Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024), Exams of Nursing

Download Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) and more Exams Nursing in PDF only on Docsity! Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Which of the following laws requires an insurer to notify an applicant in writing that an investigative consumer report may be made on the applicant? -Uniform Provisions Law. -Freedom of Information Act. -Medical Information Bureau Disclosure Act -Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) - Correct Answer ✅Fair Credit Reporting Act (Insurance Information and Privacy Protection Act) Group health insurance specifies that what percentage of eligible individuals MUST be offered coverage under a noncontributory plan? -25 -50 -75 -100 - Correct Answer ✅100 Under an Accidental Death and Dismemberment (AD&D) policy, insurable interest must exist at which of the following times? Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -When a change of beneficiary is requested -At the inception of the policy -When a beneficiary other than a relative is named -At the time a claim is submitted - Correct Answer ✅At the inception of the policy When periodic claim payments are required under a long-term disability income policy, an insurer MUST make payments to an insured at least once every: -month -three months -six months -year - Correct Answer ✅month M and N own a small interior design studio that employs six people. The owners are concerned about the financial continuation of the business if either of them should become permanently disabled. In this situation, a producer would MOST likely recommend which of the following types of contracts? Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) When delivering a policy to a client, a producer should take all of the following actions EXCEPT: -Collect any premiums due -fully explain all exclusions and/or riders -keep the policy in the producer's office for safe-keeping on behalf of the client -review all benefits provided by the policy - Correct Answer ✅keep the policy in the producer's office for safe-keeping on behalf of the client The Social Security program provides all of the following benefits EXCEPT: -Retirement -survivor -disability -workers compensation - Correct Answer ✅workers compensation Which of the following definitions MOST accurately describes the Probationary Period? -The period of time from the date of the loss until the benefits begin Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -The period of time from the date of the loss until benefits are actually received by the policyowner -The waiting period a new hire must satisfy prior to becoming eligible for group health coverage -The period of time once a claim is received by the insurance company before it pays benefits to the policyowner - Correct Answer ✅The waiting period a new hire must satisfy prior to becoming eligible for group health coverage Under a group health plan, an employer may offer additional benefits to classes of employees on the basis of all of the following factors EXCEPT: -length of employment -gender -salary grade -job category - Correct Answer ✅gender An insured becomes disabled three years after his Disability Income policy is issued. The disability is caused by a condition that existed prior to the policy issue date but was not specifically excluded from coverage. In this situation, the insurer will most likely take which of the following actions? Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -Pay the full claim -Pay the claim for a maximum of six months only -Deny the claim on the basis of misrepresentation -Deny the claim because it involves a pre-existing condition - Correct Answer ✅Pay the full claim On June 1, S purchased a Major Medical policy and paid the initial premium to Producer T. On July 1, Producer T received the policy from the insurance company. The policy contained a Ten-Day Free Look provision. On July 3, Producer T attempted to deliver the policy but found that S was not at home. On July 5, Producer T was able to deliver the policy to S. On July 7, S decided he did not want the policy. S had 10 days from which of the following dates to return the policy to the company and obtain a full premium refund? -July 1 -July 3 -July 5 -July 7 - Correct Answer ✅July 5 Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -provide Disability Income benefits to people on Medicare -provide Medical Expense coverage to persons meeting certain minimum income requirements -provide funds for people injured in natural disasters - Correct Answer ✅provide Medical Expense coverage to persons meeting certain minimum income requirements A health care plan that reimburses a flat fee for medical care it provides at a clinic it owns and operates is referred to as: -Health Maintenance Organization -Medicaid -Medicare -a Multiple Employer Trust (MET) - Correct Answer ✅Health Maintenance Organization A health care plan designed to combine small employers together into a group to purchase medical expense insurance for their employees is called a: -risk retention group -Multiple Employer Trust (MET) Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -Preferred Provider Organization (PPO) -Third Party Administrator (TPA) - Correct Answer ✅Multiple Employer Trust (MET) Medicare Supplement policies are primarily designed to: -offset the high cost of Medicare -provide additional retirement income to supplement Social Security retirement benefits -provide additional benefits beyond those provided by Medicare -provide a reinsurance network that spreads the Medicare risk among private insurance companies - Correct Answer ✅provide additional benefits beyond those provided by Medicare An applicant for insurance submits an application to an insurer for underwriting but does not forward any premium payment with the application. Legally, the applicant is making -an inquiry for an offer -an offer -a counteroffer Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) -an acceptance - Correct Answer ✅an inquiry for an offer Which of the following statements is CORRECT about a Waiver of Premium provision in