Health and Accident Insurance - Test Questions

Question 1

Ron has a new employer and wishes to enroll in the company’s group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ______ day gap without previous health insurance?

Answer 1

63

Question 2

A group Disability Income plan that pays tax-free benefits to covered employees is considered________.

Answer 2

Fully Contributory

Question 3

A person covered with an individual health plan__________.

Answer 3

is issued a policy

Question 4

Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15, with the policy indicating the effective date being May 30. On which date would Sonya have coverage?

Answer 4

May 30

Question 5

A common exclusion with Vision plans is_____?

Answer 5

Lasik Surgery

Question 6

According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual________.

Answer 6

Is eligible for insurance upon hire.

Question 7

Under group health insurance, a certificate of coverage is issued to the_________.

Answer 7

Employee.

Question 8

The policyholder for a group health benefit plan is considered to be the________.

Answer 8

Employer

Question 9

The limited period of time given to all members to sign up for a group health plan is called the_________.

Answer 9

Enrollment Period

Question 10

Group health plans may deny participation based upon the________.

Answer 10

Members part-time employment status

Question 11

When are group disability benefits considered to be tax-free to the insured?

Answer 11

When the recipient pays the premium

Question 12

Continued coverage under COBRA would be provided to all of the following_________,________________,________________.

Answer 12

former dependent of employee no longer of dependent status, terminated employee, divorced spouse of employee

Question 13

Health Insurance Involves two perils, accident and _________.

Answer 13

Sickness

Question 14

Without a Section 125 Plan in place, what would happen to an employee’s payroll contribution to an HSA?

Answer 14

It would be considered taxable income to the employee

Question 15

Which of the following does Coordination of Benefits allow?

Answer 15

Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid

Question 16

A master contract and certificate of coverage can be found in which type of policy?

Answer 16

Group

Question 17

When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability act (HIPAA)?

Answer 17

When participation or contribution rules have been violated

Question 18

Under the Health Insurance Portability and Accountability Act (HIPAA), the employee’s new Group Health Plan will verify Creditable Coverage so that the___________.

Answer 18

Employee’s waiting period for coverage of a preexisting condition can be reduced under the new employer’s health plan

Question 19

If an employee contributes 50% toward the disability plan premium provided by an employer, what would be considered the taxable income of a $1000 monthly disability benefit?

Answer 19

$500

Question 20

The election of COBRA for continuation of health coverage will________.

Answer 20

Maintain the same coverage and increase the premium

Question 21

Which of the following is INELIGIBLE to participate in a Section 125 Plan?

Answer 21

An S-Corp owner with a greater than 2% share.

Question 22

An employer is issued a group medical insurance policy. This single contract is known as a (n)__________.

Answer 22

Master Policy

Question 23

The purpose of the Coordination of Benefits provision in group accident and health plans is to___________.

Answer 23

Avoid overpayments of claims.

Question 24

Coordination of Benefits regulation applies to all of the following:

Answer 24

Group Vision plan, Self-funded group health plan, and group health plan.

Question 25

Which of the following decisions would a Health Savings Account (HSA) owner be unable to make?
1) The amount contributed by the employer
2) The amount contributed by the owner
3) The underlying account investments used
4) The medical Expenses paid for by the HSA

Answer 25

The amount contributed by the employer

Question 26

In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at__________.

Answer 26

60% of the benefit.

Question 27

Which of the following is typically NOT eligible for coverage in a group health policy?
1) Full-time employee
2) Temporary Employee
3) Business Owner
4) Partner in a partnership

Answer 27

Temporary Employee

Question 28

HIPAA considers which of the follow as “individually identifiable health information”?
1) A person’s Employment history
2) a person’s net income
3) a person’s hire date
4) a person’s health claim information

Answer 28

A person’s health claim information

Question 29

Health insurance will typically cover which of the following perils?
1) Death due to illness
2) Injury due to accident
3) Death due to accident
4) Dismemberment

Answer 29

Injury due to accident

Question 30

Which of the following would be considered a possible applicant and contract policyholder for a group health benefits?
1) Human Resource Department
2) Employer
3) Insured employee
4) Insurance Company

Answer 30

Employer