Health Insurance Basics Flashcards
An application for health insurance is completed by a producer and signed by the applicant. The applicant remembers information that needs to be added to the application before being submitted to the insurer and contacts the producer, who has returned to the office. Which of the following statements is correct?
A
The applicant will have the opportunity to correct any information when the policy is delivered
B
The producer can make any changes necessary with verbal consent of the applicant
C
The producer must meet with the applicant in person to update the information and have the applicant initial the changes
D
Once the application is signed, answers reported on the application cannot be changed
C
The producer must meet with the applicant in person to update the information and have the applicant initial the changes
Which party to a health insurance contract is responsible for making the premium payments?
A
Producer
B
Policyowner
C
Beneficiary
D
Insured
B
Policyowner
If an incomplete application is accepted by the underwriter and a policy is issued without requesting the missing information, which of the following statements applies?
A
The producer will be personally responsible out of pocket for any claims filed based on the missing information in the application
B
The insurer waives its right to contest a claim based on the incomplete application
C
The insurer can void the contract at any time since this is considered fraudulent
D
The policy can be contested if a loss occurs within 2 years of the policy being issued
B
The insurer waives its right to contest a claim based on the incomplete application
If a premium is submitted with the application and a conditional receipt is issued, coverage is effective:
A
The date of application, or date of a completed medical exam if required, whichever is later, as long as the policy would have been issued as applied for
B
The date the insured or owner signed the policy delivery receipt
C
The date the insurance company received the results of a required medical exam
D
The date the policy is issued and mailed to the producer
A
The date of application, or date of a completed medical exam if required, whichever is later, as long as the policy would have been issued as applied for
All of the following are individual underwriting factors, EXCEPT:
A
Gender
B
Tobacco use
C
Marital Status
D
Age
C
Marital Status
which one of the following is the primary source of underwriting information?
A
Investigative consumer report
B
Application
C
Medical exam
D
Attending Physician Statement
B
Application
Which of the following sources of insurability alerts members about an insurance applicant’s previous claim information?
A
APS
B
MIB
C
Consumer Investigative Report
D
Agent’s Report
B
MIB
If a premium is paid at the time of application and the policy is issued as applied, legal delivery can occur at the time of:
A
Completed medical exam
B
Issuance of the policy
C
Application
D
When a statement of good health is provided
B
Issuance of the policy
If a premium is not paid at the time of application, the producer will obtain which of the following at the time of policy delivery?
A
Signed statement of good health
B
Attending physician’s statement
C
Conditional receipt
D
Notice of consent
A
Signed statement of good health
ll of the following are potential risks of replacement of an individual health or disability insurance policy, except:
A
Coverage may be reduced or excluded due to a pre-existing condition
B
Coverage due to an accident will be restricted for 30 days after the effective date of the policy
C
Premiums may be higher than the original policy
D
A new probationary period may go into effect limiting coverage for losses due to sickness
B
Coverage due to an accident will be restricted for 30 days after the effective date of the policy
In the event there is a policy issued and there are questions on the insurance application that went unanswered:
A
It will be assumed that the insurer waived their right to have answers to those questions
B
The agent will fill in the answers after the fact
C
A new application must be filed
D
The insurer will cancel the policy
A
It will be assumed that the insurer waived their right to have answers to those questions
The prior medical conditions for which the applicant has received, or should have received, medical advice or treatment within a specified period before the effective date of a policy are called:
A
Probationary Conditions
B
Excluded Conditions
C
Elimination Period Exclusions
D
Pre-Existing Conditions
The prior medical conditions for which the applicant has received, or should have received, medical advice or treatment within a specified period before the effective date of a policy are called:
A
Probationary Conditions
B
Excluded Conditions
C
Elimination Period Exclusions
D
Pre-Existing Conditions
D
Pre-Existing Conditions
A premium is paid at the time of application and a conditional receipt is issued. If the policy is issued as applied for, and assuming a medical exam has already been completed, coverage becomes effective:
A
At the date of application
B
Upon policy delivery
C
After the free look expires
D
At the time the policy is issued
A
At the date of application
Consumers must be made aware of all of the following in a replacement sale, except:
A
There may be a waiting period for pre-existing conditions
B
The new policy may have a higher premium
C
The new policy may be offered with lower benefits, limitations, or exclusions of coverage
D
The financial ratings from each rating service
D
The financial ratings from each rating service
