Note 7 - Health Law PDF

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Health Law...

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age, medical condition, and occupation are not factors.

When does a Probationary Period provision become effective in a health insurance contract? - At the policy's inception

When must a written disclosure be given to the applicant or policy holder regarding administrative fees charged by the agent? - Prior to any services being rendered

When must insurable interest be present in order for a life insurance policy to be valid? - When the application is made

When must insurable interest exist for a life insurance contract to be valid? - Inception of the contract

When offering health insurance coverage to an employee, a health insurer must inform the employer of all the following information - Provisions relating to renewability of coverage Provisions relating to exclusions Benefits and premiums available under all health insurance coverage for which the employer is qualified

When offering health insurance coverage to an employee, a health insurer must inform the employer of all the following information EXCEPT - the terms of the insurer's provider agreement

When soliciting a Medicare Supplement policy, an insurance agent should advise an applicant that the - agent is there to determine what, if any, policy is appropriate for the purchaser, considering existing coverage

When third-party ownership is involved, applicants who also happen to be the stated primary beneficiary are required to have: - insurable interest in the proposed insured

Which accident and health policy provision addresses preexisting conditions? - Time limit on certain defenses

Which contract permits the remaining partners to buy-out the interest of a disabled business partner? - Disability Buy-Sell

Which federal law allows an insurer to obtain an inspection report on a potential insured? - Fair Credit Reporting Act

Which Federal law allows an insurer to obtain an inspection report on a potential insured? - Fair Credit Reporting Act

Which health policy clause specifies the amount of benefits to be paid? - Insuring

Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract? - entire contract

Which is NOT a type of agent authority - Principal

Which long term care insurance statement is true? - Pre-existing conditions must be covered after the coverage has been in force for six months

Which mode of payment is nOT used by health insurance policies - Single premium

Which mode of payment is NOT used by health insurance policies? - Single premium

Which of the following actions is considered an Adverse Underwriting Decision? - Terminating insurance coverage

Which of the following actions will an insurance company most likely NOT take if an applicant, who has diabetes, applies for a Disability Income policy? - Issue the policy with an altered Time of Payment of Claims provision

Which of the following are NOT managed care organizations? - Medical Information Bureau (MIB)

Which of the following BEST describes a Hospital Indemnity policy? - coverage that pays a stated amount per day of a covered hospitalization

Which of the following BEST describes a short-term medical expense policy? - Nonrenewable

Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)? - more physicians to choose from

Which of the following BEST describes how pre-admission certifications are used? - Used to prevent nonessential medical costs

Which of the following characteristics is associated with a large group disability income policy? - No medical underwriting

Which of the following claims are typically excluded from Medical expense policies? Intentionally self-inflicted injuries"

Which of the following correctly explains the actions an agent should take if a customer wants to apply for an insurance policy? - Complete the application and review the information with the customer prior to obtaining the customer's signature, then send the application off to the insurance company

Which of the following costs would a Basic Hospital/Surgical policy likely cover? - Surgically removing a facial birthmark

Which of the following does Social Security NOT provide benefits for? - Dismemberment

Which of the following health insurance coverages is best suited for meeting the expenses of catastrophic illness? - Major Medical

Which of the following health insurance policy provisions specifies the health care services a policy will provide? - insuring clause

Which of the following health policy provisions states that the producer does NOT have authority to change the policy or waive any of its provisions? - Entire contract

Which of the following health policy provisions states that the producer does NOT have the authority to change the policy or waive any of its provisions? - Entire contract

Which of the following individuals is required to hold an appointment with an insurance company which they represent? - an agent

Which of the following is NOT a defined group for purchasing group insurance? - nonprofit organization

Which of the following is NOT a limited benefit plan? - Life insurance policies

Which of the following is NOT an unfair trade practice? - reinsurance

Which of the following is NOT considered an insurance advertisement? - an employer bulletin announcing the availability of coverage for employees

Which of the following is NOT defined group for purchasing insurance? - Nonprofit organization

Which of the following is NOT included in the policy face? - Exclusions

Which of the following is the MOST important factor when deciding how much Disability Income coverage an applicant should purchase? - Applicant's monthly income

Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party? - Subrogation

Which of the following medical expenses does Cancer insurance NOT cover? - arthritis

Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures? - commercial insurer

Which of the following phrases refers to the fees charged by a healthcare professional? - Usual, customary, and reasonable expenses

Which of the following policy features allows an insured to defer current health charges to the following year's deductible instead of the current year's deductible? - Carryover provision

Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy? - Entire contract

Which of the following provisions specifies how long a policy owner's health coverage will remain in effect if the policy owner does not pay the premium when it is due? - grace period

The grace period is the additional period of time after a premium payment is due that will allow the policy to remain in force in the event of nonpayment

Which of the following provisions specifies how long a policyowner's health coverage will remain in effect if the policyowner does not pay the premium when it is due? - grace period

Which of the following reimburses its insureds for covered medical expenses - Preferred provider organizations

Which of the following reimburses its insureds for covered medical expenses? - Commercial insurers...