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Health Insurance Exam| Questions and Verified ANSWERs| Grade A Which of the following incidents would NOT be covered by an Accidental Death and Dismemberment policy?
ANSWER: Suicide
Which of the following statements BEST describes the HIPAA portability rules for an individual who changes from one group medical plan to another?
ANSWER: Reduces or eliminates any pre-existing conditions
excluded under the new plan
What type of group plan is excluded from HIPAA statutes?
ANSWER: Disability income
Which of the following statements BEST describes disability buy-sell insurance policies?
ANSWER: Policy proceeds are typically received tax-free
Kate received a group accident and health termination notice.How many days does she have to apply for a converted policy?
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ANSWER: 31
How many employees must an employer have for the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to apply?
ANSWER: 20 or more
Which parties are directly involved in a group accident and health insurance contract?
ANSWER: Employer and insurer
Trade association groups that are eligible for group medical
benefits normally are:
ANSWER: in the same industry
In regards to health insurance, employees age 65 or older are
typically required to:
ANSWER: be offered the same group health benefits offered to
the younger employees
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ABC Partnership is a business with a limited number of partners. Which disability buy-sell agreement is best suited for this business?
ANSWER: Cross purchase agreement
How are benefit payments from individually-owned medical expense policies treated for tax purposes?
ANSWER: Exempt from income taxes
In which of the following situations can an insurance company offer group health insurance?
ANSWER: The sponsoring group provides an employer-
employee relationship
If group health benefit levels are too high, what could be the end result?
ANSWER: Overutilization of the plan
Group accident and health insurance may be offered by an
insurer when the sponsoring group:
ANSWER: provides an employer-employee relationship
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Steve has a group disability income policy where the premiums are paid by his employer. He elected to pay for additional residual disability coverage. Which of the following statements is true?
ANSWER: Steve will pay taxes on the disability benefit
received from his employer, but will receive any residual disability benefits tax-free
A characteristic of a Preferred Provider Organizations (PPO) is:
ANSWER: If service is obtained outside the PPO, benefits are
reduced and costs increase
The agreement in which hospitals and physician groups in a specific area contract with an insurance company to provide
medical care at predetermined costs is:
ANSWER: Preferred Provider Organization (PPO)
Inpatient psychiatric care is covered under Part A Medicare for