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2024 HEALTH INSURANCE FLORIDA 2-40 PRACTICE EXAM QUESTIONS 2 WITH 100% CORRECT ANSWERS
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2024 HEALTH INSURANCE FLORIDA 2-40 PRACTICE EXAM QUESTIONS 2 WITH 100% CORRECT ANSWERS
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2024 HEALTH INSURANCEFLORIDA 2-40 PRACTICE EXAM
QUESTIONS 2 WITH 100%
CORRECT ANSWERS
Which of the following is NOT a form of medical insurance?
-Business overhead expense
-Surgical expense
-Hospital expense
-Long term care - CORRECT ANSWERS- Business overhead expense
(Explanation:Business Overhead Expense insurance is designed to reimburse
a business for overhead expenses in the event a business owner becomes
disabled. Expenses such as rent, utilities, telephone, equipment, employees'
salaries, etc.)
All of the following are state or federal government programs that provide
health insurance, EXCEPT?
-Medicare
-OASDI disability
-Medicaid
-Medigap - CORRECT ANSWERS- Medigap (Explanation:A Medigap policy is a
Medicare supplement insurance policy sold by private insurance companies
to fill "gaps" in Medicare Parts A and B.)
What type of health insurance is available to assist low-income individuals? -
CORRECT ANSWERS- Medicaid
Which of the following is NOT a purpose of licensing?
A) To authorize and enable the licensee to actively and in good faith engage
in the insurance business as an agent
B) For the applicant to be familiar with the Florida insurance laws
C) To authorize the agent to insure risks
D) To facilitate the public supervision of such activities in the public interest -
CORRECT ANSWERS- To authorize the agent to insure risks
The following qualifications are required for a life or health agent license,
except?
A) Be at least 21 years of age
B) Pass a written licensing examination
,C) Complete 40 hours of classroom or correspondence instruction within 4
years immediately preceding the application
D) Submit fingerprints and a background check - CORRECT ANSWERS- Be at
least 21 years of age ( You have to be at least 18 years of age)
What types of reserves are set aside and held by health insurance
companies? - CORRECT ANSWERS- Premium and Claims reserves
(Explanation:Reserves are set aside for the payment of future claims.)
Group health insurance is generally written on a basis that provides for
dividends or experience rating. What is the basis called? - CORRECT
ANSWERS- Participating (Explanation:Group plans written by mutual
companies provide for dividends while stock companies frequently issue
experience-rated plans.)
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 - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERS-
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 - CORRECT ANSWERS- 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 -
CORRECT ANSWERS- 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 - CORRECT
ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 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 - CORRECT ANSWERS- 30 days
during every 18-month period
If an HMO is found guilty of unfair trade practices, what is the maximum
penalty that can be charged?
-Up to $50,000
-Up to $150,000
-Up to $200,00
-Up to $100,000 - CORRECT ANSWERS- Up to $200,00
Which of the following statements about Worker's Compensation laws is
INCORRECT?
-Employers can purchase coverage through the state program, private
insurers or can self-insure
-Worker's compensation provides benefits for work-related injuries, illness or
death
-Not all states have a workers compensation law
-Basic principle is that work-related injuries are compensable by the
employer without regard to fault - CORRECT ANSWERS- Not all states have a
workers compensation law
What year was the Social Security Act amended to add health insurance
protection for the aged and disabled?
-1973
-1965
-1985
-1935 - CORRECT ANSWERS- 1965
All of the following are true statements about Workers Compensation,
EXCEPT..?
-Benefits are not paid unless there is employer negligence
-Pays benefits for work related injuries and illnesses
-Employee does not contribute to the plan
-All states have Workers Compensation laws - CORRECT ANSWERS- Benefits
are not paid unless there is employer negligence
Which of the following is a state administered disability plan?
-Social Security
-Workers Compensation
-Medigap
-Medicare - CORRECT ANSWERS- Workers Compensation
All of the following are nontraditional methods of providing health insurance,
EXCEPT?
-Multiple Employer Trusts
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