If an agent makes a correction on the application for health insurance, who must initial
the correct answer? - CORRECT ANSWER-The applicant
What is the
... [Show More] term used for a written request for an insurer to issue an insurance contract
based on the provided information? - CORRECT ANSWER-Application
What information are the members of the Medical Information Bureau required to
report? - CORRECT ANSWER-Adverse medical information about the applicants or
insured.
When should an agent obtain a Statement of Good Health from the insured? -
CORRECT ANSWER-When the premium was paid upon policy delivery and not the
time of application.
What is the entire contract in health insurance underwriting? - CORRECT ANSWERThe application and policy issued.
What entities make up the Medical Information Bureau? - CORRECT ANSWERInsurers
What is the best way to make a change on an application for insurance? - CORRECT
ANSWER-Start over with a fresh application
In health insurance, the policy itself and the insurance application form what? -
CORRECT ANSWER-The entire contract
If an insurer decides to obtain medical information from different sources in order to
determine the insurability of an applicant, who must be notified of the investigation? -
CORRECT ANSWER-The applicant
Who must sign a health insurance application? - CORRECT ANSWER-The
policyowner, the insured (if different), and the agent
If an underwriter requires extensive information about the applicant's medical history,
what report will best serve this purpose? - CORRECT ANSWER-Attending Physicians
statement
Who is responsible for paying the cost of a medical examination required in the process
of underwriting? - CORRECT ANSWER-Insurer
Whose responsibility is it to inform an applicant for health insurance about the insurer's
information gathering practices? - CORRECT ANSWER-The agent
What type of hospital policy pays a fixed amount each day that the insured is in the
hospital? - CORRECT ANSWER-Hospital indemnity
What is the term for a period of time immediately following a disability during which
benefits are not payable? - CORRECT ANSWER-Elimination period
What is the primary purpose of disability income insurance? - CORRECT ANSWER-To
replace income lost due to a disability
Who are the parties in a group health contract? - CORRECT ANSWER-The employer
and the insurer
Under what type of care do insurers negotiate contracts with health care providers to
allow subscribers have access to health care services at a favorable cost? - CORRECT
ANSWER-Preferred Provider Organization (PPO)
How are HMO territories typically divided? - CORRECT ANSWER-geographic areas
Why do HMOs encourage members to get regular checkups? - CORRECT ANSWERTo help catch health problems early when treatment has the greatest chance for
success (i.e. preventive care)
Who chooses a primary care physician in an HMO plan? - CORRECT ANSWER-The
individual member
What is a fee-for-service health plan? - CORRECT ANSWER-Under a fee-for-service
plan, providers receive payments for each service provided
What are the three types of basic medical expense insurance? - CORRECT ANSWERHospital, surgical, and medical
What is the capital sum in Accidental Death and Dismemberment (AD&D) coverage? -
CORRECT ANSWER-A percentage of the principle sum
What is the main principle of an HMO plan? - CORRECT ANSWER-Preventive care
In health insurance, what is considered a sickness? - CORRECT ANSWER-An illness
that first arises while the policy is in force
What do individual insureds receive as proof of their group health coverage? -
CORRECT ANSWER-Certificate of insurance
In what type of health plans are providers paid for services in advance, regardless of the
services provided? - CORRECT ANSWER-Prepaid plans
Can Alzheimer's disease be excluded from coverage under a long-term care policy? -
CORRECT ANSWER-No, organic cognitive disorders, such as Alzheimer's or
Parkinson's must be covered
With key person disability insurance, who pays the policy premiums? - CORRECT
ANSWER-The business (employer)
What type of health insurance would pay for hiring a replacement for an important
employee who becomes disabled? - CORRECT ANSWER-Key-person disability
insurance
What are the two types of flexible spending accounts? - CORRECT ANSWER-Health
care accounts and dependent care accounts
In order to be eligible for coverage by an HSA, an individual must also be covered by
what type of health plan? - CORRECT ANSWER-High deductible health plan (HDHP)
What does the amount of disability benefit that an insured can receive depend on? -
CORRECT ANSWER-The insured's income at the time of policy application
What is the purpose of COBRA? - CORRECT ANSWER-To allow continuation of health
insurance coverage for terminated employees
What is the purpose of a buy-sell agreement for health insurance policies? - CORRECT
ANSWER-To specify how the business will pass between owners when one of them
dies or becomes disabled
What is the purpose of respite care in long-term care insurance? - CORRECT
ANSWER-To provide relief for a major caregiver (usually a family member)
What type of groups are eligible for group health insurance? - CORRECT ANSWEREmployer-sponsored and association-sponsored groups
How can an HMO member see a specialist? - CORRECT ANSWER-Referral by the
primary physician
What types of injuries and services will be excluded from major medical coverage? -
CORRECT ANSWER-Injuries caused by war, intentionally self-inflicted injuries, injuries
covered by workers compensation, regular dental/vision/hearing care, custodial care,
and elective cosmetic surgery
What is the role of the gatekeeper in an HMO plan? - CORRECT ANSWER-To control
costs for the service of specialists
Can an insured who belongs to a POS plan use an out-of-network physician? -
CORRECT ANSWER-Yes, but the copays and deductibles may be higher
In group insurance, what is the name of the policy? - CORRECT ANSWER-Master
policy
What is the purpose of the coinsurance provision in health insurance policies? -
CORRECT ANSWER-To prevent over-utilization of the policy benefits
If a health insurance policy has a 31-day grace period, what does that mean? -
CORRECT ANSWER-The policy remains in effect for 31 days after the premium is due
and not paid
What is the name of the act by the insured to voluntarily give up insurance? -
CORRECT ANSWER-Cancellation
Who pays the expense for an autopsy under the physical examination and autopsy
provision? - CORRECT ANSWER-The insurer
According to the Time Limit on Certain Defenses provision in health insurance policies,
when can an insurer contest fraudulent misstatements on a health insurance
application? - CORRECT ANSWER-Any time while the policy is in force
Which health insurance provision describes the insured's right to cancel coverage? -
CORRECT ANSWER-Renewal provision
After the elimination period, a totally disabled insured qualified for benefits from a
disability income policy that has a waiver of premium rider. What will happen to the
premium that was paid into the policy during the elimination period? - CORRECT
ANSWER-Premium will be refunded
If the insured pays a monthly premium for health insurance, how long would the grace
period be on the policy? - CORRECT ANSWER-10 days
What will determine the length of the grace period in a health insurance policy? -
CORRECT ANSWER-The mode of the premium payment
Who decides which optional provisions would be included in a health policy? -
CORRECT ANSWER-The insurance company
How will changing one's occupation to be more hazardous affect the health insurance
policy in force? - CORRECT ANSWER-Claim benefits will be reduced to what the
premium would have bought for a more hazardous occupation
The insured on a health policy misstates his age on the insurance application. If this
misrepresentation is discovered, what will happen to the policy? - CORRECT
ANSWER-The benefit amount payable under the policy will be adjusted to the insured' [Show Less]