Health Insurance Exam
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Health Insurance Exam
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25 Questions

1. Health policies contain how many required Uniform Provisions?
2. Worker' compensation covers losses resulting from:
3. Randall has a major medical policy with a flat $500 deductible and an 80/20 co-insurance with a stop loss of $2 - 000. What would Randall's total out of pocket expense be if he was to go to the hospital and was charged $25 - 000 for medical expenses - his surgeon charged $10 - 500 - and he had not yet met his deductible?
4. Which of the following correctly describes Medicaid?
5. Once an insured has paid a specified amount of his covered expenses - usually $1 - 000 to $2 - 000 - under the stop-loss feature of health insurance - the insurance company pays:
6. Which of the following factors will insurers use when issuing policies to substandard risks?
7. Eduardo has a $5 - 000 basic hospital expense policy - he also has a supplemental major medical with a $500 deductible - he incurs $4 - 000 worth of expenses - how much will he have to pay?
8. How do HMOs emphasize preventive care?I. encouraging routine physical exams II. use curative care instead of preventive care III. diagnostic screening IV. give choice of doctors
9. The primary beneficiary designation in an Accidental Death & Dismemberment policy may be:
10. A insurance policy with XYZ Insurance states that the insurer will not refuse to renew the policy and furthermore - the insurer may not cancel the policy. However - the insurer may change the premium by classes of insureds. This policy is:
11. Which of the following is/are health insurance risk factor(s):
12. Which of the following statements about a conditional receipt is true?
13. Agent Thumblebitton has just been told by a policyowner that she is three years younger than was listed on the application. The agent should:
14. I. A medical examination may be required.II. An investigative report may be required. III. The Medical Information Bureau (MIB) will send its report directly to the prospect.
15. The preexisting condition exclusion in a health policy is designed to protect the insurance company against:
16. Health Maintenance Organizations are required to provide for all of the following except:
17. The health policy that always renews without an increase of premium would be identified as:
18. Which of the following will not be in the outline of coverage?
19. Preexisting conditions are referred to in which of the following health policy areas:
20. What is the incontestable clause called in health insurance?
21. All of the following statements regarding maternity benefits are correct EXCEPT
22. Which of the following requirements generally must be met before an individual is eligible to participate in a group health plan?
23. Which policies are required to coordinate benefits?
24. Which deductible(s) is/are included in supplemental major medical? I. Flat II. Corridor III. Integrated
25. On which element of the contract are the application and premium payment based?