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Health Insurance Florida 2-40 Practice Exam Questions #2/ 299 Q&A.

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Health Insurance Florida 2-40 Practice Exam Questions #2/ 299 Q&A. Terms like: Which of the following is NOT TRUE regarding eligibility for subsidies for families under the new health care act? -For those who make between 100-400% of the Federal Poverty -Level -Cannot be covered by an employe...

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Health Insurance Florida 2-40 Practice Exam
Questions #2/ 299 Q&A.
Which of the following is NOT TRUE regarding eligibility for subsidies for families
under the new health care act?
-For those who make between 100-400% of the Federal Poverty -Level
-Cannot be covered by an employer
-Cannot be eligible for Medicare
-Can be eligible for Medicaid - Answer: Can be eligible for Medicaid

Which of the following operates as a corporation, society, or association to
provide life insurance primarily for the mutual benefit of its members, has a lodge
or social system with rituals and representative form of government?
A) Mutual companies

Page 1 of 115

,B) Fraternal associations
C) Stock companies
-Fraternal benefit society - Answer: B) Fraternal associations

What does each member pay in a typical HMO plan?
-Fixed premium based on a deductible and copay
-Fixed premium whether or not plan is used
-Premium based on how often plan is used - Answer: Fixed premium whether or
not plan is used

Which of the following is correct about those who are eligible for Medicare and
wish to join an HMO?
-They must have a current Medicare supplement policy
-They must be told that'll be getting all the benefits from the Medicare Advantage
plan
-They must be age 70 and above
-They must have been enrolled previously in an HMO - Answer: They must be told
that'll be getting all the benefits from the Medicare Advantage plan

Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - Answer: Business overhead expense (Explanation: Business
Overhead Expense insurance is designed to reimburse a business for overhead

Page 2 of 115

,expenses in the event a business owner becomes disabled. Expenses such as rent,
utilities, telephone, equipment, employees' salaries, etc.)

All of the following are state or federal government programs that provide health
insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - Answer: Medigap (Explanation:A Medigap policy is a Medicare
supplement insurance policy sold by private insurance companies to fill "gaps" in
Medicare Parts A and B.)

What type of health insurance is available to assist low-income individuals? -
Answer: Medicaid

What types of reserves are set aside and held by health insurance companies? -
Answer: Premium and Claims reserves (Explanation:Reserves are set aside for the
payment of future claims.)

Group health insurance is generally written on a basis that provides for dividends
or experience rating. What is the basis called? - Answer: Participating
(Explanation:Group plans written by mutual companies provide for dividends
while stock companies frequently issue experience-rated plans.)

Page 3 of 115

, Joyce is totally disabled. Her HMO policy just terminated. All of the following are
correct regarding "extension of benefits" for Joyce, EXCEPT?
-Coverage ends once maximum benefits have been exhausted
-Coverage ends once another carrier assumes coverage
-Coverage ends if no longer totally disabled
-Coverage ends after 18 months - Answer: Coverage ends after 18 months

All of the following are correct regarding Florida regulation of HMOs, EXCEPT?
-Must obtain a Certificate of Authority
-Must file a report of its activities within 3 months of the end of each fiscal year
-Must deposit $100,000 with the Rehabilitation Administration Expense Fund
-Must be sold by agents licensed and appointed as health insurance agents -
Answer: Must deposit $100,000 with the Rehabilitation Administration Expense
Fund (Explanation:
They must deposit $10,000 with the Rehabilitation Administration Expense Fund.)

What is "capitation" as it relates to an HMO?
-Amount to be collected by the HMO from participating health care providers
-Fixed amount paid by an HMO during a policy period
-Fixed amount paid by an HMO to a physician for medical services
-Amount required to be deposited with the State of Florida - Answer: Fixed
amount paid by an HMO to a physician for medical services

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