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Life and Health Insurance Final Exam 164 Questions with Verified Answers,100% CORRECT
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Life and Health Insurance Final Exam 164 Questions with Verified Answers
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Life and Health Insurance Final Exam 164 Questions withVerified Answers
________ is a health insurance policy that only covers physician services and
procedures. Proves first dollar benefits by the insurer, but low coverage limits. -
CORRECT ANSWER Basic Medical Expense
________ is a health insurance policy that only covers room and board if the
insured stays overnight in a hospital and the miscellaneous expenses that occur
because of that stay. - CORRECT ANSWER Basic Hospital Expense
________ is a health insurance policy that only covers surgeries, surgeons and
anesthesiologists. It provides first dollar benefits by the insurer, but low limits. -
CORRECT ANSWER Basic Surgical Expense
______ is a health insurance policy that offers broad coverage and high benefits
for hospitalization, surgeries, and physician services subject to deductibles and
coinsurance. - CORRECT ANSWER Major Medical Expense
_________ is a type of traditional medical expense insurance designed to
reimburse the policyowner for out of pocket medical expenses. It is characterized
by typically low deductibles (100-500), coinsurance, and stop loss limits. -
CORRECT ANSWER Comprehensive Major Medical
What feature of Major Medical policy requires 100% payment of covered
expenses after the insured's claim cost reaches a certain level? - CORRECT
ANSWER Stop Loss
The amount of loss paid by the policyowner before the health insurance policy
pays the claims is known as.. - CORRECT ANSWER Deductible
Mary has a Major Medical policy with a $200 deductible and 80/20 coinsurance
allocation. If she suffers a covered loss of $8200, how much will Mary be required
to pay for this loss? - CORRECT ANSWER $1800
,_______ is a health insurance policy that does not have a deductible. The
company pays first when a claim is submitted. - CORRECT ANSWER First Dollar
Coverage
Charlie owns a Comprehensive Major Medical policy with a $1000 Base plan, a
$500 deductible and 80/20 coinsurance. If he suffers a covered loss of $9500, how
much will the company pay? - CORRECT ANSWER $7400
Which is the correct order of the basic claim calculation? - CORRECT ANSWER
Apply the base plan; subtract the deductible; allocate the coinsurance; check by
adding
You own a Major Medical policy with a $500 deductible and 80/20 coinsurance.
You suffer a covered loss of $4500 and calculate that the company will pay $3200
towards your loss. The company only pays $3019.78. Which of the following could
NOT account for the difference? - CORRECT ANSWER Elimination Period
The individual who controls a Major Medical policy, pays the premiums and is
authorized to receive any benefits from the contract is known as the - CORRECT
ANSWER owner
Which policy would be covered with the rights of a dependent child? - CORRECT
ANSWER Major Med
Coinsurance does which of the following? - CORRECT ANSWER Reduces the
deductible
All of the following characterizes basic medical EXCEPT - CORRECT ANSWER
Ancillary expenses
Which of the following do Medical Expense companies utilize to eliminate small
claims? - CORRECT ANSWER Deductibles
Which of the following do Medical Expense companies use to reduce adverse
selection? - CORRECT ANSWER Preexisting conditions limitations
, The Affordable Care Act allows dependents to remain on a parent/guardian's
healthcare plan until age - CORRECT ANSWER 26
A Disability Income Policy deductible is expressed in time and known as an -
CORRECT ANSWER Elimination Period
______ is the key rating factor for Disability policy - CORRECT ANSWER
Occupation
________ requires that the insured to be unable to perform the duties of his or
her own occupation in order to receive disability income benefits. - CORRECT
ANSWER Own Occupation
________ requires the insured to be unable to perform any occupation they
would be reasonably suited to do based on education, training or work
experience in order to receive disability income benefits from the policy. -
CORRECT ANSWER Any Occupation
Short term disability is ______ year(s) or less. - CORRECT ANSWER Two
Any period exceeding ___ years is considered long term. - CORRECT ANSWER Five
Generally, policy limits are limited to _____% or ____% of your earned income. -
CORRECT ANSWER 60%;80%
What type of disability requires no proof of loss of time or duties? - CORRECT
ANSWER Presumptive Disability
________ promises to pay the amount Social Security would have paid if Social
Security Disability would have been approved. - CORRECT ANSWER Social Security
Rider
__________ will pay the estimated Social Security Disability benefit while Social
Security is determining eligibility. - CORRECT ANSWER Additional Monthly Benefit
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