a Disability Income policy? -It allows the insurer to deduct premiums due from the disabled insured's benefit payments. -It allows the insurer to increase the amount of premium during the insured's time of disability. -It allows the insured to extend the length of the Grace Period while disabled. -It allows the insured to maintain a policy in force while disabled and unable to pay premiums. - Correct Answer ✅It allows the insured to maintain a policy in force while disabled and unable to pay premiums. Which of the following provisions explains that a producer does not have the authority to waive the provisions of an insurance contract? -Legal actions -Reinstatement -Time limit on certain defenses Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to: Increase the premium rate for one insured without increasing the rate for others in the same class Increase the premium rate for an entire class of insured, only on the anniversary date Increase the benefits for an individual insured Decrease benefits for one insured without decreasing benefits for others in the same class - Correct Answer ✅Increase the premium rate for an entire class of insured, only on the anniversary date The Internal Revenue Service (IRS) considers Disability Income benefits paid under an employer-paid group Disability Income (generally) to be: Taxable for thirteen weeks only Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Non-taxable for twenty-six weeks only Fully taxable Non-taxable - Correct Answer ✅Non-taxable A producer and an applicant complete an application for a health policy and submit it to the insurer for underwriting without any premium. The underwriter issues a policy and mails it to the producer for delivery to the applicant. The producer should take all of the following actions during the delivery of the policy to the applicant EXCEPT: Collect the initial premium payment Issue a conditional receipt Have the applicant complete a statement of continued good health Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Explain the Free Look provision which begins on the policy delivery date - Correct Answer ✅Issue a conditional receipt A married insured has an Accidental Death and Dismemberment (AD&D) policy that names his brother as the primary beneficiary and his son as the contingent beneficiary. If the insured and his brother are both killed instantly in a train accident, the policy proceeds would be paid to which of the following? The insured's estate The brother's estate The insured's son The insured's spouse - Correct Answer ✅The insured's son An individual who has had a heart murmur since birth is likely to be issued an individual health policy that includes: Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) 10 15 20 - Correct Answer ✅20 Under the Claims Forms provision of a health policy, if the insurance company fails to send out the claim forms within the time period required by the provision, the insured should: Demand a full refund of all premiums paid plus interest Submit the claim in any form, which must be accepted by the company as adequate proof of loss Request the state Department of Insurance to act as umpire in settling the claim Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Do nothing until the claim form arrives - Correct Answer ✅Submit the claim in any form, which must be accepted by the company as adequate proof of loss Which of the following provisions designates the person to whom claim payments are to be made? Time of Payment of Claims Entire Contract Notice of Claim Payment of Claims - Correct Answer ✅Payment of Claims The Consideration clause in an accident and health policy states that: The applicant pays the initial premium Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Insurable interest must exist between the parties involved Any attachments to the policy constitute the entire contract of insurance Certain claims will be excluded under the policy - Correct Answer ✅The applicant pays the initial premium The Elimination Period in most Disability Income policies applies: To each separate disability To claims for accidents only Only the first time the insured is disabled during the first 30 days of the contract - Correct Answer ✅To each separate disability Which of the following statements is CORRECT about coinsurance? Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Avoid double payment of benefits to an insured who has duplicate group coverage Investigate the claims history of an insured and his dependents Avoid duplicate premium charges to an employer for the same employee - Correct Answer ✅Avoid double payment of benefits to an insured who has duplicate group coverages A prehospitalization authorization program (pre-certification) is a good example of: Managed care Traditional indemnity Medicare Workers' Compensation - Correct Answer ✅Managed care Which of the following reports may include information obtained by a telephone call to the proposed insured? Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Medical Information Bureau (MIB) report Attending physician's report Inspection report Producer's report - Correct Answer ✅Inspection report The purpose of the Medical Information Bureau (MIB) is to: -recommend the premium rates that should be charged for health policies issued to substandard risks -share medical data among member companies -provide background data used to experience-rate large group health plans -provide actuarial information to participating members on dread diseases - Correct Answer ✅share medical data among member companies Because health insurance policies are offered on a "take it or leave it" basis, they are referred to as which of the following types of contracts? Aleatory Contracts Executory Contracts Unilateral Contracts Health Insurance Florida 2-40 Practice Exam Questions and Answers (Latest Update 2024) Contracts of Adhesion - Correct Answer ✅Contracts of Adhesion Person who is considered an under-average or impaired insurance risk because of physical conditions family or personal history of disease, occupation, residence in unhealthy climate or dangerous habits. - Correct Answer ✅Substandard Risk