Tennessee Health Insurance License Review ExamFX with Answers.
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TennesseeHealthInsuranceLicense ReviewExamFX
withAnswers.
All of the following could be considered rebates if offered to an insured in the sale of
insurance EXCEPT
a)An offer to share in commissions generated by the sale.
b)Dividends from a mutual insurer.
c)An offer of employment.
d)Stocks,...
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Tennessee Health Insurance License Review ExamFX
with Answers.
All of the following could be considered rebates if offered to an insured in the sale of
insurance EXCEPT
a)An offer to share in commissions generated by the sale.
b)Dividends from a mutual insurer.
c)An offer of employment.
d)Stocks, securities, or bonds. - Correct Answer b)Dividends from a mutual insurer.
Dividends paid to policyholders of a mutual insurer are not considered to be a rebate
because the policy specifies that they might be paid.
Which provision states that the insurance company must pay Medical Expense claims
immediately? - Correct Answer Time of Payment of Claims - The Time Payment of Claims
provision requires that claims will be paid immediately upon receipt of proofs of loss
except for periodic payments, which are to be paid as specified in the policy.
Which of the following is NOT a feature of a guaranteed renewable provision?
a)The insured has a unilateral right to renew the policy for the life of the contract.
b)Coverage is not renewable beyond the insured's age 65.
c)The insured's benefits cannot be reduced.
d)The insurer can increase the policy premium on an individual basis. - Correct Answer
d)The insurer can increase the policy premium on an individual basis. Guaranteed
renewable provision has all the same features that the noncancellable provision does,
with the exception that the insurer can increase the policy premium on the policy
anniversary date. However, the premiums can only be increased on a class basis, not on
an individual policy.
In insurance, an offer is usually made when - Correct Answer An applicant submits an
application to the insurer.
Under a Key Person disability income policy, premium payments - Correct Answer Are
made by the business and are not tax-deductible.
What is the typical deductible for basic surgical expense insurance? - Correct Answer $0
Which of the following is true about the requirements regarding HIV exams?
a)Results may be disclosed to the agent and the underwriter.
b)Prior informed oral consent is required from the applicant.
c)HIV exams may not be used as a basis for underwriting.
d)The applicant must give prior informed written consent. - Correct Answer d)The
applicant must give prior informed written consent. A separate written consent form must
be obtained prior to an HIV exam. HIV exam results may be disclosed to underwriters, but
not agents.
, Unless otherwise extended, how soon from the proof of loss must an insurer advise the
insured of the acceptance or denial of a claim? - Correct Answer 60 days - After proof of
loss has been submitted and a receipt has been acknowledged, an insurer must conduct
an investigation and submit a notice to the insured of the acceptance or denial of the claim
within 60 days. This time requirement may be extended for an additional 60 days if a
reason for the extension is provided to the insured.
The HMO Act of 1973 required employers to offer an HMO plan as an alternative to
regular health plans if the company had more than 25 employees. How has this plan since
changed? - Correct Answer Employees are no longer forced to offer HMO plans.
An insured is covered by a disability income policy that contains an accidental means
clause. The insured exits a bus by jumping down the steps and breaks an ankle. What
coverage will apply? - Correct Answer No coverage will apply, since the injury could have
been forseen.
A client has a new individual disability income policy with a 20-day probationary period
and a 30-day elimination period. Ten days later, the client breaks their leg and is off work
for 45 days. How many days of disability benefits will the policy pay? - Correct Answer 15
days - A probationary period refers to the amount of time that coverage is not available for
illness-related disabilities, so it would not apply to a broken leg. The elimination period,
however, is the time that must elapse between the onset of the disability and when
benefits will start being paid. In this case, the individual is considered disabled for 45 days,
and the benefits will start to be paid after 30 days. So, the client will receive benefits for 15
days.
An insured pays a monthly premium of $100 for her health insurance. What would be the
duration of the grace period under her policy? - Correct Answer 10 days - The grace
period is 7 days if the premium is paid weekly, 10 days if paid monthly, and 31 days for all
other modes.
In a group health policy, a probationary period is intended for people who - Correct
Answer Join the group after the effective date - The probationary period is the waiting
period new employees must satisfy before becoming eligible for benefits.
Which of the following does the Insuring Clause specify? - Correct Answer The Insuring
Clause lists the insured, the insurance company, what kind of losses are covered, and for
how much the losses would be compensated.
Following hospitalization because of an accident, Bill was confined in a skilled nursing
facility. Medicare will pay full benefits in this facility for how many days? - Correct Answer
20 - Following hospitalization for at least three days, if medically necessary, Medicare
pays for all covered services during the first 20 days in a skilled nursing facility. Days 21
through 100 require a daily copayment.
Medicare Part A services do NOT include which of the following?
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