Pearson Vue National Health Insurance
Practice Test/ Quizzes & Correct Ans.
An insurer must provide claim forms to an insured within a MAXIMUM of how many days after
receiving notice of an Accident & Health claim?
A. Five
B. Fifteen
C. Twenty
D. Thirty - Answer: b
Under a group health plan, an employer may offer additional benefits to classes of employees
on the basis of all of the following factors EXCEPT:
A. length of employment
B. gender
C. salary grade
Page 1 of 16
,D. job category - Answer: b
Which of the following statements is CORRECT about a Waiver of Premium provision in a
Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's benefit payments.
B. It allows the insurer to increase the amount of premium during the insured's time of
disability.
C. It allows the insured to extend the length of the Grace Period while disabled.
D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums.
- Answer: d
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following
policy features?
A. Extensions of coverage
B. Benefits clause
C. Riders
D. Exclusions - Answer: d
An insured becomes disabled three years after his Disability Income policy is issued. The
disability is caused by a condition that existed prior to the policy issue date but was not
specifically excluded from coverage. In this situation, the insurer will most likely take which of
the following actions?
A. Pay the full claim
B. Pay the claim for a maximum of six months only
C. Deny the claim on the basis of misrepresentation
D. Deny the claim because it involves a pre-existing condition - Answer: a
Page 2 of 16
, A health care plan that reimburses a flat fee for medical care it provides at a clinic it owns and
operates is referred to as:
A. Health Maintenance Organization
B. Medicaid
C. Medicare
D. Multiple Employer Trust (MET) - Answer: a
Which of the following laws requires an insurer to notify an applicant in writing that an
investigative consumer report may be made on the applicant?
A. Uniform Provisions Law
B. Freedom of Information Act
C. Medical Information Bureau Disclosure Act
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) - Answer: d
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
A.increase the premium rate for one insured without increasing the rate for others in the same
class
A. increase the premium rate for one insured without increasing the rate for others in the same
class
B. increase the premium rate for an entire class of insureds
C. increase the benefits for an individual insured
D. decrease benefits for one insured without decreasing benefits for others in the same class -
Answer: d
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
Page 3 of 16
Practice Test/ Quizzes & Correct Ans.
An insurer must provide claim forms to an insured within a MAXIMUM of how many days after
receiving notice of an Accident & Health claim?
A. Five
B. Fifteen
C. Twenty
D. Thirty - Answer: b
Under a group health plan, an employer may offer additional benefits to classes of employees
on the basis of all of the following factors EXCEPT:
A. length of employment
B. gender
C. salary grade
Page 1 of 16
,D. job category - Answer: b
Which of the following statements is CORRECT about a Waiver of Premium provision in a
Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's benefit payments.
B. It allows the insurer to increase the amount of premium during the insured's time of
disability.
C. It allows the insured to extend the length of the Grace Period while disabled.
D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums.
- Answer: d
Suicide, pre-existing conditions and self-inflicted injuries are dealt with in which of the following
policy features?
A. Extensions of coverage
B. Benefits clause
C. Riders
D. Exclusions - Answer: d
An insured becomes disabled three years after his Disability Income policy is issued. The
disability is caused by a condition that existed prior to the policy issue date but was not
specifically excluded from coverage. In this situation, the insurer will most likely take which of
the following actions?
A. Pay the full claim
B. Pay the claim for a maximum of six months only
C. Deny the claim on the basis of misrepresentation
D. Deny the claim because it involves a pre-existing condition - Answer: a
Page 2 of 16
, A health care plan that reimburses a flat fee for medical care it provides at a clinic it owns and
operates is referred to as:
A. Health Maintenance Organization
B. Medicaid
C. Medicare
D. Multiple Employer Trust (MET) - Answer: a
Which of the following laws requires an insurer to notify an applicant in writing that an
investigative consumer report may be made on the applicant?
A. Uniform Provisions Law
B. Freedom of Information Act
C. Medical Information Bureau Disclosure Act
D. Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) - Answer: d
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
A.increase the premium rate for one insured without increasing the rate for others in the same
class
A. increase the premium rate for one insured without increasing the rate for others in the same
class
B. increase the premium rate for an entire class of insureds
C. increase the benefits for an individual insured
D. decrease benefits for one insured without decreasing benefits for others in the same class -
Answer: d
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
Page 3 of 16
