Exam Prep

Question 1

Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured’s other health insurance?

Answer 1

Hospital Indemnity Policy

Question 2

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

Answer 2

Enrollment Period

Question 3

An insurer may refuse to renew an employer’s small group health plan due to…

Answer 3

Nonpayment of Premium

Question 4

Preferred risk policies with reduced premiums are issued by insurance companies because the insured has..

Answer 4

Better than average mortality or morbidity experience

Question 5

The first payment for a newborn accident and health coverage is due ___ days after the birth.

Answer 5

31

Question 6

Ohio requires that a licensee completes ___ hours of continuing education on the subject of ethics every reporting period.

Answer 6

3

Question 7

Medicare Part A covers what?

Answer 7

Inpatient hospital stay

Question 8

If an agent is believed to be causing considerable harm, the superintendent…

Answer 8

May issue a cease and desist order against the agent

Question 9

An insurer’s ability to make unpredictable payouts to policyowners is called…

Answer 9

Liquidity

Question 10

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

Answer 10

Employer

Question 11

An example of a health insuring corporation (HIC) specialty care provider is a

Answer 11

Neurologist

Question 12

An agent’s license may only be suspended or revoked if the agent…

Answer 12

Has been afforded a right to a hearing

Question 13

Replacement can best be described as

Answer 13

Exchanging a new policy for one already in force

Question 14

Long-Term Care policies or certificates issued in Ohio are required to have what?

Answer 14

A nonforfeiture value

Question 15

An insurance producer is often responsible for field underwriting during the application process. All of these are possible field underwriting roles except?

Answer 15

Providing commission information to the applicant

Question 16

An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to

Answer 16

6 months

Question 17

Coverage for newborns under an accident and health plan must include coverage for

Answer 17

Birth abnormalities

Question 18

Insurance represents the process of risk…

Answer 18

Transference

Question 19

A proposed insured for a health insurance policy was treated for heart disease within the past year. When applying for health insurance, the heart disease…

Answer 19

Indicates a preexisting condition

Question 20

Long-Term Care policies may provide coverage for claims arising from

Answer 20

Senile dementia

Question 21

A Medicare Supplement policy is

Answer 21

Designed to fill in the gaps of Part A and Part B Medicare

Question 22

Justin is receiving disability income benefits from a group policy paid for by his employer. How are these benefits treated for tax purposes?

Answer 22

Taxable income

Question 23

What is not typically included under “hospital care” for most health insuring corporation (HIC) plans?

Answer 23

Private duty nursing

Question 24

Which three levels of care are long-term policies provided with?

Answer 24

Skilled nursing, intermediate, and custodial care

Question 25

Confidentiality of health information (stated by Ohio HIC laws) applies to information supplied by...

Answer 25

Both by the covered individual and by the providers

Question 26

An individual who removes the risk of loosing money in the stock market by never purchasing stocks is said to be engaging in

Answer 26

Risk avoidance

Question 27

The monthly benefit for an individual disability income policy is usually limited to a percentage of the insured's income in order to avoid

Answer 27

Over insurance

Question 28

Which of the following signatures is not required on an individual insurance application?

Answer 28

Insurer

Question 29

Which of these preventative care services is not provided by health insuring corporation (HIC) primary care physicians?

Answer 29

Adult hearing screenings

Question 30

What is a legal entity created for the sole purpose of providing affordable group health coverage to its participants?

Answer 30

Multiple Employer Welfare Arrangement (MEWA)

Question 31

Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have?

Answer 31

Calendar-year deductible

Question 32

What does Medicare Part D cover?

Answer 32

Prescription drugs

Question 33

What do coordination benefits allow?

Answer 33

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

Question 34

What is the primary factor that determines the benefits paid under a disability income policy?

Answer 34

Wages

Question 35

A health care provider claim may be settled using what payment method?

Answer 35

Fee-for-service

Question 36

Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of...

Answer 36

100% of costs

Question 37

An employer is issued a group medical insurance policy. This single contract is known as?

Answer 37

Master policy

Question 38

Which of the following statements is true about Medicaid?

