2-15 Florida Insurance Practice Exam Study Questions and Answers with Verified Solutions 2024
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Course
2-15 Florida Insurance
Institution
2-15 Florida Insurance
An organization outside the members of a self-insurance group which, for a fee, processes claims, completes benefits paperwork and often analyzes claims information is known as the:
1) primary administrator (PA).
2) second-party administrator (SPA)
3) third party administrator (TPA)
4) admi...
2-15 Florida Insurance Practice Exam Study
Questions and Answers with Verified Solutions
2024
An organization outside the members of a self-insurance group which, for a fee,
processes claims, completes benefits paperwork and often analyzes claims information
is known as the:
1) primary administrator (PA).
2) second-party administrator (SPA)
3) third party administrator (TPA)
4) administrator. -Correct Answer ✔
According to the NAIC Model Health Insurance Policy Provisions, under the
_________________________ provision, the insurer is prohibited from denying a claim
on the basis of a preexisting condition after the contestable period expires.
1) Insurance with Other Insurers
2) Insurance with Other Insurer
3) Time Limit on Certain Defenses
4) Timely Payment of Claims -Correct Answer ✔3) Time Limit on Certain Defenses
Which statement is CORRECT about the Department of Financial Services' right to
examine an agent's records?
1) The Chief Financial Officer may examine an agent's records only on a yearly basis.
2) An examination can be conducted at any time to discover any unfair trade practices.
3) An agent's records involving a premium transaction are not subject to examination.
4) Florida statutes do not give the Department the right to examine the affairs of
insurance licensees to discover unfair trade practices. -Correct Answer ✔
Which of the following statements about HMOs is correct?
1) HMOs stress preventive care.
2) HMOs rarely assess deductibles.
3) HMOs provide coverage for routine doctor visits and hospital care.
4) All - HMOs stress preventive care, rarely assess deductibles, and provide coverage
for routine doctor visits and hospital care. -Correct Answer ✔4) All - HMOs stress
preventive care, rarely assess deductibles, and provide coverage for routine doctor
visits and hospital care.
Where do the figures showing the amount of a life insurance company's legal reserves
appear on its balance sheet?
2-15 Florida Insurance Practice
,2-15 Florida Insurance Practice
1) As a liability
2) As an asset
3) As a capital improvement
4) As property -Correct Answer ✔
There are no cash values in _____________ insurance.
1) endowment
2) term
3) whole life
4) universal -Correct Answer ✔
________________ requires the policyowner to benefit from the insured's continued
existence or the insured's enjoyment of good health; or to suffer a loss when the insured
dies or is disabled.
1) Beneficiary designation
2) Insurable interest
3) Co-dependency
4) Indemnification -Correct Answer ✔2) Insurable interest
In 2012, the allowed deferred amount under IRC Section 457 plans is 33 1/3% of the
participant's applicable income or $_______, whichever was less.
According to medical cost management principles, mandatory second opinions are not
necessary before an insured undergoes any nonlife-threatening surgery.
2-15 Florida Insurance Practice
, 2-15 Florida Insurance Practice
1) TRUE
2) FALSE -Correct Answer ✔2) FALSE
"Capitation" as used by HMOs means:
1) the amount paid to an HMO by a physician or provider for administrative costs.
2) the amount paid by an HMO to the state in order to do business.
3) the amount an HMO pays to a physician or provider in exchange for rendered
medical services.
4) the amount paid to an HMOs medical management service. -Correct Answer ✔
In health insurance policy underwriting, the three most important factors are:
1) moral hazards, avocation, and occupation.
2) moral hazards, occupation, and physical condition.
3) moral hazards, morale hazards, and physical condition.
4) morale hazards, avocation, and occupation. -Correct Answer ✔
What type of annuity settlement would best be used to distribute funds from the
settlement of large sums of money (such as with lawsuits and lotteries)?
1) A fixed settlement annuity
2) A variable annuity
3) A structured settlement annuity
4) A tax sheltered settlement annuity -Correct Answer ✔
Which of the following types of insurance contracts are NOT considered valued
contracts?
1) Disability income insurance
2) AD&D insurance
3) Medical expense plans
4) Life insurance -Correct Answer ✔
According to agent ethics, it is recommended that agents meet with their clients
________ and complete a review.
1) monthly
2) every 3 months
3) every 6 months
4) annually -Correct Answer ✔
Basic Medical Expense insurance limits coverage to specific types of medical care.
1) TRUE
2-15 Florida Insurance Practice
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