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Arizona Health Insurance exam

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Arizona Health Insurance exam

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1. The affordable care act requires that all health care plans include the following essential benefits:

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careThe agentWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Coverage offered through state insurance exchanges

2. Qualified health plans

Coverage offered through state insurance exchangesThe agentWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision care

3. What is a reinsurance treaty?

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careThe agentCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

4. Who needs to make sure that the current policy is not cancelled before the new policy is issued?

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.The agent

5. Policy issuance alternative situations

Coverage offered through state insurance exchanges- if the applicant is too great of a risk - they can be denied - if the risk is more that standard but less than a decline - the underwriter could offer the policy on a rated-up basis or issue a contract with an exclusion rider (if the policy is rated up - the premium will be increased)- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

6. Under the legal actions provision - the insured must wait __________ - but not later than __________ after proof of loss - before legal action can be brought against the company.

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.60 days/2 years

7. Insurable risks due to chance

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesA loss that is outside of the insured's controlWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

8. Minors of at least __________ may contract life and disability insurance on their own lives - and the lives of their immediate family.

15 years old- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

9. Young adults under the age of 30 - and individuals who cannot obtain affordable coverage may be able to purchase individual __________ that cover essential benefits. These plans offer lower monthly premiums bu also feature high deductibles. The insured is ually required to pay all medical costs up to a certain amount.

Catastrophic plans- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

10. Mental health parity and addiction equity act

When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careA federal law that requires coverage parity for mental health benefits with benefits under the insured's medical/surgical coverageCoverage offered through state insurance exchanges

11. Medicare part c/advantage - no cliams forms required - almost any medical problem is covered for a set fee so health care costs can be budgeted - the hmo or ppo may pay for services not usually covered by medicare or medicaid supplement policies (prescriptions - eye exams - hearing aids or dental care)

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesMost __________ hmos require that medical services be received throguh the plan - except in emergencies. A few allow greater freedom of choice through point of service plans.When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

12. If the insured has 2 or more policies from different companies that provide benefits on an __________ - and the policies cover the same expenses - and if the insurance companies were not notified that the other coverage existed - then each insurer will pay a proportionate share of any claim.

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Expense-incurred basis

13. Notice of a claim provision

Coverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Spells out the insured's duty to provide the insurer with reasonable notice in the event of a loss- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision care

14. In insurance - who makes the offer and who accepts it?

Coverage offered through state insurance exchangesThe applicant usually makes the offer when submitting the application. Acceptance takes place when an insurer's underwriter approves the application and issues a policy.When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision care

15. - ensure the confidentiality - integrity - and availability of personally identifiable information created - collected - used - and/or disclosed by the exchange - personally identifiable information that may only be used by or disclosed to those authorized to receive or view it - return information must be kept confidential - personally identifiable information is protected against any reasonably anticipated threats or hazards to the confidentiality - integrity - and availability of such information - personally identifiable information is securely destroyed or disposed of in an appropriate and reasonable manner

When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Coverage offered through state insurance exchanges- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhat does hipaa stand for?

16. 190

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Medicare part a helps pay for up to __________ days in a participating skilled nursing facility in each benefit period - following a 3 day inpatient hospital for a related illness. To get this type of care - the insured's doctor must certify that daily skilled care is necessary.

17. Insurable risks that are definite and measurable

Coverage offered through state insurance exchanges- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careA loss that is specific as to the cause - time - place and amount. An insurer must be able to determine how much the benefit will be when it becomes payable.When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

18. _________ are organized and owned by a corporation or firm to serve the parent organization;s insurance needs at lower rates than other insurers and without the uncertainties of commercial insurance.

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careCoverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Captive insurers

19. Medical insurance; financed from monthly premiums paid by insureds and from the general revenues of the federal government

When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Medicare part cCoverage offered through state insurance exchanges- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision care

20. Medicare part b

Coverage offered through state insurance exchangesWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.What doctor services are covered by medicare part b?- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision care

21. What is a nonparticipating policy?

A policy issued by a stock company in which policy owners do not share in profits or losses that does not pay dividends to policy owners - but does pay taxable dividends to stock holders.Coverage offered through state insurance exchanges- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.

22. The purpose of retention is:

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.1. to reduce expenses and improve cash flow 2. to increase control of claim reserving and claims settlements 3. to fund for losses that cannot be insuredCoverage offered through state insurance exchanges

23. Part a: hospital insurance part b: medical insurancepart c: medicare advantage part d: prescription drugs

When an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Coverage offered through state insurance exchanges- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careMedicare part a

24. What are the prime considerations when underwriting health insurance policies?

- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Coverage offered through state insurance exchanges- age - gender - occupation - physical condition - avocations - moral and morale hazards - financial status of the applicant

25. When health insurers set their __________ - they are only permitted to base them on four standards.

Premium rates- ambulatory patient services - emergency services - hospitalization - maternity and newborn care - mental health and substance use disorder services - including behavioral health treatment - prescription drugs - rehabilitative and habilitative services and devices - laboratory services - preventive and wellness services and chronic disease management - pediatric services - including oral and vision careWhen an insurer has an automatic reinsurance agreement between itself and the reinsurer in which the reinsurer is bound to accept all risks ceded to it. Usually negotiated for a period of a year or longer.Coverage offered through state insurance exchanges

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25 Questions

❤ If you liked Fatskills, consider supporting us by checking out The Life Manuals You Never Got.

About | Explore | User Guide | Topics | Subjects | Doubt Solver | Career Aptitude Test | Answers | Free Tools | What Should We Know? Privacy | Terms |

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All trademarks, logos and brand names are the property of their respective owners. All company, product and service names used in this website are for identification purposes only. Use of these names, trademarks and brands does not imply endorsement.

About | Explore | User Guide | Topics | Subjects | Doubt Solver | Career Aptitude Test | Answers | Free Tools | What Should We Know?
Privacy | Terms |

Without work one finishes nothing. - Ralph Waldo Emerson
© 2026 Fatskills.com