Health 2

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Health 2 1. The purpose of Disability Income insurance is to provide: protection against economic death unemployment income surgical expense reimbursement hospitalization expense reimbursement 2. A recurrent disability is normally considered: I. to be a problem that the insurance company cannot be expected to cover over and over II. for repeat coverage if the insured has worked a specified period after completing a previous indemnity period I only II only I and II Neither I nor II 3. Regarding disability, a disability that is a permanent physical impairment leaving the individual incapable of performing the previous regular occupation, but capable of performing some other type of work, is a: permanent total disability permanent partial disability temporary total disability temporary partial disability 4. Disability Income payments must be paid at least: Weekly Monthly Quarterly Annually 5. An insured's disability income policy defines total disability as the insured's inability to perform the duties of any occupation for which he or she is reasonably qualified by education, training or experience. Which of the following is true about this definition? This is known as the own occupation definition and is more restrictive than other definitions. It is the any occupation definition and is more restrictive than other definitions. This is known as the own occupation definition and is less restrictive than other definitions. This is the any occupation definition and is less restrictive than other definitions. 6. Before Crankston was disabled, he was a fulltime grave digger earning about $70,000 annually. Now, two years later, he is only able to work part time, earning about $25,000 annually. Under a Residual Disability policy it is likely that Crankston would be classified as: totally and permanently disabled recurrently disabled partially disabled not disabled at all 7. Which of the following statements about Medicaid is/are true? I. It is one of the major parts of Medicare. II. It is intended to provide medical assistance for certain categories of people who are needy. III. It supplements Medicare for those over age 65, who qualify. IV. It is funded entirely by the State Government. II, III, and IV I and II only II & lll IV only 8. Which of the statements below about Medicare Part B are true? I. There is an annual deductible. II. There is coinsurance of 80% - 20% after the deductible is met. I only II only I and II Neither I nor II 9. Which of the following statements concerning Accidental Death and Dismemberment coverage is/are true? 1. Death benefits are paid only if death occurs within 60 days of an accident. 2. Dismemberment benefits may be paid for loss of use. 3. Accidental death benefits are paid only if death results from an accidental bodily injury as defined in the policy? 1 & 2 1 & 3 2 & 3 1, 2, & 3 10. Regarding Limited Risk, Special Risk, and Disability Income policies, which statement is true? Accidental means are more limiting than accidental results. Accidental results is more limiting than accidental means. Accidental results and accidental means do not apply to these types of policies. My interest in this subject matter is about shot. 11. The time period specified in the Free Look provision begins: when the policy is issued when the policy is delivered when the application is signed when the application is approved 12. Which of the following may normally be used as a definition of total disability? I. house-confined II. inability to perform the duties of any occupation III. inability to perform the duties of the insured's own occupation I only I and II only II and III only I and III only 13. Eustis Toolis had a $2000 per month disability policy with a benefit period to age 65 and a 6 month waiting period. She became disabled at age 64 1/2. How much would she receive? $2000 $1000 $12000 Nothing 14. An agent takes an application for health insurance on Bone and Marrow Lykes and their family. When the agent returns to her office she discovers two unanswered questions on the application. Which action should she take? Call the Lykes and get the information over the telephone. Reconstruct the sales interview and answer the questions based on the information she can remember. Submit the application to her company as is. Go back to the Lykes and have them complete the unanswered questions. 15. When completing an application for medical insurance, an agent should do which of the following? 1. The agent should review the applicant's health statement and bind the coverage. 2. The agent should complete the Medical Information Bureau report. 3. The agent should witness the applicant's signature. 4. The agent should sign the applicant's name if the applicant lives out of state. 1, 2 & 3 1 & 3 2 only 3 only 16. The purpose of the optional elimination (waiting) period is: It provides a trial period of coverage for the insured at little cost. It limits the insurer's risk related to accidental injuries. It gives the insured an opportunity to cancel the policy and obtain a refund if not entirely satisfied. It helps the insured to reduce the cost of the policy by accepting the risk of a short term disability. 