Practice Test Questions Flashcards
Which health saving accounts is available to employers of all sizes?
HRA’s(health reimbursement account) they are funds set aside by employers to reimburse employees for qualified medical expenses; they’re available to all sizes of employers
An insured had $500 left in his health reimbursement account when he quit his job. What happens to that money?
The insured can have access to the $500 at his previous employers discretion.
Occasional visits by which of the following medical professionals will not be covered under the LTC’s home health care?
Attending physicians
The goals of HICAP are to provide what?
Info through community forums about the myths and realities of Medicare and private health insurance.
Counseling and advocacy to assist individuals with long-term care planning and insurance policies, biking and claims
Legal representation and advice when necessary and appropriate.
An insurance contract requires that both the insured and the insurer meet certain conditions in order for the contract to be enforceable. What contract characteristic does this describe?
Conditional- an conditional contract requires both the insurer and policyowner to meet certain conditions before the contract can be executed
How many long-term care policies can be sold to an insured within a 12- month period before the number of policies is considered to be unnecessary?
2
Insurers may change which of the following on a guaranteed renewable health insurance policy?
Rates by class- on this policy the insurer may increase premiums on a class basis only and not on an individual policy.
What is not the principal goal of a PPO?
To provide medical services ONLY from physicians in the network
What is not the purpose of HIPAA?
To provide IMMEDIATE coverage to new employees who had been previously covered for 18 months.
Sue has an HSA and is planning to leave her current job for a new job. When she leaves her job, what will happen to her HSA?
It will continue because it is owned by sue, not the employer
In regards to group disability income insurance, are employees covered on and off the job?
Employees who are injured on the job are covered by workers comp. Group disability income insurance is designed to cover employees only while they are OFF the job, so coverage is considered to be non occupational.
Is there a time limit that business overhead expense policies will cover?
There is no limit for that policy.
If one takes social security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
Nothing! Medicare part A and part B will automatically be effective the month you turn 65.
An insured is involved in a car accident. In addition to less serious injuries he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will the insured receive presumptive disability benefits?
No benefits will be received. They require the loss of both limbs. Total or permanent blindness or loss of speech or hearing. Because the insured blindness was temporary and only had the loss of one leg, he does not qualify for benefits.
In forming an insurance contract, when does the acceptance usually occur?
When the insurers underwriter approves coverage. When the policy is issued.
How long does the initial enrollment period for Medicare part B last?
7 months!
When is the insurability conditional receipt given?
When the premium is paid at the time of the application
What are the factors used to determine losses and cost of insuring risks in a group disability policy
Stability, price, and longevity with a particular carrier
Who has jurisdiction regarding the regulation of providers?
All entities that provide coverage designed to pay for health care providers services and expenses must be under the jurisdiction of either the department of insurance or other governmental agencies.
What insurance coverages would be allowed with an MSA?
Long-term care insurance, workers comp. MSA participants cannot have Medicare or any other health plan that isn’t a HDHP.
The mode of the premium payment will do what to the grace period?
It will vary the length of the grace period in the health insurance policy
Will inpatient hospital care for HMO members be provided outside of the service area?
Care can be provided outside of the service area. The HMO will provide the member with inpatient hospital care in or out of the service area
Under the affordable care act, what percentage of preventive care must be covered without cost sharing?
100%
An employee insured under a group health policy is injured in a car wreck while performing her duties for her employer, this results in her hospitalization. What will the insurance pay?
The group policy will not pay because the employee was injured at work. The insured would have to rely on workers comp for coverage.
