Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
SECTION 3 - TEXAS ACCIDENT AND HEALTH LAW - Correct Answer :>>>
✔✔SECTION 3 - TEXAS ACCIDENT AND HEALTH LAW
1) Under the Health Insurance Portability and Accountability Act (HIPAA), group
medical expense coverage is 'portable' from one group to another group
without any new probationary period as long as there is no gap in coverage
more than ____ days: - Correct Answer :>>> ✔✔A- 10
B- 31
C- 63
D- 20
2) In a Family Health policy, coverage for a newborn child commences: - Correct
Answer :>>> ✔✔A- When the insurer receives written or oral notice of the
birth
B- 24 hours after birth
C- Three days from the date of birth
D- At the instant of birth
3) When two Group Medical Expense insurance polices provide coverage for the
same claim, one policy is considered to be primary and the other policy is
considered to be excess under the ___________________________________
clause: - Correct Answer :>>> ✔✔A- Relation of earnings to insurance
B- Pro-rata liability
C- Other insurance
Page 1 of 107
,Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
D- Coordination of Benefits
4) On a Medicare Supplement policy, what is the maximum probationary period
before the insurer must cover pre-existing conditions: - Correct Answer :>>>
✔✔A- Three months
B- 24 months
C- Six months
D- 12 months
5) Historically, the definition of a Small Employer under Texas's Small Group
Health law is one who has at least _____ employee(s) but not more than _____
employees on a typical business day during the course of any one calendar year:
- Correct Answer :>>> ✔✔A- Three / 75
B- Two / 50
C- One / 49
D- Five / 99
6) Group Medical Expense Health insurance policies must cover newly born and
newly adopted children for at least ____ days: - Correct Answer :>>> ✔✔A- 15
B- 61
C- 31
D- 10
Page 2 of 107
,Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
7) The Coordination of Benefits clause in group health insurance indicates: -
Correct Answer :>>> ✔✔A- How the insurer will coordinate with the hospital
B- That when two policies are in force, one will be primary and one will be
excess
C- How the insurer will coordinate with the doctor
D- That when two policies are in force, they will share the claim equally
8) Prior to implemenation of the PPACA, to avoid a new probationary period
when replacing health insurance coverage, an individual should have prior
"creditable coverage" for at least _______ months. - Correct Answer :>>>
✔✔A- 24 months
B- 6 months
C- 18 months
D- 12 months
9) On Group Health insurance, state law may regulate all of the following
EXCEPT: - Correct Answer :>>> ✔✔A- The grace period
B- COBRA continuation requirements
C- Participation requirements
D- Small group eligibility requirements
10) All of the following are true about large employer Group Medical Expense
plans EXCEPT: - Correct Answer :>>> ✔✔A- The limiting age of an unmarried
child of an enrollee is age 21
Page 3 of 107
, Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
B- Unmarried grandchildren of the insured under age 26 may be covered, if
dependent
C- They may not limit or exclude initial coverage of a newborn or adopted child
in any way
D- They must provide coverage for drug and alcohol treatment in the same
manner as they cover any other illness
11) Long Term Care Insurance is an Individual or Group Insurance policy
designed to provide coverage for at least ______ months for custodial care
services provided in a setting other than an acute care unit of a hospital. -
Correct Answer :>>> ✔✔A- 6 months
B- 18 months
C- 24 months
D- 12 months
12) A long-term care policy sold in this state must be Guaranteed renewable: -
Correct Answer :>>> ✔✔A- For life
B- To age 75
C- To age 85
D- To age 65
13) All of the following are true about Skilled Nursing Home Care under
Medicare EXCEPT: - Correct Answer :>>> ✔✔A- It is subject to co-insurance
B- It is covered under Part B
Page 4 of 107
Accident & Health Practice Test – 300 Q&A
Bank.
SECTION 3 - TEXAS ACCIDENT AND HEALTH LAW - Correct Answer :>>>
✔✔SECTION 3 - TEXAS ACCIDENT AND HEALTH LAW
1) Under the Health Insurance Portability and Accountability Act (HIPAA), group
medical expense coverage is 'portable' from one group to another group
without any new probationary period as long as there is no gap in coverage
more than ____ days: - Correct Answer :>>> ✔✔A- 10
B- 31
C- 63
D- 20
2) In a Family Health policy, coverage for a newborn child commences: - Correct
Answer :>>> ✔✔A- When the insurer receives written or oral notice of the
birth
B- 24 hours after birth
C- Three days from the date of birth
D- At the instant of birth
3) When two Group Medical Expense insurance polices provide coverage for the
same claim, one policy is considered to be primary and the other policy is
considered to be excess under the ___________________________________
clause: - Correct Answer :>>> ✔✔A- Relation of earnings to insurance
B- Pro-rata liability
C- Other insurance
Page 1 of 107
,Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
D- Coordination of Benefits
4) On a Medicare Supplement policy, what is the maximum probationary period
before the insurer must cover pre-existing conditions: - Correct Answer :>>>
✔✔A- Three months
B- 24 months
C- Six months
D- 12 months
5) Historically, the definition of a Small Employer under Texas's Small Group
Health law is one who has at least _____ employee(s) but not more than _____
employees on a typical business day during the course of any one calendar year:
- Correct Answer :>>> ✔✔A- Three / 75
B- Two / 50
C- One / 49
D- Five / 99
6) Group Medical Expense Health insurance policies must cover newly born and
newly adopted children for at least ____ days: - Correct Answer :>>> ✔✔A- 15
B- 61
C- 31
D- 10
Page 2 of 107
,Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
7) The Coordination of Benefits clause in group health insurance indicates: -
Correct Answer :>>> ✔✔A- How the insurer will coordinate with the hospital
B- That when two policies are in force, one will be primary and one will be
excess
C- How the insurer will coordinate with the doctor
D- That when two policies are in force, they will share the claim equally
8) Prior to implemenation of the PPACA, to avoid a new probationary period
when replacing health insurance coverage, an individual should have prior
"creditable coverage" for at least _______ months. - Correct Answer :>>>
✔✔A- 24 months
B- 6 months
C- 18 months
D- 12 months
9) On Group Health insurance, state law may regulate all of the following
EXCEPT: - Correct Answer :>>> ✔✔A- The grace period
B- COBRA continuation requirements
C- Participation requirements
D- Small group eligibility requirements
10) All of the following are true about large employer Group Medical Expense
plans EXCEPT: - Correct Answer :>>> ✔✔A- The limiting age of an unmarried
child of an enrollee is age 21
Page 3 of 107
, Texas General Lines Insurance Exam | Life,
Accident & Health Practice Test – 300 Q&A
Bank.
B- Unmarried grandchildren of the insured under age 26 may be covered, if
dependent
C- They may not limit or exclude initial coverage of a newborn or adopted child
in any way
D- They must provide coverage for drug and alcohol treatment in the same
manner as they cover any other illness
11) Long Term Care Insurance is an Individual or Group Insurance policy
designed to provide coverage for at least ______ months for custodial care
services provided in a setting other than an acute care unit of a hospital. -
Correct Answer :>>> ✔✔A- 6 months
B- 18 months
C- 24 months
D- 12 months
12) A long-term care policy sold in this state must be Guaranteed renewable: -
Correct Answer :>>> ✔✔A- For life
B- To age 75
C- To age 85
D- To age 65
13) All of the following are true about Skilled Nursing Home Care under
Medicare EXCEPT: - Correct Answer :>>> ✔✔A- It is subject to co-insurance
B- It is covered under Part B
Page 4 of 107