17. A health insurance policy includes an endorsement indicating the insurer will allow the policy to continue in force without further premiums if the insured is totally and permanently disabled. What endorsement is attached to this policy? Guaranteed insurability Impairment Rider Multiple indemnity Waiver of premium 18. A health insurance policy includes an endorsement indicating the insurer will allow the policy to continue in force without further premiums if the insured is totally and permanently disabled. What endorsement is attached to this policy? Guaranteed insurability Imapairment rider Multiple indemnity Waiver of premium 19. Examples of those covered under a Limited Risk Plan are I. Chopin's Hands ( if living) II. Dread Diseases III. A Test Pilot IV. Airplane Passengers I II I & IV II & IV 20. Which of the following describes a representation? An insurance company guarantees that policy benefits will be paid promptly on receipt of a Proof of Loss. An insurance company guarantees that premiums paid will be refunded within 30 days after the policy's effective date if an insured is dissatisfied with the policy. When a prospect's statement on an application is held to be substantially true. When a prospect's statement on an application is held to be absolutely true. 21. Dread disease, a travel accident, vision care, and hospital indemnity policies are all examples of: LTC policies Limited policies Special risk Blanket policies 22. Johnson was covered under a residual individual disability income plan with a benefit period to age 65. The policy had a six month elimination period and a 14 day probationary period. Johnson suffered a heart attack 10 days into the policy's effective date. The earliest the benefits would become payable would be: after the six month waiting period after the 14 day elimination period immediately never 23. There are _____ standard Medicare supplement policies. 5 10 12 14 24. The non-disabling injury benefit pays: I. a flat amount equal to the insured's salary II. a percentage amount equal to the insured's salary III. the actual cost of medical treatment IV. a percentage amount equal to the weekly or monthly benefit I II & III III & IV IV 25. Which of the following statements about Medicare is true? I. Payments are made directly to the hospital, not to the Medicare recipient. II. Home health care benefits and skilled facility care are provided under Part A. . I only II only I and II Neither I nor II 26. Which of the following statements about the total disability provision of health insurance policies is true? It is a uniform policy provision regulated by state law. It is a uniform policy provision spelled out by federal regulations. It is a provision that may vary from policy to policy. It is a provision that can be changed only by an agent of an insurance company after a policy is issued. 27. A limited risk policy covers: risks not covered by accident and health policies specific risks all risks unusual types of risks 28. Which of the following provisions in a disability policy protects an insurance company against pre-existing conditions? Recurrent Disability Probationary Period Elimination (Waiting) Period Residual Disability 29. Robert was insured under an own occupational residual disability policy which had a 5 year benefit period along with a six month elimination period. He was totally disabled by a chicken bone. He received disability payments for 2 years after which he returned to work on a full time basis. Five months later he was disabled by the same chicken bone. Which of the following statements is correct? It is a recurrent disability and the policy will pick up where it left off. There is no waiting period and it will pay for 3 years. It is a new disability and will require a new elimination period, but it will pay for 5 more years. It is a recurrent disability and it will pay for 5 years. None of the above. Chicken bone disabilities are never covered. 30. Which of the following statements is true about the conditional receipt issued to an applicant for an individual disability income policy? Coverage begins immediately as of the date of the conditional receipt. An agent should give an applicant the conditional receipt after taking an application, even if the applicant has not been paid the premium. If an applicant is an acceptable risk, the conditional receipt binds the insurance company as of either date of the receipt or date of the medical exam, whichever is later. If unfavorable information is discovered during the underwriting process, the conditional receipt guarantees standard coverage. 31. Which is true about Medicare? Part A is optional. Part B is mandatory. Both part A and part B are optional. Part A is mandatory and part B is optional. 32. A guaranteed insurability rider may be attached to: a basic dental hospital plan dental plans disability plans major medical plans 33. All of the following usually pertain to the probationary period on a disability policy EXCEPT: It is found in the insuring clause. It is one of the 12 mandatory clauses. It requires a certain waiting period for illness. It requires no waiting period for accidents. 