b. Corridor Deductible
c. Common Accident limit
d. Family Deductible limit - ANSWER: d. Family Deductible limit
Common exclusions on health policies include all of the following except:
a. Expenses covered under Workers' Compensation
b. Cosmetic surgery unless necessitated by an accident
c. Expenses incurred while in a government owned or operated hospital
d. Injury which occurred while being held hostage during a bank robbery - ANSWER:
d. Injury which occurred while being held hostage during a bank robbery
After the basic benefits are exhausted, the corridor deductible must be paid before
the benefits of what coverage becomes payable?
a. Basic Hospital
b. Basis Surgical
c. Basic Medical
d. Major Medical - ANSWER: d. Major Medical
If a disability is treated as a recurrence, the insured:
a. Has to satisfy the elimination period again but has an entire benefit period
available to receive benefits
b. Does not have to satisfy the elimination period again but only has whatever time
was left on the benefit period
c. Has to satisfy the elimination period again and only has whatever time was left on
the benefit period
d. Does not have to satisfy the elimination period again and has the entire benefit
period available to receive benefits - ANSWER: b. Does not have to satisfy the
elimination period again but only has whatever time was left on the benefit period
LATEST ACTUAL EXAM
What is the feature that limits the amount of money that an insured has to pay out
of pocket once he has paid a certain amount under the coinsurance clause? -
ANSWER: Stop Loss
The deductible that an insured has to pay before benefits begin to be paid by the
insurer in a major medical policy is known as the - ANSWER: Initial Deductible
How is coinsurance in an individual health policy regulated?
a. The insured can change the rates as long as they wish
b. There are no regulations
c. The insurer can change the rates as long as they don't exceed 25%
d. The insurer must leave the rate after the first year but not to exceed 25% -
ANSWER: b. There are no regulations
Group medical expense policies must cover all of the following except:
a. Maternity benefits
b. Chemical dependency
c. Mental illness
d. Work related injuries covered under Workers' Compensation - ANSWER: d. Work
related injuries covered under Workers' Compensation
Regardless of your expenses, this policy pays a flat amount per day in the hospital.
What is it called?
a. Major Medical
b. Hospital Expense Plan
c. Universal Life
d. Hospital Indemnity or Hospital Income Plan - ANSWER: d. Hospital Indemnity or
Hospital Income Plan
Pre-admission certification is a cost control method which is one of the ways that an
insurer can contain premium costs under what type of provisions?
a. Gate Keeping
b. Subrogation
c. Case Management
d. Closed Panel - ANSWER: c. Case Management
What is the feature found in a major medical policy that replaces a certain amount of
coverage each year lost as a result of a claim?
a. Stop-Loss
b. Family Deductible
c. Cost of Living
d. Restoration of benefits - ANSWER: d. Restoration of benefits
, Which of the following is usually covered as a basic hospital miscellaneous expense?
a. Doctor visits
b. Home health care
c. Surgical expense
d. Operating room charges - ANSWER: d. Operating room charges
A major medical insurance policy would cover expenses for all of the following
except:
a. Doctor's fees for an operation
b. Charges covered under Workers' Compensation Insurance
c. Hospital room and board charges
d. Charges for cosmetic surgery necessitated by an accident - ANSWER: b. Charges
covered under Workers' Compensation Insurance
In a major medical policy, what limits the amount of total deductible on a per person
deductible policy?
a. Coinsurance
b. Corridor Deductible
c. Common Accident limit
d. Family Deductible limit - ANSWER: d. Family Deductible limit
Common exclusions on health policies include all of the following except:
a. Expenses covered under Workers' Compensation
b. Cosmetic surgery unless necessitated by an accident
c. Expenses incurred while in a government owned or operated hospital
d. Injury which occurred while being held hostage during a bank robbery - ANSWER:
d. Injury which occurred while being held hostage during a bank robbery
After the basic benefits are exhausted, the corridor deductible must be paid before
the benefits of what coverage becomes payable?
a. Basic Hospital
b. Basis Surgical
c. Basic Medical
d. Major Medical - ANSWER: d. Major Medical
If a disability is treated as a recurrence, the insured:
a. Has to satisfy the elimination period again but has an entire benefit period
available to receive benefits
b. Does not have to satisfy the elimination period again but only has whatever time
was left on the benefit period
c. Has to satisfy the elimination period again and only has whatever time was left on
the benefit period
d. Does not have to satisfy the elimination period again and has the entire benefit
period available to receive benefits - ANSWER: b. Does not have to satisfy the
elimination period again but only has whatever time was left on the benefit period
