Health Insurance Florida 2-40 Practice
Exam Questions #2
__________ are set aside via an coverage business enterprise and unique for the fee of destiny
claims.
A) Reserves
B) Dividends
C) Capital accounts
D) Premiums - ANS-Reserves
'Insurance Transaction' consists of?
A) Negotiations.
B) Informal communication amongst producers.
C) Setting up an unattended brochure stand.
D) Taking a random smartphone survey. - ANS-Negotiations
A financial institution or credit score union will not provide a loan until the borrower buys
insurance from a selected agency. This is referred to as?
A) Misrepresentation
B) Rebating
C) Churning
D) Coercion - ANS-Coercion
(It is an unfair change exercise to go into into any agreement to dedicate, any act of boycott,
coercion, or intimidation ensuing in an unreasonable restraint of, or monopoly in, the business of
coverage.)
A courtroom reporter develops arthritis making it not possible to continue this employment. The
reporter now has different employment at a reduced earnings and gets a month-to-month
benefit from an coverage settlement due to which of the subsequent policy provisions?
A) Residual Disability
B) Recurrent Disability
C) Partial Disability
D) Total Disability - ANS-Residual Disability
(Residual Disability acknowledges one's potential to maintain to work, but at a reduction of
earnings.Arthritis is what forms because of an harm from an accident or otherwise,
consequently it's taken into consideration a residual disability.)
A fake statement within the application which could render the contract void, if cloth to the
recognition of the hazard, is referred to as a?
A) Representation
B) Concealment
(A misrepresentation can render the contract void, if fabric to the reputation of the risk.)
A famous dancer makes a decision to take out a special policy masking her legs for $1 million.
What kind of coincidence policy is this?
-Disability profits coverage
-Limited danger policy
-Major Medical coverage
-Special risk coverage - ANS-Special danger policy
A company that gives administrative services for employers, acts as liaison among the insurer
and agency and approaches claims, and so forth. Is a(n)?
A) Third Party Administrator
B) Administrative Services Only
C) Staff Plan
D) Gatekeeper - ANS-Third Party Administrator
(The key words are acts as liaison between the insurer and enterprise.)
A fitness policy now not conforming to the Uniform Individual Accident and Sickness Policy
Provisions Law...
A) Is invalid.
B) May be voided.
C) Will be construed as if it conformed to the Law.
D) The insurer is fined and the coverage corrected - ANS-Will be construed as though it
conformed to the Law.
(According to the Conformity with State Statutes Provision (an Optional Uniform Provision), any
provision on the policy effective date this is in struggle with statutes of the kingdom is robotically
amended to fulfill country necessities.)
A lifestyles agent might not promote which type of insurance?
A) Annuities
B) Viatical agreement broking
C) Limited credit insurance
D) Variable contracts - ANS-Limited credit insurance
(A lifestyles agent is appointed to additionally sell existence coverage and stuck-dollar annuity
contracts, but no limited credit insurance.)
A Medical Expense Policy list of the amount the insurer will pay for every medical fee incurred is
known as a _____ _____ _____. ?
A) Conclusion of Benefits
B) Schedule of Benefits
C) Secluded Emergency Benefits
D) Social Insurance Benefits - ANS-Schedule of Benefits
,(Under a Schedule of Benefits, the amount payable is itemized for every medical cost protected
with the aid of the plan.)
A policy that covers inpatient health practitioner visits and may be improved to include payment
for office visits, diagnostic x-ray, laboratory fees, ambulance and nurses prices whilst not
hospitalized, and maternity advantages for an extra top rate, is considered which of the
following?
A) Medical Expense Policy
B) Basic Physician's Expense Policy
C) Major Medical Policy
D) Supplementary Major Medical Policy - ANS-Medical Expense Policy
(Key word became within the question "costs". The question is describing a Medical Expense
Policy, on occasion known as a Regular (Basic) Medical Expense Policy.)
A procedure used by dental coverage vendors to determine the benefit to be paid is referred to
as?
A) Preliminary Evaluation
B) Pretreatment Examination
C) Precertification
D) Least Coverage Provision - ANS-Precertification
(Precertification or Predetermination of Benefits, although not generally mandatory, lets in each
the affected person and the dentist to understand what's going to be blanketed before remedy.)
A software designed to provide accelerated assistance to individuals who are unable to pay for
his or her medical needs is called?
A) Medicaid (In California, Medi-Cal)
B) Medicare Part A
C) Supplemental Security Income
D) State Supplemental Payment Program - ANS-Medicaid (In California, Medi-Cal)
(Medicaid (in California, Medi-Cal) is the federal and country administered program that offers
accelerated assistance to folks that are unable to pay for their own scientific desires.)
A specific length earlier than new insurance is going into effect for a detailed condition is called
which of the following?
A) Waiting duration
B) Exclusion
C) Probationary length
D) Morbidity table - ANS-Probationary length
(The question establishes a length earlier than insurance goes into impact for exact conditions,
now not a duration earlier than an worker is even eligible to enroll for organization advantages,
which might be a waiting length.)
Abigail has a preexisting circumstance mentioned in her new A & H coverage. If she submits a
declare for this condition all through the probationary duration, what is going to the insurer do?
A) Reduce the blessings paid.
, B) Pay a reduced quantity or deny any claim price.
C) Pay benefits in full.
D) Provide insurance most effective if this claim is nonoccupational. - ANS-Pay a discounted
amount or deny any declare payment.
(Since Abigail's declare happened at some point of the Probationary Period, the insurer might
probable deny any declare outright or at the least pay a reduced quantity.)
Accident and Health Insurance, insures for 2 principal perils, they are?
A) Driving below the have an effect on and riding while intoxicated.
B) On the process and off the job.
C) Accidental damage and sickness.
D) Automobile and domestic fitness care. - ANS-Accidental injury and sickness.
After COBRA continuation of advantages has expired, how lengthy does the terminated
employee have to convert their group certificate to an man or woman coverage?
-90 days
-31 days
-forty five days
-one hundred eighty days - ANS-31 days
Albert owns a printing enterprise in which he, at instances, prints counterfeit money. One day
while processing humorous money, his arm changed into severely broken. His coverage will?
A) Not pay when you consider that he became worried in an unlawful act at the time of harm.
B) Pay as he became injured on equipment generally used for prison functions.
C) This is classified as a Workers' Compensation declare.
D) Will pay however will cancel his settlement whilst he's convicted of the crime. - ANS-Not pay
for the reason that he was concerned in an illegal act on the time of damage.
(Illegal Occupation/Act (an Optional Uniform Provision) allows the insurer the right to disclaim
liability if the insured is injured even as acting an illegal career or committing an unlawful act.)
All are Optional Provisions, EXCEPT?
A) Illegal Occupation.
B) Legal Actions.
C) Change of Occupation.
D) Misstatement of Age. - ANS-Legal Actions.
(Legal Actions is a Mandatory Uniform Provision. All other responses are Optional Uniform
Provisions.)
All insurance companies authorized in Florida ought to be audited via the Office of Financial
Regulation once each __________.
A) Year
B) three years
C) 5 years
D) 7 years - ANS-3 years
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