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Health Insurance Florida 2-40 Practice Exam Questions #2/ 299 Q&A. h 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 a$12.99
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Health Insurance Florida 2-40 Practice Exam Questions #2/ 299 Q&A. h 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 a
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Course
Health Insurance Florida 2-40
Institution
Health Insurance Florida 2-40
Health Insurance Florida 2-40 Practice Exam Questions #2/ 299 Q&A. Terms like:
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 ...
Health Insurance Florida 2-40 Practice Exam
Questions #2/ 299 Q&A.
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
Joyce is totally disabled. Her HMO policy just terminated. All of the following are
correct regarding "extension of benefits" for Joyce, EXCEPT?
Page 1 of 115
,-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
When a person is covered by an HMO, the contract certificate or member's
handbook must be delivered within how many days after approval of the
enrollment by the HMO?
-20 days
Page 2 of 115
,-10 days
-5 days
-14 days - Answer: 10 days
Which of the following statements about health service organizations is true?
-They reimburse Policyowners directly for physicians' fees
-They provide loss of income benefits to Policyowners
-They reimburse Policyowners directly for all medical expenses
-They provide benefit payments directly to the hospitals and physicians providing
services - Answer: They provide benefit payments directly to the hospitals and
physicians providing services
What is the period of time for an HMO "open enrollment"?
-45 days during every 18-month period
-30 days during every 12-month period
-30 days during every 18-month period
-45 days during every 12-month period - Answer: 30 days during every 18-month
period
If an HMO is found guilty of unfair trade practices, what is the maximum penalty
that can be charged?
-Up to $50,000
-Up to $150,000
-Up to $200,00
-Up to $100,000 - Answer: Up to $200,00
Page 3 of 115
, Which of the following statements about Worker's Compensation laws is
INCORRECT?
-Employers can purchase coverage through the state program, private insurers or
can self-insure
-Worker's compensation provides benefits for work-related injuries, illness or
death
-Not all states have a workers compensation law
-Basic principle is that work-related injuries are compensable by the employer
without regard to fault - Answer: Not all states have a workers compensation law
What year was the Social Security Act amended to add health insurance
protection for the aged and disabled?
-1973
-1965
-1985
-1935 - Answer: 1965
All of the following are true statements about Workers Compensation, EXCEPT..?
-Benefits are not paid unless there is employer negligence
-Pays benefits for work related injuries and illnesses
-Employee does not contribute to the plan
-All states have Workers Compensation laws - Answer: Benefits are not paid
unless there is employer negligence
Page 4 of 115
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