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Ohio Health and Life Insurance Exam QUESTIONS
AND CORRECT DETAILED SOLUTIONS LATEST
UPDATED VERSION JUST RELEASED
Question: Consider a situation where an employee, aged 66, is covered by both Medicare and
his employers group health plan. In managing a claim, how should there benefits be
coordinated to effectively utilize the coverage provided by both Medicare and the employers
plan, ensuring the most efficient payment process - ANSWER✔✔Medicare is the secondary
payer
Question: If an employer and an employee are sharing a $5,000 medical claim. The employer
covers 70% of the claim, while the employee covers the remaining 30%. Which of the following
statements is true regarding an employee's contributions to health insurance premiums. -
ANSWER✔✔The employee's contribution of $1,500 (30%) can be made with pre-tax dollars if
using an HSA or FSA
Question: The contract terminology that states a policy must have a benefit payment is -
ANSWER✔✔aleatory
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Question: What statement about Health Insurance Corporations is not true -
ANSWER✔✔Benefits are provided on a reimbursement basis
Question: Which of the following would commonly be excluded in a health policy -
ANSWER✔✔Self-Inflicted Injuries
Question: What type of policy would cover 1 of 2 business owners by paying small payments
over time, then a lump sum when they do not go back to work? - ANSWER✔✔Buy-Sell
Question: LTC policies in Ohio are required to include which feature - ANSWER✔✔Non-
forfeiture value
Question: A type of long term care that requires intermediate care is known as -
ANSWER✔✔Intermediate Care
Question: Community Rating on health plans are distinguished by Experience rating due to -
ANSWER✔✔The claims of similar and like people within the area
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Question: LTC suitability will not use which of the following - ANSWER✔✔The insureds physical
status for occupational work
Question: What is it called when an insurer only chooses to do business with higher risks
individuals - ANSWER✔✔Adverse Selection
Question: Which of the following best describes reinsurance - ANSWER✔✔Insurer transferring
risk to another insurer
Q:Which of the following best describes a mutual insurer - ANSWER✔✔The policyholders
receive a refund of overpayments in premiums
Question: The monthly benefit for an individual disability income policy is typically limited to a
percentage of the insureds income to avoid: - ANSWER✔✔Over insurance
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Question: Long term care policies will be offered by a producer with which option -
ANSWER✔✔A refund option
Question: HMO's will provide care in which scenario? - ANSWER✔✔Out-of-network
emergencies
Question: For members of a Health Insuring Corporation who are they required to se for all
non emergencies - ANSWER✔✔Primary Care Physician
Question: If Thomas works for an employer who offers an HRA who is the party that funds the
HRA - ANSWER✔✔Employer
Question: Which of these is not a valid form of risk management - ANSWER✔✔Transforming
Question: A whole new life policy has required - ANSWER✔✔Entire Contract
Ohio Health and Life Insurance Exam QUESTIONS
AND CORRECT DETAILED SOLUTIONS LATEST
UPDATED VERSION JUST RELEASED
Question: Consider a situation where an employee, aged 66, is covered by both Medicare and
his employers group health plan. In managing a claim, how should there benefits be
coordinated to effectively utilize the coverage provided by both Medicare and the employers
plan, ensuring the most efficient payment process - ANSWER✔✔Medicare is the secondary
payer
Question: If an employer and an employee are sharing a $5,000 medical claim. The employer
covers 70% of the claim, while the employee covers the remaining 30%. Which of the following
statements is true regarding an employee's contributions to health insurance premiums. -
ANSWER✔✔The employee's contribution of $1,500 (30%) can be made with pre-tax dollars if
using an HSA or FSA
Question: The contract terminology that states a policy must have a benefit payment is -
ANSWER✔✔aleatory
, Page 2 of 135
Question: What statement about Health Insurance Corporations is not true -
ANSWER✔✔Benefits are provided on a reimbursement basis
Question: Which of the following would commonly be excluded in a health policy -
ANSWER✔✔Self-Inflicted Injuries
Question: What type of policy would cover 1 of 2 business owners by paying small payments
over time, then a lump sum when they do not go back to work? - ANSWER✔✔Buy-Sell
Question: LTC policies in Ohio are required to include which feature - ANSWER✔✔Non-
forfeiture value
Question: A type of long term care that requires intermediate care is known as -
ANSWER✔✔Intermediate Care
Question: Community Rating on health plans are distinguished by Experience rating due to -
ANSWER✔✔The claims of similar and like people within the area
, Page 3 of 135
Question: LTC suitability will not use which of the following - ANSWER✔✔The insureds physical
status for occupational work
Question: What is it called when an insurer only chooses to do business with higher risks
individuals - ANSWER✔✔Adverse Selection
Question: Which of the following best describes reinsurance - ANSWER✔✔Insurer transferring
risk to another insurer
Q:Which of the following best describes a mutual insurer - ANSWER✔✔The policyholders
receive a refund of overpayments in premiums
Question: The monthly benefit for an individual disability income policy is typically limited to a
percentage of the insureds income to avoid: - ANSWER✔✔Over insurance
, Page 4 of 135
Question: Long term care policies will be offered by a producer with which option -
ANSWER✔✔A refund option
Question: HMO's will provide care in which scenario? - ANSWER✔✔Out-of-network
emergencies
Question: For members of a Health Insuring Corporation who are they required to se for all
non emergencies - ANSWER✔✔Primary Care Physician
Question: If Thomas works for an employer who offers an HRA who is the party that funds the
HRA - ANSWER✔✔Employer
Question: Which of these is not a valid form of risk management - ANSWER✔✔Transforming
Question: A whole new life policy has required - ANSWER✔✔Entire Contract
