NY Series 17-52 Latest Update 2024-2025 Actual
Exam from Credible Source with 160 Questions
and 100% Verified Detailed Correct Answers
Guaranteed A+ Approved by Professor
A man works for Company A and his wife works for Company B. The spouses are
covered by health plans through their respective companies that also cover the other
spouse. If the husband files a claim, - CORRECT ANSWER: The insurance through his
company is primary.
A medical insurance plan in which the health care provider is paid a regular fixed
amount for providing care to the insured and does not receive additional amounts of
compensation dependent upon the procedure performed is called - CORRECT
ANSWER: Prepaid plan.
A rating method in which the premium is the same for all covered persons, regardless of
age, sex, or health status is referred to as - CORRECT ANSWER: Community rating
An individual applies for a life policy. Two years ago he suffered a head injury from an
accident, so he cannot remember parts of his past, but is otherwise competent. He has
also been hospitalized for drug abuse, but does not remember this when applying for
insurance. The insurer issues the policy and learns of his history one year later. What
will probably happen? - CORRECT ANSWER: The policy will not be affected.
An insured is involved in a car accident. In addition to general, less serious injuries, he
permanently loses the use of his leg and is rendered completely blind. The blindness
improves a month later. To what extent will he receive Presumptive Disability benefits? -
CORRECT ANSWER: No benefits
At what point must an Outline of Coverage be delivered? - CORRECT ANSWER: At the
time of application or upon delivery of the policy
For the purpose of insurance, risk is defined as - CORRECT ANSWER: The uncertainty
or chance of loss.
,How many eligible employees must be included in a contributory health insurance plan?
- CORRECT ANSWER: 50%
If an employee terminates her employment, which of the following provisions would
allow her to continue health coverage under an individual policy, if requested within 60
days? - CORRECT ANSWER: Conversion
If seeking repayment of Medicaid funds per the Medicaid Estate Recovery Act would
cause a hardship to survivors, states may - CORRECT ANSWER: Waive the estate
recovery requirement.
In an HMO policy, one of the main responsibilities of the primary care physician (PCP)
as a gatekeeper is to do which of the following? - CORRECT ANSWER: Help control
costs
In which Medicare supplemental policies are the core benefits found? - CORRECT
ANSWER: All plans
Medicaid provides all of the following benefits EXCEPT - CORRECT ANSWER: Income
assistance for work-related injury.
On a major medical insurance policy, the amount that an insured must pay on a claim
before the insurer will pay is known as - CORRECT ANSWER: Deductible.
Pertaining to insurance, what is the definition of a fiduciary responsibility? - CORRECT
ANSWER: Promptly forwarding premiums to the insurance company
Short term - CORRECT ANSWER: less than 2 years
The insuring clause of a disability policy usually states all of the following EXCEPT -
CORRECT ANSWER: The method of premium payment.
, The Patient Protection and Affordable Care Act includes all of the following provisions
EXCEPT - CORRECT ANSWER: Individual tax deduction for premiums paid.
The purpose of managed care health insurance plans is to - CORRECT ANSWER:
Control health insurance claims expenses.
To attain currently insured status under Social Security, a worker must have earned at
least how many credits during the last 13 quarters? - CORRECT ANSWER: 6 credits
To be eligible under HIPAA regulations, for how long should an individual converting to
an individual health plan have been covered under the previous group plan? -
CORRECT ANSWER: 18 months
Twenty-five days after a health insurance policy is delivered, the policyowner decides
that she would like to return the policy and receive a refund of premium. Which of the
following is true? - CORRECT ANSWER: The policyowner will not receive a refund
because the free-look period is over.
Under the Affordable Care Act, a special enrollment period allows an individual to enroll
in a qualified health plan within how many days of a qualifying event? - CORRECT
ANSWER: 60 days
Under which of the following circumstances may the uniform individual accident and
sickness policy provisions be changed? - CORRECT ANSWER: If the change is more
favorable to the policyholder
Under which of the following disability income plans would the benefits be subject to
income tax? - CORRECT ANSWER: Group
What is the best way to change an application? - CORRECT ANSWER: Start over with
a fresh application
Exam from Credible Source with 160 Questions
and 100% Verified Detailed Correct Answers
Guaranteed A+ Approved by Professor
A man works for Company A and his wife works for Company B. The spouses are
covered by health plans through their respective companies that also cover the other
spouse. If the husband files a claim, - CORRECT ANSWER: The insurance through his
company is primary.
