NV Health Final Exam 1 Questions With
Complete Solutions Graded A+
Which law requires the applicant be notified before a consumer report is ordered: -
CORRECT ANSWER-Fair Credit Reporting Act
The Insuring Clause of an A&H policy usually states all of the following, EXCEPT:
A. That insurance against loss is provided
B. That a loss must result directly from stated accidents or sicknesses
C. The method of premium payment
D. The identities of the insurance company and the insured - CORRECT ANSWER-C.
The method of premium payment
Which of the following statements about Medicare is/are true?
I. Payments are made directly to the hospital providing services rather than to the
insured
II. Benefits can continue beyond the hospitalization period - CORRECT ANSWER-
Correct Answer: Both I and II
The Misstatement of Age provision gives the insurance company the right to:
A. Bring suit for fraud
B. Cancel the contract
C. Adjust benefits payable
D. Reduce dividends payable - CORRECT ANSWER-C. Adjust benefits payable
,Which of the following statements about group A&H provisions and practices is/are
true?
I. Insurance company practices are generally less liberal under Group policies than
under Individual policies
II. Experience rating is generally utilized under Group policies - CORRECT ANSWER-
Correct Answer: II only
A&H insurance provides coverage for sickness and injury that includes which of the
following benefits?
I. Income benefits due to loss of time from work
II. Benefit payments for hospital care - CORRECT ANSWER-Correct Answer: Both I
and II
Explanation:
There are three different types of A&H insurance: 1) Medical Expense; 2) Disability
Income and 3) AD&D. A&H is a general term including all three types.
The part of a HMO policy, which provides for the claim to be shared between the insurer
and the insured, is known as which of the following?
A. Deductible
B. Out of pocket maximum
C. Co-pay
D. Usual, customary and reasonable - CORRECT ANSWER-C. Co-pay
, Answers given by applicants to questions on applications for A&H insurance are
considered which of the following?
I. Representations
II. Warranties - CORRECT ANSWER-I only - - Representations
A&H coverage becomes effective when the:
A. First premium has been paid and received in the insurance company's home office
B. First premium has been paid and the application has been approved
C. Producer delivers the policy to the insured
D. Medical examination has been completed and the premium paid - CORRECT
ANSWER-B. First premium has been paid and the application has been approved
Which of the following policies can be written on a Non-cancelable and Guaranteed
Renewable basis?
I. A Major Medical Expense policy
II. A Disability Income policy - CORRECT ANSWER-II only - A Disability Income policy
Explanation:
Major Medical policies are cancelable, meaning the insurer may cancel you at any time
with proper advance notice. AD&D and Disability Income policies often voluntarily give
up the right to cancel as a marketing strategy and may be non-cancelable, guaranteed
renewable or both.
An optionally renewable policy is renewable:
A. If a physical exam is passed
B. At the option of the insured
Complete Solutions Graded A+
Which law requires the applicant be notified before a consumer report is ordered: -
CORRECT ANSWER-Fair Credit Reporting Act
The Insuring Clause of an A&H policy usually states all of the following, EXCEPT:
A. That insurance against loss is provided
B. That a loss must result directly from stated accidents or sicknesses
C. The method of premium payment
D. The identities of the insurance company and the insured - CORRECT ANSWER-C.
The method of premium payment
Which of the following statements about Medicare is/are true?
I. Payments are made directly to the hospital providing services rather than to the
insured
II. Benefits can continue beyond the hospitalization period - CORRECT ANSWER-
Correct Answer: Both I and II
The Misstatement of Age provision gives the insurance company the right to:
A. Bring suit for fraud
B. Cancel the contract
C. Adjust benefits payable
D. Reduce dividends payable - CORRECT ANSWER-C. Adjust benefits payable
,Which of the following statements about group A&H provisions and practices is/are
true?
I. Insurance company practices are generally less liberal under Group policies than
under Individual policies
II. Experience rating is generally utilized under Group policies - CORRECT ANSWER-
Correct Answer: II only
A&H insurance provides coverage for sickness and injury that includes which of the
following benefits?
I. Income benefits due to loss of time from work
II. Benefit payments for hospital care - CORRECT ANSWER-Correct Answer: Both I
and II
Explanation:
There are three different types of A&H insurance: 1) Medical Expense; 2) Disability
Income and 3) AD&D. A&H is a general term including all three types.
The part of a HMO policy, which provides for the claim to be shared between the insurer
and the insured, is known as which of the following?
A. Deductible
B. Out of pocket maximum
C. Co-pay
D. Usual, customary and reasonable - CORRECT ANSWER-C. Co-pay
, Answers given by applicants to questions on applications for A&H insurance are
considered which of the following?
I. Representations
II. Warranties - CORRECT ANSWER-I only - - Representations
A&H coverage becomes effective when the:
A. First premium has been paid and received in the insurance company's home office
B. First premium has been paid and the application has been approved
C. Producer delivers the policy to the insured
D. Medical examination has been completed and the premium paid - CORRECT
ANSWER-B. First premium has been paid and the application has been approved
Which of the following policies can be written on a Non-cancelable and Guaranteed
Renewable basis?
I. A Major Medical Expense policy
II. A Disability Income policy - CORRECT ANSWER-II only - A Disability Income policy
Explanation:
Major Medical policies are cancelable, meaning the insurer may cancel you at any time
with proper advance notice. AD&D and Disability Income policies often voluntarily give
up the right to cancel as a marketing strategy and may be non-cancelable, guaranteed
renewable or both.
An optionally renewable policy is renewable:
A. If a physical exam is passed
B. At the option of the insured
