Page 1 of 74
COLORADO LIFE & HEALTH INSURANCE EXAMS |
( NEW UPDATES) STUDY BUNDLE WITH
COMPLETE SOLUTIONS | QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A
utilization review .....ANSWER.....a set of formal techniques to
monitor the use or clinical necessity of health care, determining
the application of exclusions, and the medical necessity of
treatment.
30 days for electronic; 45 days for paper .....ANSWER.....With a
clean claim, the insured has ? days for paying or denying
electronic and ? days for paper claims.
Enforces .....ANSWER.....The Commissioner ______ laws and does
not create them.
5 years .....ANSWER.....Every ____ years, a licensed insurer must
be examined by the state commissioner.
,Page 2 of 74
Adverse selection .....ANSWER.....What is a major concern for
Underwriters, especially during the open enrollment period?
Conversion privilege .....ANSWER.....Allows individual policy
conversion upon plan group termination
Non-taxable .....ANSWER.....Benefits are taxable or non-taxable
(?) to employees.
20 .....ANSWER.....Employers with ___ + employees are required
to offer COBRA for up to 18 months after an employee is
terminated.
Master policy .....ANSWER.....In group health insurance a ______
type of policy is issued to the group sponsor.
Impairment rider .....ANSWER.....Temporary or permanent rider
added to a policy that includes specific conditions which would
normally cause a policy to be declined.
,Page 3 of 74
Free Look Period .....ANSWER.....The period of time for the
insured to look over a policy after it is issued (10 days for health
insurance, 15 for life)
Class .....ANSWER.....The guaranteed renewable provision states
that premiums can only be increased by _________.
Legal Actions Provision .....ANSWER.....The ___________ states
that one has 60 days after proof of loss with a 2-year limit on
certain defenses.
Insurers .....ANSWER.....The insuring clause includes
____________'s promise to pay benefits.
Proof of loss provision .....ANSWER.....This provision states that the
insured must provide proof of loss within 90 days, up to a 1-year
maximum.
elimination period .....ANSWER.....waiting period after a loss
occurs before benefit period begins (30, 90 days, up to 1 year)
, Page 4 of 74
Part C .....ANSWER.....Medicare Advantage plan, substitution for
original benefits (A & B)
Medicare Part A .....ANSWER.....Hospital insurance, covers
inpatient and hospice
Medicare Part B .....ANSWER.....Outpatient treatment, ER
treatment, preventive care is looped under Part ___
Supplement Part A .....ANSWER.....Also known as Medigap, this
part covers core benefits, including hospice care; premiums vary.
Guaranteed Insurability Rider .....ANSWER.....Optional rider that
enables the policyowner to purchase additional amounts of
coverage at predetermined times without proof of insurability
Accidental Death Benefit Rider .....ANSWER.....doubles the face
amount of life insurance if death occurs as a result of an accident
Term Insurance Rider .....ANSWER.....Often added to a whole life
policy to increase coverage.
COLORADO LIFE & HEALTH INSURANCE EXAMS |
( NEW UPDATES) STUDY BUNDLE WITH
COMPLETE SOLUTIONS | QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A
utilization review .....ANSWER.....a set of formal techniques to
monitor the use or clinical necessity of health care, determining
the application of exclusions, and the medical necessity of
treatment.
30 days for electronic; 45 days for paper .....ANSWER.....With a
clean claim, the insured has ? days for paying or denying
electronic and ? days for paper claims.
Enforces .....ANSWER.....The Commissioner ______ laws and does
not create them.
5 years .....ANSWER.....Every ____ years, a licensed insurer must
be examined by the state commissioner.
,Page 2 of 74
Adverse selection .....ANSWER.....What is a major concern for
Underwriters, especially during the open enrollment period?
Conversion privilege .....ANSWER.....Allows individual policy
conversion upon plan group termination
Non-taxable .....ANSWER.....Benefits are taxable or non-taxable
(?) to employees.
20 .....ANSWER.....Employers with ___ + employees are required
to offer COBRA for up to 18 months after an employee is
terminated.
Master policy .....ANSWER.....In group health insurance a ______
type of policy is issued to the group sponsor.
Impairment rider .....ANSWER.....Temporary or permanent rider
added to a policy that includes specific conditions which would
normally cause a policy to be declined.
,Page 3 of 74
Free Look Period .....ANSWER.....The period of time for the
insured to look over a policy after it is issued (10 days for health
insurance, 15 for life)
Class .....ANSWER.....The guaranteed renewable provision states
that premiums can only be increased by _________.
Legal Actions Provision .....ANSWER.....The ___________ states
that one has 60 days after proof of loss with a 2-year limit on
certain defenses.
Insurers .....ANSWER.....The insuring clause includes
____________'s promise to pay benefits.
Proof of loss provision .....ANSWER.....This provision states that the
insured must provide proof of loss within 90 days, up to a 1-year
maximum.
elimination period .....ANSWER.....waiting period after a loss
occurs before benefit period begins (30, 90 days, up to 1 year)
, Page 4 of 74
Part C .....ANSWER.....Medicare Advantage plan, substitution for
original benefits (A & B)
Medicare Part A .....ANSWER.....Hospital insurance, covers
inpatient and hospice
Medicare Part B .....ANSWER.....Outpatient treatment, ER
treatment, preventive care is looped under Part ___
Supplement Part A .....ANSWER.....Also known as Medigap, this
part covers core benefits, including hospice care; premiums vary.
Guaranteed Insurability Rider .....ANSWER.....Optional rider that
enables the policyowner to purchase additional amounts of
coverage at predetermined times without proof of insurability
Accidental Death Benefit Rider .....ANSWER.....doubles the face
amount of life insurance if death occurs as a result of an accident
Term Insurance Rider .....ANSWER.....Often added to a whole life
policy to increase coverage.