Answer 38

It's funded by federal, state and local taxes

Question 39

How many employees must an employer have for a terminated employee to be eligible for COBRA?

Answer 39

20

Question 40

HIPAA considers what as "individually identifiable health information"?

Answer 40

A person's health claim information

Question 41

What is not considered a supplemental health insuring corporation (HIC) service?

Answer 41

Outpatient medical services

Question 42

An employee has ___ days after the date of marriage to add a new spouse to a small group health care plan

Answer 42

30

Question 43

Intentional withholding of material facts that would affect an insurance policy's validity is

Answer 43

Concealment

Question 44

Medicaid is intended for

Answer 44

Poverty stricken people

Question 45

Which type of long-term care benefit would be appropriate for a stroke victim who requires speech therapy administered at home?

Answer 45

Home health care

Question 46

Key Person Disability insurance pays benefits to the...

Answer 46

Employer

Question 47

An order issued by the superintendent that prohibits a specific practice listed in the order is called?

Answer 47

Cease and desist order

Question 48

Advertisements for accident and health policies that only cover a stated illness must display a statement that the...

Answer 48

Policy is limited

Question 49

Group dental plans will frequently place a limit on annual benefits in order to minimize what?

Answer 49

Adverse selection

Question 50

All plans allow for employee contributions to be taken out on a pre-tax basis except?

Answer 50

Health Reimbursement Arrangement Plan

Question 51

Which of the following would evidence ownership in a participating health insurance contract?

Answer 51

Policy ownership

Question 52

_____ is not an element of a valid contract

Answer 52

Countersignature

Question 53

What percent of a participant's income are group long-term disability benefit amounts typically limited to?

Answer 53

60%

Question 54

The typical long-term care insurance policy is designed to provide a minimum of ___ year(s) of coverage

Answer 54

1

Question 55

An insurance policy that is only renewable only at the option of the insurance company. This policy is considered to be?

Answer 55

Optionally renewable

Question 56

An agent's appointment may only be terminated by the

Answer 56

Insurer

Question 57

An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called?

Answer 57

Coinsurance

Question 58

What amount will be paid under a policy where the insured misstated his/her age?

Answer 58

An amount the premium would have purchased at the correct age

Question 59

Which type of business insurance is meant to cover the costs of continuing to do business while the owner is disabled?

Answer 59

Business overhead expense policy

Question 60

An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim.

Answer 60

15

Question 61

What is not considered advertising?

Answer 61

A rating from a service company

Question 62

One of the most important considerations when replacing health insurance would be the...

Answer 62

Exclusions on a new policy

Question 63

What would not be considered a presumptive disability?

Answer 63

Loss of a leg OR arm

Question 64

Long-term care insurance applications must contain plain and unambiguous health questions. The exception to this rule would be applications for...

Answer 64

Guaranteed issue

Question 65

The superintendent determines an examination of insurer's books and records is necessary. After receiving the notification, the insurer...

Answer 65

Must not impede the examination

Question 66

A Medicare supplement plan can be cancelled by the insurer...

Answer 66

For nonpayment of premiums

Question 67

The purpose of the Coordination of Benefits provision in group accident and health plans is to?

Answer 67

Avoid overpayment of claims

Question 68

An example of an endodontic treatment is a

Answer 68

Root canal

Question 69

What would be considered a possible applicant and contract policyholder for group health benefits?

Answer 69

Employer

Question 70

An employer with under 20 employees must allow a terminated employee to continue accident and health coverage for a minimum of ___ months

Answer 70

12

Question 71

A beneficiary change can occur when?

Answer 71

Normally at any time during the policy term

Question 72

In group health care, what is the purpose of coordination of benefits provision?

Answer 72

Determines what is paid by the primary and secondary insurers in the event of a claim

Question 73

Loss of income insurance provides what?

Answer 73

An individual the means to replace wages

Question 74

Backdating an insurance policy occurs when

Answer 74

The policy's effective date is earlier than the present

Question 75

In what form do disability income policies typically pay benefits?

Answer 75

Periodic income

Question 76

Ambiguities in an insurance policy are always resolved in the favor of the...

Answer 76

Insured