OKLAHOMA 2-40 Health and Accident
Insurance State Exam Prep Newest
Multiple Employer Welfare Arrangement (MEWA) provides what type of benefits? -
Insurance
XYZ Company pays the entire premium for its group health plan. The MINIMUM
percentage of eligible employees that must be covered is - 100%
In Major Medical Expense policies, what is the intent of Stop Loss provision? - Limits
an insured's out-of-pocket medical expenses
Q is hospitalized for 3 days and receives a bill for $10,100. Q has a Major Medical
policy with a $100 deductible and 80/20 coinsurance. How much will Q be responsible
for paying on this claim? - $2,100
Omitting information that affects the issuance or the rate of an insurance contract is
called - concealment
Florida requires that coverage for newborns begins "from the moment of birth" and
continues for - 18 months
In order to establish a Health Reimbursement Arrangement (HRA), it MUST - be
established by the employer
Which provision allows a portion of any used medical benefits to be restored following
a particular amount of benefits has been used, or after the policy has been in effect for a
particular period of time? - Restoration of used benefit
Disability policies do NOT normally pay for disabilities arising from which of the
following? - War
According to Florida law, when must an agent deliver the Outline of Coverage to a
Medicare Supplement applicant? - At the time of application
An agent selling Medicare Supplement policies must provide every applicant with a(n)
- Suitability form
One definition of replacement is "the act of replacing an existing insurance policy with
another". Replacement is - closely regulated and requires full disclosure
Who makes the legally enforceable promises in a unilateral insurance policy? -
insurance company
, Which of the following acts is an agent NOT authorized to do on behalf of an insurer? -
Authorize claim payments
Which of the following BEST describes a Hospital Indemnity policy? - Coverage that
pays a stated amount PER DAY of a covered hospitalization
What is required in the Florida Employee Health Care Access Act? - Small group
benefit plan are to be issued on a "guarantee-issue" basis
The waiting period for a pre-existing condition under a Medicare Supplement policy
may NOT go beyond - 6 months
J purchased a Disability Income Policy that ONLY J can terminate and on which the
rates will never increase above those illustrated in the policy. Which of the following
types of policies did J purchase? - Noncancelable
What is the elimination period of an individual disability policy? - Time period a
disabled person must wait before benefits are paid
This type of deductible provision waives the deductible for all family members after
some of them have satisfied individual deductibles within the same year - Family
maximum deductible
Under an Individual Disability policy in Florida, what is the minimum schedule of time in
which claims must be made to an insured? - Monthly
Under a Long Term Care policy, which benefit would be typically excluded or limited? -
Alcohol rehabilitation
P is a Major Medical policyowner who is hospitalized as a result of injuries sustained
from participating in a carjacking. How will the insurer most likely handle this claim? -
Claim will be denied
A mutual insurance company and a stock insurance company have one main
difference between them. What is the Major contrast? - Stock company is owned by its
shareholders.
Mutual company is owned by its policyholders.
Upon reaching the limiting age, a handicapped child can extend their health insurance
coverage as a dependent - only if the child is incapable of employment and chiefly
dependent on the policyowner
Which Unfair Trade Practice involves an agent suggesting that an insurance policy is
like a share of stock? - Misrepresentation
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