A medical insurance plan in which the health care provider is paid a regular fixed
amount for providing care to the insured and does not receive additional amounts of
compensation dependent upon the procedure performed is called - CORRECT
ANSWER: Prepaid plan.
A rating method in which the premium is the same for all covered persons, regardless of
age, sex, or health status is referred to as - CORRECT ANSWER: Community rating
An individual applies for a life policy. Two years ago he suffered a head injury from an
accident, so he cannot remember parts of his past, but is otherwise competent. He has
also been hospitalized for drug abuse, but does not remember this when applying for
insurance. The insurer issues the policy and learns of his history one year later. What
will probably happen? - CORRECT ANSWER: The policy will not be affected.
An insured is involved in a car accident. In addition to general, less serious injuries, he
permanently loses the use of his leg and is rendered completely blind. The blindness
improves a month later. To what extent will he receive Presumptive Disability benefits? -
CORRECT ANSWER: No benefits
At what point must an Outline of Coverage be delivered? - CORRECT ANSWER: At the
time of application or upon delivery of the policy
For the purpose of insurance, risk is defined as - CORRECT ANSWER: The uncertainty
or chance of loss.
,How many eligible employees must be included in a contributory health insurance plan?
- CORRECT ANSWER: 50%
If an employee terminates her employment, which of the following provisions would
allow her to continue health coverage under an individual policy, if requested within 60
days? - CORRECT ANSWER: Conversion
If seeking repayment of Medicaid funds per the Medicaid Estate Recovery Act would
cause a hardship to survivors, states may - CORRECT ANSWER: Waive the estate
recovery requirement.
In an HMO policy, one of the main responsibilities of the primary care physician (PCP)
as a gatekeeper is to do which of the following? - CORRECT ANSWER: Help control
costs
In which Medicare supplemental policies are the core benefits found? - CORRECT
ANSWER: All plans
Medicaid provides all of the following benefits EXCEPT - CORRECT ANSWER: Income
assistance for work-related injury.
On a major medical insurance policy, the amount that an insured must pay on a claim
before the insurer will pay is known as - CORRECT ANSWER: Deductible.
Pertaining to insurance, what is the definition of a fiduciary responsibility? - CORRECT
ANSWER: Promptly forwarding premiums to the insurance company
Short term - CORRECT ANSWER: less than 2 years
The insuring clause of a disability policy usually states all of the following EXCEPT -
CORRECT ANSWER: The method of premium payment.
, The Patient Protection and Affordable Care Act includes all of the following provisions
EXCEPT - CORRECT ANSWER: Individual tax deduction for premiums paid.
The purpose of managed care health insurance plans is to - CORRECT ANSWER:
Control health insurance claims expenses.
To attain currently insured status under Social Security, a worker must have earned at
least how many credits during the last 13 quarters? - CORRECT ANSWER: 6 credits
To be eligible under HIPAA regulations, for how long should an individual converting to
an individual health plan have been covered under the previous group plan? -
CORRECT ANSWER: 18 months
Twenty-five days after a health insurance policy is delivered, the policyowner decides
that she would like to return the policy and receive a refund of premium. Which of the
following is true? - CORRECT ANSWER: The policyowner will not receive a refund
because the free-look period is over.
Under the Affordable Care Act, a special enrollment period allows an individual to enroll
in a qualified health plan within how many days of a qualifying event? - CORRECT
ANSWER: 60 days
Under which of the following circumstances may the uniform individual accident and
sickness policy provisions be changed? - CORRECT ANSWER: If the change is more
favorable to the policyholder
Under which of the following disability income plans would the benefits be subject to
income tax? - CORRECT ANSWER: Group
What is the best way to change an application? - CORRECT ANSWER: Start over with
a fresh application
