California Life, Accident and Health Cram Course Exam 1-3/ 125+ Q&A
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Accident and Health Cram Course
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Accident And Health Cram Course
California Life, Accident and Health Cram Course Exam 1-3/ 125+ Q&A
Question #90425
Part A of Medicare provides basic hospital benefits including coverage for the care and counseling of the terminally ill, which is known as:
ALong term care
BHome health care
CSkilled nursing facility c...
California Life, Accident and Health Cram
Course Exam 1-3/ 125+ Q&A
Question #90425
Part A of Medicare provides basic hospital benefits including coverage for the care
and counseling of the terminally ill, which is known as:
ALong term care
BHome health care
CSkilled nursing facility care
DHospice care - Answer: D
Explanation:
Medicare is a federal health insurance program for people 65 or older who qualify
for Social Security, people of any age with permanent kidney failure, and those
who are permanently and totally disabled. An individual is automatically eligible
for Medicare Part A with no monthly premium at age 65, which includes coverage
for hospitalization, skilled nursing, home health care and hospice care.
Question #90441
Page 1 of 67
,Medical Information Bureau (MIB) members must report which of the following:
ALife insurance death claims
BHealth conditions discovered during the underwriting process
CInsurance company actions taken
DAdverse underwriting decisions - Answer: B
Explanation:
The MIB is a non-profit information agency formed to assist health insurers
uncover misrepresentations or fraudulent actions by applicants for insurance. MIB
members that find an impairment in underwriting report such findings, as well as
situations which applicants have previously been involved in and information
received from physicians or other persons commenting on the status of a
proposed insured.
Question #90460
If a $100,000 Whole Life insurance policy with a cash value of $10,500 lapsed and
the insured selected the reduced paid-up non-forfeiture option, all of the
following would be true EXCEPT:
AThe new policy would have a cash value
BThe new policy would have a face amount of $100,000
CThe new policy would not require proof of insurability
DThe new policy would provide coverage to age 100 - Answer: B
Explanation:
If the insured selects the reduced-paid up non-forfeiture option, the insurer will
use the cash value in the lapsed policy to buy the insured a new Whole life policy
at the insured's current age without evidence of insurability. The new policy will
be paid-up until age 100 or the insured's death, whichever comes first, and will
Page 2 of 67
,have an immediate cash value. However, $10,500 would not be enough to buy the
insured a $100,000 policy, so coverage will be reduced.
Question #90495
Under the Women's Health and Cancer Rights Act all health insurance plans which
cover mastectomies must also cover which of the following:
ARehabilitation
BReconstructive surgery
CHome health care
DPrescription drug coverage - Answer: B
Explanation:
Under WHCRA, group health plans, insurance companies and health maintenance
organizations (HMOs) offering mastectomy coverage also must provide coverage
for certain services relating to the mastectomy in a manner determined in
consultation with a attending physician. This required coverage includes all stages
of reconstruction of the breast on which the mastectomy was performed, surgery
and reconstruction of the other breast to produce a symmetrical appearance, and
prostheses and treatment of physical complications of the mastectomy.
Question #90423
Medical Information Bureau (MIB) members consist of:
ALife & Health insurers
BWorkers Compensation insurers
CAll answer options are incorrect
DFire & Casualty insurers - Answer: A
Explanation:
Page 3 of 67
, The MIB is a nonprofit information agency supported by Life & Health insurance
companies, in order to help insurers uncover misrepresentations or fraudulent
actions by applicants. MIB member companies that find health impairments in
underwriting report their findings to the MIB in the form of a code number. The
MIB discloses to underwriters the applicants prior health history, including
information received from doctors. However, insurance company underwriting
actions are not recorded anywhere in MIB files.
Question #90471
A Comprehensive Major Medical Expense policy generally includes all of the
following EXCEPT:
AFirst dollar coverage with high lifetime limits
BA deductible
CA capitation fee
DCo-insurance - Answer: c
Explanation:
'Capitation' fees are a characteristic of HMOs, not policies written by insurance
companies. A 'capitation' fee is a per person fee that an HMO pays a doctor based
upon the number of patients they see during a specified period of time.
Comprehensive Major Medical Expense insurance is a combination of a Basic plan
and a Major Medical plan, which is generally the best coverage you can obtain
from an insurance company.
Question #90400
When an Agent pleads 'nolo contendere' to a violation of the insurance code, it
means:
AHe is pleading guilty to a violation of the insurance code
Page 4 of 67
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