Florida Health and Accident Insurance State
Exam (A)|71 Questions and Answers
Which mode of payment is NOT used by health insurance policies? - -Single
Premium
-The Coordination of Benefits provision - -prevents an insured covered by
two health plans from making a profit on a covered loss
-After an insured gives notice of loss, what must he/she do if the insurer
does not furnish forms? - -File written proof of loss
-Which of these types of coverage is best described as a short term medical
policy? - -interim coverage
-The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives
workers (and their families) whose employment has been terminated the
right to - -continue group health benefits
-Information obtained from a phone conversation to the proposed insured
can be found in which of these reports? - -Inspection report
-Which of the following types of health coverage frequently uses a
deductible? - -Major Medical policy
-A Health Reimbursement Arrangement MUST be established - -by the
employer
-Which action could result in a hearing being ordered by the Department of
Financial Services? - -Performing insurance transactions without a license
-Health insurance benefits NOT covered due to an act of war are - -excluded
by the insurer in the contract provisions
-Which of the following is an example of an Unfair Trade Practice? - -
Coercion
-Which of the following is NOT required in the Outline of Coverage for a
health insurance policy? - -Projection of the policy's future costs
-The policy provision that entitles the insurer to establish conditions the
insured must meet while a claim is pending is - -Time Limit on Certain
Defenses
, -Which of these is NOT a characteristic of a Health Reimbursement
Arrangement (HRA)? - -Employee funds the HRA entirely
-The reason for a business having a Business Overhead Expense Disability
Plan is to cover - -fixed business expenses
-Medicare Part B does NOT cover - -inpatient hospital services
-Which of the following statements about a Guaranteed Renewable Health
Insurance policy is CORRECT? - -Premiums normally increase at the time of
the renewal
-Periodic health claim payments MUST be made at least - -monthly
-How many days does an insurance company have to reject a reinstatement
application before it is automatically reinstated? - -45
-Which of the following provisions is NOT required in HMO
contracts/certificates? - -Seven-day grace period
-Which of the following is NOT a limited benefit plan? - -life insurance
policies
-An insured covered by a group Major Medical plan is hospitalized after
sustaining injuries that resulted from an automobile accident. Assuming the
plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much
will the INSURED be responsible to pay with $11,000 in covered medical
expenses? - -$3,000
-The clause identifying which losses resulting from an accident or sickness
are insured by the policy is called - -Insuring clause
-Which of these do NOT constitute policy delivery? - -Policy issued with a
rating
-Which of the following acts is an agent NOT authorized to do on behalf of an
insurer? - -Authorize claim payments
-In health insurance policies, a wavier of premium provision keeps the
coverage in force without premium payments - -After an insured has
become totally disabled as defined in the policy
-Which of the following medical expenses does Cancer insurance NOT cover?
- -Arthritis
Exam (A)|71 Questions and Answers
Which mode of payment is NOT used by health insurance policies? - -Single
Premium
-The Coordination of Benefits provision - -prevents an insured covered by
two health plans from making a profit on a covered loss
-After an insured gives notice of loss, what must he/she do if the insurer
does not furnish forms? - -File written proof of loss
-Which of these types of coverage is best described as a short term medical
policy? - -interim coverage
-The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives
workers (and their families) whose employment has been terminated the
right to - -continue group health benefits
-Information obtained from a phone conversation to the proposed insured
can be found in which of these reports? - -Inspection report
-Which of the following types of health coverage frequently uses a
deductible? - -Major Medical policy
-A Health Reimbursement Arrangement MUST be established - -by the
employer
-Which action could result in a hearing being ordered by the Department of
Financial Services? - -Performing insurance transactions without a license
-Health insurance benefits NOT covered due to an act of war are - -excluded
by the insurer in the contract provisions
-Which of the following is an example of an Unfair Trade Practice? - -
Coercion
-Which of the following is NOT required in the Outline of Coverage for a
health insurance policy? - -Projection of the policy's future costs
-The policy provision that entitles the insurer to establish conditions the
insured must meet while a claim is pending is - -Time Limit on Certain
Defenses
, -Which of these is NOT a characteristic of a Health Reimbursement
Arrangement (HRA)? - -Employee funds the HRA entirely
-The reason for a business having a Business Overhead Expense Disability
Plan is to cover - -fixed business expenses
-Medicare Part B does NOT cover - -inpatient hospital services
-Which of the following statements about a Guaranteed Renewable Health
Insurance policy is CORRECT? - -Premiums normally increase at the time of
the renewal
-Periodic health claim payments MUST be made at least - -monthly
-How many days does an insurance company have to reject a reinstatement
application before it is automatically reinstated? - -45
-Which of the following provisions is NOT required in HMO
contracts/certificates? - -Seven-day grace period
-Which of the following is NOT a limited benefit plan? - -life insurance
policies
-An insured covered by a group Major Medical plan is hospitalized after
sustaining injuries that resulted from an automobile accident. Assuming the
plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much
will the INSURED be responsible to pay with $11,000 in covered medical
expenses? - -$3,000
-The clause identifying which losses resulting from an accident or sickness
are insured by the policy is called - -Insuring clause
-Which of these do NOT constitute policy delivery? - -Policy issued with a
rating
-Which of the following acts is an agent NOT authorized to do on behalf of an
insurer? - -Authorize claim payments
-In health insurance policies, a wavier of premium provision keeps the
coverage in force without premium payments - -After an insured has
become totally disabled as defined in the policy
-Which of the following medical expenses does Cancer insurance NOT cover?
- -Arthritis
