Complete Florida Health Insurance Agent 2-40
Pre-Licensing Exam 2024-2025 (300 Frequently
Tested Questions with Rationale) MULTIPLE
CHOICE EXAM
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
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
B) Fraternal associations
C) Stock companies
-Fraternal benefit society
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
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
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?
-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
,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
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
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
, -10 days
-5 days
-14 days
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
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
30 days during every 18-month period
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