One of the most important considerations when replacing health insurance would be the
A) Age of the insured
B) Exclusions on a new policy
C) Occupation of the insured
D) Cost
B) Exclusions on a new policy
The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross income. Which of the following is considered a tax deductible medical expense under this rule?
A) Long Term Care insurance premiums
B) Dread Disease insurance pr
A) Long Term Care insurance premiums
How are premiums paid by the insured for personally owned disability income insurance treated for tax purposes?
A) partially tax deductible
B) not tax deductible
C) fully tax deductible
D) tax deferred
B) not tax deductible
Which of the following is NOT an example of utilization review?
A) monitoring length of hospital stay
B) ongoing inspection of accident prone individuals
C) monitoring the appropriateness of care
D) setting a hospital release date for a patient
B) ongoing inspection of accident prone individuals
Which of the following is considered to be a point of service (POS) plan?
A) Preferred provider organization
B) Managed care plan
C) Protected care provider
D) Restricted provider organization
B) Managed care plan
The difference between pre-certification and concurrent review is that pre-certification
A) costs more to the patient
B) costs less to the patient
C) is considered a cost containment measure
D) occurs before the treatment is provided
D) occurs before the treatment is provided
Which of these is NOT a relevant factor in the health insurance principle of morbidity?
A) Age
B) Intelligence
C) Occupation
D) Health
B) Intelligence
Jim is the insured on a health insurance policy and holds two jobs. If "occupation" is used to classify the risk, the insurer will most likely classify Jim according to the occupation that
A) is most hazardous
B) pays the lowest wage
C) pays the highest w
A) is most hazardous
When a person has more than one occupation, they should be rated for the occupation that represents the higher risk.
Which of the following is a requirement for ANY change in an insurance application?
A) Change must be initiated by the agent
B) Change must be initialed by the applicant
C) Change must be approved by the insurer
D) Change must be notorized
B) Change must be initialed by the applicant
What happens when an insurance policy is backdated?
A) The policy's elimination period is waived
B) The time frame for reinstating a lapsed policy is extended
C) The policy's probation period is earlier than the present
D) The policy's effective date is e
D) The policy's effective date is earlier than the present
XYZ Company has applied for group health insurance for its employees. What information would the insurer's underwriters likely use to determine the appropriate coverage and final premium rate given to the group?
A) Experience rating
B) Credit reports
C) A
A) Experience rating
An insured was injured as an innocent bystander when someone committed a felony. The insurer is
A) likely to void the policy
B) partially liable for the loss
C) not liable for the loss
D) liable for the loss
D) liable for the loss
Tara the producer is delivering a specified disease insurance policy to a new policyowner. Upon delivery, she may be expected to collect all of the following EXCEPT a(n)
A) initial premium
B) signed impairment rider acknowledgement
C) modified application
C) modified application with a new signature
What is the term used to describe the frequency and severity of certain illnesses and accidents?
A) Morbidity
B) Mortality
C) Malaise
D) Insurability
A) Morbidity
Lorenzo is self employed with an S corporation. He is unmarried and had a net profit for the tax year. What are the tax ramifications of his health insurance premiums paid for the year?
A) 50% of his health insurance costs can be deducted from his gross i
C) 100% of his health insurance costs can be deducted from his gross income
Which of the following is NOT a factor in determining the morbidity of a group of individuals?
A)Health
B) Occupation
C) Age
D) Race
D) Race
Which of the following is NOT considered to be insurer expenses?
A) Maintenance costs
B) Policy premiums
C) Employees' salaries
D) Utilities
B) Policy premiums
Which of these factors do NOT affect the rates of medical insurance?
A) Health
B) Race
C) Occupation
D) Gender
B) Race
Which of the following typically does NOT provide a form of managed care?
A) Preferred Provider Organization (PPO)
B) Point-of-Service (POS) plan
C) Major medical indemnity plan
D) Health Maintenance Organization (HMO)
C) Major medical indemnity plan
A 10% excise tax is normally applied to an early withdrawal from an IRA. According to HIPAA, this tax will not be applied if the withdrawal is used for medical expenses that exceed ____ of the individual's adjusted gross income.
A) 5%
B) 6.5%
C) 7.5%
D) 8
C) 7.5%
Which of the following factors is NOT used in underwriting health insurance policies?
A) Sex
B) Intelligence
C) Age
D) Income
B) Intelligence
Premium mode is a term used to describe the
A) premium past due
B) method of payment
C) frequency of the premium payment
D) premium paid
C) frequency of the premium payment
Which of these characteristics of an applicant is NOT taken into consideration when assessing risk for Disability coverage?
A) health of applicant
B) gender of applicant
C) number of children
D) occupation of applicant
C) number of children
XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?
A) Premiums are paid with tax credits
B) Benefits are partially taxable
C) Benefits are fully taxabl
C) Benefits are fully taxable
Pierre is covered by his employer's group major medical plan. His employer pays for 75% of the premium and he pays for 25%. How much would a $10,000 benefit be taxable as income under this plan?
A) $10,000
B) $7,500
C) $2,500
D) $0
D) $0
In which of the following processes will the insurer oversee the insured's hospital stay to confirm everything is going according to schedule and that the insured will be released as planned?
A) Pre-certification review
B) Pretense review
C) Congruent rev
D) Concurrent review
The gatekeeper's role when used by an HMO is
A) establishing out-of-network providers
B) obtaining referrals to specialists from primary care physicians
C) taking applications for enrollment into an HMO
D) processing the subscriber's payments
B) obtaining referrals to specialists from primary care physicians
How does rising morbidity rates affect health insurance?
A) Increased premiums
B) Decreased premiums
C) Fewer claims
D) Lower deductibles
A) Increased premiums
Morbidity rates show the expected incidence of sickness or disability within a given group during a given period of time. A rise in morbidity rates can cause an increase in health insurance premiums.
Bill the producer is collecting the initial premium on a health policy. Which of the following statements is true?
A) The contract is not in force without the initial premium being paid
B) A partial initial premium is acceptable
C) The insured has no adva
A) The contract is not in force without the initial premium being paid
An example of a primary care physician would be a(n)
A) internist
B) psychologist
C) endocrinologist
D) chiropractor
A) internist