34. An agent has just taken an application for an Individual Disability Income policy and has received the initial premium. She has given the prospect a conditional receipt. At this time it would be appropriate for her to tell the prospect which of the following? I. A medical examination may be required. II. An investigative report may be required. III. The Medical information Bureau (MIB) will send its report directly to the prospects. I and II only I and III only II and III only I, II, and III 35. In a disability income policy, there is a period during which no benefits will be paid for illness of any kind. This period usually does not apply to accidents, but only to illness. The term that describes this interim is the: elimination period benefit period waiver period probationary period 36. All of the following are true of Medicaid EXCEPT: Medicaid is operated by the State and subsidized by the Federal Government. Medicaid covers the total cost of visiting nurses to the home. Medical assistance is provided to the aged, blind, disabled, and families with dependent children who are financially poor. Anyone who cannot get Health Insurance coverage due to poor health can quality for Medicaid. 37. A doctor who is receiving Disability Income benefits is unable to return to work full-time, but continues her practice on a part-time basis. Which of the following would allow the doctor to continue to receive benefits? A Residual Benefit clause A Contingent Benefit clause A Concurrent Benefit clause A Guaranteed Insurability clause 38. Which of the following statements about a dismemberment provision in a health insurance policy is true? It provides benefits for the loss of specific parts of the body. It lists the ways in which a policy can be dismembered. It is included in all health policies. It provides coverage only for work-related accidents. 39. Under some policies, an injury that DOES NOT QUALIFY the insured for monthly disability income benefits may make the insured eligible for: outpatient compensation an emergency room benefit medical expense reimbursement a non-disabling benefit 40. An applicant for insurance may pay the initial premium and receive a document from the agent indicating that if the policy is issued as requested, coverage begins on the date of the document. What is this document called? Executing agreements Conditional receipt Warranty Notice of inspection 41. Which part of Medicare requires premium payments by the most eligible participants? Part A, basic hospital insurance Part B, supplementary medical insurance Respite care All of the above 42. A 35 year old male computer programmer and his 35 year wife, also a computer programmer, apply for disability insurance. Which would pay the higher monthly premium? The male programmer The female programmer They would both pay the same Not enough info 43. Which part of Medicare requires premium payment by most eligible participants? Part A, basic hospital insurance Part B, supplementary medical insurance Respite Care All of the above 44. The dismemberment benefit (the capital sum) is an Accidental Death and Dismemberment policy and will pay for which of the following? 1. loss of hands above the wrist 2. loss of 3/4 of the foot 3. loss of an eye 4. all fingers (including the thumbs) on both hands 2 & 4 1, 2, & 3 1 & 3 all the above 45. Which of the following accurately describes the 'free look' provision? It allows the proposed insured to look over a policy carefully before applying for it. It allows the proposed insured to look over the application carefully before completing it. It allows the insured to look over the issued policy for a specific number of days and return it for a premium refund if desired. It allows the insurance company to obtain an inspection report and medical examination on the proposed insured prior to issuing the policy. 46. Under the typical health insurance policy, which of the following would qualify as dismemberment? I. Sally loses all the fingers on her left hand except the thumb. II. Right handed Ed permanently loses the use of his right hand and arm in an auto accident. I only II only I and II Neither I nor II 47. When individual disability benefits are paid directly to the individual who has paid the premium, a question of taxation arises. Which would be the most appropriate response? The premium was tax deductible, the benefit will be considered as taxable income. An exclusion ratio is used to determine the amount of benefit considered taxable. The premium was tax deductible, therefore the benefit will be considered tax-free. The premium was not tax deductible and the benefit is tax free. 48. The basic Hospital Insurance (Part A) of Medicare covers: I. hospital expenses II. physicians fees and services I only II only I and II Neither I nor II 49. Which of the following statements is not correct concerning Medicaid? 1. To be eligible, one must be poor or become poor. 2. Medicaid provides for custodial care in a nursing home. 3. It is a federally administered program. 4. It is available to people of all ages. 1 2 3 4 50. Which is true about Part A of Medicare? I. The insured must pay a premium. II. The insured must pay a deductible. I only II only I and II Neither I nor II 51. A Guaranteed Insurability clause can be attached to which of the following types of health policies? A Hospital Indemnity policy Disability income policy Major Medical policy Cancer Policy 52. The lifetime reserve for Medicare is: 30 days 60 days 90 days 120 days 53. When an application for health insurance is submitted without an initial premium, the earliest effective date is: The date the application is taken by the agent. The date the insurance company issues the policy. The date the policy is received by the agent. The date the policy is delivered to the prospect by the agent and the premium is collected.

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