When an employee's coverage terminates under a group health policy, the employee must be offered continuation coverage for
A. 60 days
B. 180 days
C. 365 days
D. 18 months
18 months
Accident and health policies that provide coverage on an expense-incurred basis for a family member of the insured
A. must cover only those family members covered
at the time the policy is issued
B. must cover a newborn child from the moment
of birth
C. m
must cover a newborn child from the moment
of birth
. An individual accident and health policy whose premiums are paid on a quarterly basis, without any subsidy assistance, must contain a grace period
of at least how many days?
A. 15
B. 31
C. 45
D. 60
31
Which of the following coverage exclusions or limitations is permitted under a long-term care policy issued in Colorado?
A. Preexisting conditions
B. Alzheimer's disease
C. Senile dementia
D. Parkinson's disease
Preexisting conditions
Which of the following is NOT considered an essential health benefit?
A. Emergency services
B. Long-term care services
C. Maternity and newborn care
D. Prescription drugs
Long-term care services
All accident and health policies issued in Colorado that provide major medical services must
offer policyholders the opportunity to purchase
A. disability coverage
B. double indemnity coverage
C. home health care coverage
D. supplemental coverage
home health care coverage
An insurer providing group health coverage may not be required to issue a converted policy to
A. anyone covered by Medicare
B. anyone not covered by a Medicare supplement
policy
C. anyone whose coverage ended because of
layoffs
D. dependents whose coverag
anyone covered by Medicare
Which of the following statements about a Medicare supplement policy is CORRECT?
A. The insurer may cancel it on the grounds of
the insured's health status alone.
B. The insurer may cancel it because the insured
has not paid the premiums.
C. It can indemn
The insurer may cancel it because the insured
has not paid the premiums.
An insurance policy that increases benefits to keep
up with anticipated cost increases for long-term
care services is said to have
A. inflation protection
B. guaranteed benefits
C. Medicare supplemental protection
D. loss of income protection
inflation protection
How often must an individual accident and health insurance policy pay for the mammograms of a 56-year-old Colorado woman?
A. Once every year
B. Once every 2 years
C. Once every 5 years
D. Coverage for mammography is not mandated
for women over the age of
Once every year
Suppose that an insurance producer urges an elderly applicant to buy a second Medicare supplement policy "just to be sure" all potential
medical expenses are covered. This sale is
A. mandatory because high medical costs are
almost never fully covered by M
prohibited because the sale of a supplement
which will provide the person with more than
one Medicare supplement is illegal
Long-term care policies can limit or exclude coverage for all of the following circumstances
EXCEPT
A. preexisting conditions or diseases
B. family history of heart condition before the
effective date of coverage
C. treatment provided in a government faci
family history of heart condition before the
effective date of coverage
What accident and health insurance renewability
clause means the insurer cannot unilaterally change any provision while the policy is in force but can change premium rates by class?
A. Noncancellable
B. Guaranteed renewable
C. Provisional
D. Transitional
Guaranteed renewable
The primary difference between the Colorado Partnership LTC policy and other LTC policies is
A. Medicaid asset protection
B. optional inflation protection
C. higher daily benefits
D. longer lifetime benefits
Medicaid asset protection
If an individual collected $100,000 in benefits from her Colorado Partnership LTC policy, how much asset protection will she receive?
A. None, the minimum is $200,000
B. $50,000 (50%)
C. $100,000 (100%)
D. $200,000 (200%)
$100,000 (100%)
. How many days is the free-look period for a purchaser of a long-term care insurance policy?
A. 10
B. 30
C. 60
D. 90
30
An insurer can deny a claim under a longterm care insurance policy for any material misrepresentation made by the insured if it has
been in effect for
A. fewer than 6 months
B. more than 6 months
C. at least 1 year
D. no more than 2 years
fewer than 6 months
Which of the following is a set of formal techniques that evaluates the clinical necessity,
appropriateness, or efficiency of health care services and procedures?
A. Rating review
B. Participation review
C. Mandated review
D. Utilization review
Utilization review