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52 Cards in this Set
- Front
- Back
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All of the following are basic forms of health insurance coverage EXCEPT
A. medical expense B. limited pay health C. disability income D. accidental death and dismemberment |
B. limited pay health
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Which of the following premium factors is unique to health insurance (as opposed to life insurance) ?
A. Age B. Sex C. Morbidity D. Interest |
C. Morbidity
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Assume a health insurance contract states that it will pay $350 a month to the insured, should she become totally disabled. Which term most aptly defines this kind of contract?
A. Participating B. Valued C. Inclusive D. Reimbursement |
B. Valued
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Which of the following statements regarding health insurance is CORRECT?
A. Once issued, health insurance policies cannot be canceled by the insurer. B. There are many premium-payment options available with health insurance policies. C. Medical expense policies reimburse the insured for the costs of medical care. D. Disability income policies are designed to pay hospital expenses associated with a disability. |
C. Medical expense policies reimburse the insured for the costs of medical care.
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HMOs are known for stressing
A. preventive medicine and early treatment B. state-sponsored health care plans C. in-hospital care and services D. health care services for government employees |
A. preventive medicine and early treatment
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The waiting period before qualifying for Social Security disability benefits is how many months?
A. 3 B. 5 C. 6 D. 12 |
B. 5
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Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures?
A. Administrative-services-only plan B. Commercial insurer C. Preferred provider organization D. Health maintenance organization |
B. Commercial insurer
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The miscellaneous expense benefit in a basic hospital expense policy normally will cover
A. physicians' bedside visits B. the administering of anesthia C. drugs and medicine administered in the hospital D. hospital room and board |
C. drugs and medicine administered in the hospital
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Which of the following is NOT a basis for occupational suitability when determining total disability?
A. Education B. Training C. Experience D. Job Interest |
D. Job Interest
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Which of the following riders provides for changes in the benefit payable based on changes in the Consumer Price Index (CPI) ?
A. Guaranteed insurability rider B. Cost-of-living adjustment rider C. Social Security rider D. Waiver of premium rider |
B. Cost-of-living adjustment rider
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Benefit periods for individual short-term disability policies typically vary from
A. 1 to 12 months B. 3 months to 3 years C. 6 months to 2 years D. 1 to 5 years |
C. 6 months to 2 years
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Which of the following terms relates to disability income insurance?
A. Service basis B. First-dollar C. Residual amount benefit D. Coinsurance |
C. Residual amount benefit
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Which definition of total disability is more favorable to the insured?
A. "Own occupation" is more favorable. B. "Any occupation" is more favorable. C. They are the same in terms of benefits to the insured. D. There is no way to determine from the information provided. |
A. "Own occupation" is more favorable.
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What is the initial period of time specified in a disability income policy that must pass, after a policy is in force, before a loss due to sickness can be covered?
A. Preexisting term B. Probationary period C. Temporary interval D. Elimination period |
B. Probationary period
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Sidney has a monthly benefit of $2,500 for total disability under a residual disability income policy. If Sidney suffers a 40% loss of his predisability income, how much will his benefit be?
A. $0 B. $1,000 C. $1,500 D. $2,500 |
B. $1,000
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The amount of payable as a death benefit in an accidental death and dismemberment policy is known as the
A. primary amount B. capital sum C. indemnity amount D. principal sum |
D. principal sum
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Theodore received a $15,000 cash benefit from his $50,00 accidental death and dismemberment policy for the accidental loss of one eye. The amount he received could be identified as the policy's
A. principal sum B. secondary sum C. capital sum D. contingent amount |
C. capital sum
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B. Linda has a $40,000 AD&D policy that pays triple indemnity. If she should be killed in a train wreck, her beneficiary would receive $120,000.
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For how many days of skilled nursing facility care will Medicare pay benefits?
A. 25 B. 60 C. 75 D. 100 |
D. 100
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Under Medicare Part B, the participant must pay all of the following EXCEPT
A. an annual deductible B. a per benefit deductible C. 20% of covered charges above the deductible D. a monthly premium |
B. a per benefit deductible
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All of the following conditions are typically covered in a long-term insurance policy EXCEPT
A. Alzheimer's disease B. senile dementia C. alcohol dependency D. Parkinson's disease |
C. alcohol dependency
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C. July 1, 2010
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D. Medicare Part A is automatically provided when a qualified individual applies for Social Security benefits.
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All of the following are required uniform provisions in individual health insurance policies EXCEPT
A. change of occupation B. grace period C. entire contract D. reinstatement |
A. change of occupation
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C. To exclude from coverage losses resulting from specified conditions
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D. The greater the benefits , the higher the premium.
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B. continuation of health insurance
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B. Group health plans provide more extensive benefits than individual health plans.
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C. Employees covered under both a short-term and long-term plan collect benefits from each simultaneously.
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B. a reserve
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A. Pure risks
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C. August 21
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C. representations
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D. mutual insurer
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A. Express
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Statements made by an applicant for life insurance that are guaranteed to be true are
A. warranties B. material statements C. representations D. declarations |
A. warranties
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C. the peril
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B. Roger's coverage began when he received the insurability receipt.
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D. Conditionally renewable
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A. preventive care
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B. PPOs operate on a prepaid basis
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All of the following benefits are available under Social Security EXCEPT
A. welfare benefits B. death benefits C. old-age or retirement benefits D. disability benefits |
A. welfare benefits
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Which of the following is NOT a typical type of long-term care coverage?
A. Skilled nursing care B. Home health care C. Hospice care D. Residential care |
C. Hospice care
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B. 20 days after an occurrence or a commencement of a loss
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All of the following are mandatory provisions in health insurance policies EXCEPT
A. proof of loss B. entire contract C. change of beneficiary D. misstatement of age |
D. misstatement of age
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C. marital status
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Which of the following is known for stressing preventive health care?
A. Administrative-services-only providers B. Lloyd's of London C. Health maintenance organizations D. Commercial insurers |
C. health maintenance organizations
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When a medical expense policy pays benefits on a fixed-rate basis, it pays
A. a certain percentage of whatever the hospital room charges are B. for total hospital expenses, less a deductible C. a flat amount per day for hospital room and board D. only for surgery and miscellaneous hospital expenses |
C. a flat amount per day for hospital room and board
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Wilbur's basic medical expense policy limits the miscellaneous expense benefit to 20 times the $90 daily room and board benefit. During his recent hospital stay, miscellaneous expenses totaled $2,100. How much, if any, of this amount will Wilbur have to pay?
A. $0 B. $210 C. $300 D. $2,100 |
C. $300
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All of the following are types of deductible provisions associated with major medical policies EXCEPT
A. corridor B. integrated C. flat D. stop-loss |
D. stop-loss
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If the coinsurance feature in a major medical insurance policy is 75/25 with a $100 deductible, how much of a $2,100 bill would the insured pay?
A. $100 B. $500 C. $600 D. $1,500 |
C. $600
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Which of the following statements concerning workers' compensation is NOT correct?
A. Workers' compensation laws are designed to return injured persons to work. B. Benefits include medical care costs and disability income. C. A worker receives benefits only if the work related injury was not her fault. D. All states have workers' compensation laws. |
C. A worker receives benefits only if the work related injury was not her fault.
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