Insurance MCQ

In Ohio, a group accident and health certificate of insurance must contain A. A copy of the group contract B. A list of all participating physicians C. The insurer's financial statement D. A summary of policy features and benefits Answer: D. A summary of policy features and benefits

In dental insurance coverage, which of the following typically is EXCLUDED? A. Treatment started prior to the eligibility date B. Preventative care C. Dental X-rays D. Root canal therapy Answer: A. Treatment started prior to the eligibility date

An individual who declines coverage under a small group accident and health benefit plan and later enrolls is called A. A late enrollee B. A re-entry enrollee C. An eligible enrollee D. A qualified enrollee Answer: A. A late enrollee

What must the claimant do if the proper forms are not provided by the insurer? A. Resubmit the claim B. Talk to a lawyer C. Proceed by providing written verification of the loss D. Assume that the claim has been denied Answer: C. Proceed by providing written verification of the loss

In Ohio, a long-term care policy which lapses may be reinstated within five months if A. The covered individual was mentally incapacitated B. The covered individual lost the premium notice C. The insurer failed to send a termination notice D. The insurer failed to send a second premium notice Answer: A. The covered individual was mentally incapacitated

Group dental insurers can discourage adverse selection by A. Limiting benefits for late enrollees B. Covering pre-existing conditions C. Allowing open enrollments D. Limiting the duration of coverage Answer: D. Limiting the duration of coverage

According to the Affordable Care Act (ACA), under what circumstances would lifetime limits and annual limits be permitted on a health plan or insurance policy? A. When coverages are not considered medically necessary B. When coverages are not considered essential health benefits C. When the insured is not considered essentially healthy D. When the insured not considered essential benefit Answer: B. When coverages are not considered essential health benefits

Under the Affordable Care Act (ACA), health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition UNLESS it is a A. Grandfathered health plan B. Transitional plan C. Any group health plan D. Some individual health plan Answer: A. Grandfathered health plan

When an agent engages in unfair practices, all of the following are true EXCEPT A. The Director can investigate the problem and hold a hearing B. The Director's decision is final C. The Director can suspend the agent's license D. The Director can issue a cease and desist order Answer: B. The Director's decision is final

In Ohio, how much advance notice must be given before terminating a long-term care policy for nonpayment of premium? A. 10 days B. 20 days C. 30 days D. 60 days Answer: C. 30 days

Which of the following is required to be included in a noncontributory accidental death and dismemberment group certificate of coverage? A. name of the group members B. number of group members C. operating expenses and cost of the policy D. description of coverage Answer: D. description of coverage

When recommending the replacement of a health and accident policy, all of the following provisions should be carefully reviewed EXCEPT A. preexisting conditions B. waiting periods C. exclusions D. grace period Answer: D. grace period

When an HIV test is requested for an individual applying for a health and accident policy, who must sign the consent form? A. agent B. insurer C. applicant D. test administrator Answer: C. applicant

Who must notify the Superintendent of a licensee's change of address? A. agent B. agency C. insurer D. managing agent Answer: A. agent

Attainment of the limiting age for dependent children will not terminate the coverage of a dependent child if A. the child is not married B. the child still lives at home C. the child is incapable of self-sustaining employment by reason of physical or mental disability D. the child is unemployed Answer: C. the child is incapable of self-sustaining employment by reason of physical or mental disability

Under the Affordable Care Act (ACA), parents can insure their dependent adult children up to their: A. 25th birthday B. 26th birthday C. 28th birthday D. 30th birthday Answer: B. 26th birthday

In Ohio, a period of accident and health insurance coverage which may be applied to reduce the length of a pre-existing condition exclusion under a new plan is called A. Creditable coverage B. Pre-existing coverage C. Prior coverage D. Continuation of coverage Answer: A. Creditable coverage

If a group endorses an accident and health insurance product in an advertisement, the public must be made aware of A. The names of the group members B. The number of group members C. Any control by the insurer over the group D. Whether the group members are insured Answer: C. Any control by the insurer over the group

Most prepaid dental plans cover A. Mouth cancer B. Oral exams C. Cosmetic dentistry D. Work related injuries Answer: B. Oral exams

All of these are common limiting factors with dental insurance EXCEPT for A. Limit placed on how many teeth can be treated annually B. Limit on cosmetic-related procedures C. Limit on number of X-rays per year D. Limit on number of annual teeth cleanings Answer: A. Limit placed on how many teeth can be treated annually