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Provisions of Health Insurance Policies Chapter Exam

Exam Instructions:

Choose your answers to the questions and click 'Next' to see the next set of questions. You can skip questions if you would like and come back to them later with the yellow "Go To First Skipped Question" button. When you have completed the practice exam, a green submit button will appear. Click it to see your results. Good luck!

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Question 1 1. What is the potential outcome if an insured does not receive pre-authorization before undergoing a medical procedure?

Question 2 2. Which process involves a doctor sending a patient to a specialist for his/her medical issue?

Question 3 3. What is a common restriction in health insurance that will not cover breast enhancement surgery?

Question 4 4. What does the alternative medicine exclusion exclude?

Question 5 5. What type of expenses does a health insurance plan NOT cover?

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Question 6 6. What is the number of days that most insurance companies use for their notice of claim provision?

Question 7 7. Is the following description an example of usual, customary or reasonable charges? Dentists in the town of Pinetree charge between $125 and $150 to clean a child's teeth.

Question 8 8. Which of the following factors would NOT influence a policyholder's policy and coverage?

Question 9 9. Which of the following characteristics of the free look period is NOT correct?

Question 10 10. Which clause in a disability policy defines the period of time that an insurance company will not pay a policyholder for an illness from which he/she may suffer?

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Question 11 11. Which of the following maximum benefit limits is represented by the following description: a maximum dollar amount that an insurance company would pay for benefits for as long as an individual was a member of the plan?

Question 12 12. Which of the following is NOT an example of a maximum benefit limit that an insurance company could place on health and disability insurance?

Question 13 13. Which of the following characteristics about a conditionally renewable policy is true?

Question 14 14. With an optionally renewable provision, on which dates is the insurance company permitted to cancel the policy?

Question 15 15. Which of the following could NOT happen if a policyholder pays an outstanding premium after the grace period?

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Question 16 16. What is the grace period provision in a health insurance policy?

Question 17 17. Which of the following expenses is eligible to be paid for with flexible spending account funds?

Question 18 18. Which of the following is an option that some flex accounts may allow for funds that aren't completely used by the end of the year?

Question 19 19. How much does your insurance pay if you purchase a Silver tier insurance from the marketplace?

Question 20 20. Which of the following has guaranteed coverage under the ACA?

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Question 21 21. Under the change of occupation provision, what would happen to the premium if a policyholder changes to a more risky occupation?

Question 22 22. Under the illegal occupation provision, for which of the following injuries would a policyholder NOT receive benefits?

Question 23 23. Which of the following procedures would NOT require pre-authorization from an insurance company?

Question 24 24. What are three unique exclusions for health insurance policies?

Question 25 25. What is the time of payment of claims provision?

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Question 26 26. Calculate how much a policyholder would pay in the following situation: Joe incurs a cost of $500 for a procedure completed in his city. His insurer pays 80% of the usual, customary and reasonable charges. His insurance company determines that the usual, customary and reasonable charges for the procedure Joe had done are $300.

Question 27 27. Which of the following is NOT true of the elimination or waiting period clause?

Question 28 28. Which of the following maximum benefit limits is represented by the following description: an amount that an insured individual must pay for each new illness or injury before an insurance company will pay?

Question 29 29. In a policy with a guaranteed renewable provision, the insurance company must renew the policy if the policyholder satisfies which of the following conditions?

Question 30 30. What type of beneficiary can the policyholder change under the change of beneficiary provision without providing written permission from the current beneficiary?

Provisions of Health Insurance Policies Chapter Exam Instructions

Choose your answers to the questions and click 'Next' to see the next set of questions. You can skip questions if you would like and come back to them later with the yellow "Go To First Skipped Question" button. When you have completed the practice exam, a green submit button will appear. Click it to see your results. Good luck!

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