Insurance MCQ

When a group is covered by a MET, who is issued the Master Policy? A. A representative for the insureds B. The insurer C. The trust D. The sponsor Answer: C.

A firm with 50 employees replaces its existing group health plan. With regard to ongoing existing claims, the replacing insurer will be: A. Required to stop paying them under COBRA B. Allowed to deny claims over 60 days old under ERISA C. Required to keep paying them under the Dual Choice Provision D. Required to continue paying them under the No Loss-No Gain law Answer: D.

When a group member terminates employment, he or she has 31 days to purchase an individual policy without proof of insurability. This is referred to as the: A. Conversion Privilege B. Extension of Benefits C. Adverse Selection D. Coordination of Benefits Answer: A.

Which of the following is incorrect regarding the group underwriting process? A. Adverse selection is not a concern for group contracts B. New employees usually become eligible to enroll after a waiting period C. Evidence of insurability is not required since premiums are adjusted annually by evaluating the group and the claims experience D. The insurer's office location is not a cost factor Answer: A.

A replacing insurer must assume liability for paying ongoing existing claims under which law? A. HIPAA B. COBRA C. No-Loss, No-Gain D. ERISA Answer: C.

The employee or the beneficiary must notify the employer within ______ days if they elect to continue coverage under COBRA. A. 90 B. 60 C. 45 D. 30 Answer: B.

Which is not a qualifying event for the continuation of dependent coverage under the Consolidated Omnibus Budget Reconciliation Act? A. Death of the employee B. The employee's eligibility for Medicare benefits C. Termination of the employee for theft D. Divorce or legal separation Answer: C.

HIPAA laws apply to groups of _____ or more. A. 5 B. 2 C. 100 D. 20 Answer: B.

Events that will cause termination of continuing health coverage under COBRA include all of the following, except: A. Timely premium payments are not made B. The employee becomes eligible for Medicare benefits C. The employer ceases to maintain any group health insurance plan D. The employee fails to convert an individual health insurance plan on the day it is offered Answer: D.

All of the following are requirements that insurers may place on a group plan to avoid adverse selection, except: A. A purpose other than obtaining insurance B. Coverage only for full-time employees C. Proof of insurability from each employee D. A minimum level of employee participation Answer: C.

When underwriting group life, the underwriter treats the group as if it were: A. Two groups, with all the males in one group and all the females in the other B. One individual C. A number of separate individuals D. A substandard risk Answer: B.

Which statement is incorrect regarding COBRA? A. The employee or beneficiary must respond to the notification of his/her right to continue coverage within 90 days, if he/she wants to continue the coverage B. Evidence of insurability is not required to continue coverage under COBRA C. Coverage continues for 29 months for individuals receiving Social Security disability D. The employer may require the former employee or beneficiary to pay an amount equal to 102% of the premium Answer: A.

COBRA is a federal law requiring employers with _____ or more employees to provide the option of continuing the employee's existing health coverage for dependents for up to _____ months following certain qualifying events such as death of the employee. A. 15, 36 B. 20, 36 C. 20,18 D. 25, 45 Answer: C.

Which of the following might be done to protect against adverse selection when underwriting group medical insurance? A. Allow coverage to begin immediately B. Include all dependents to make the group larger C. Enroll the business owner first D. Require a minimum percentage of the group to enroll Answer: D.

Which statement would be considered inaccurate regarding the underwriting of a group plan? A. The corporate home office of the group normally is the group's address B. The insurer can require a minimum percentage of the group to be enrolled to guard against adverse selection C. The cost of a group policy is determined by the type, size, and average age of the group and claims experience with previous insurers D. Contributory plans require 100% employee participation Answer: D.

What law provides the right of employees to continue health insurance coverage when changing employers by removing any restrictions against waiting periods and coverage in a new group health plan, as long as the employee has had creditable coverage? A. ERISA B. COBRA C. HIPAA D. PPACA Answer: C.

How much time after a qualifying event has occurred and notice is given of their right to continue insurance does an employee or dependent have to elect continuation of the group health plan under COBRA? A. 90 days B. 60 days C. 36 months D. 18 months Answer: B.

What benefit does COBRA provide to employees when an employee is terminated? A. Continuation of health insurance at the employee's expense for up to 36 months B. Continuation of life and health insurance if an employee quits or is fired or laid-off C. Continuation of health insurance at the employer's expense for up to 29 months D. Continuation of health insurance at the employee's expense for up to 18 months Answer: D.

What can an employee do in order to obtain coverage when they have a pre-existing condition and find that their job was just eliminated? A. Apply for Medicaid benefits B. Utilize the group plan's conversion privilege C. Find an experienced agent and apply to insurance companies that specialize in insuring high risk applicant D. Apply for Medicare benefits Answer: B.

The employees of a corporation must each pay a portion of the premium for their group insurance. This means they are members of a _____________. A. Nonparticipating plan B. Participating plan C. Contributory group plan D. Noncontributory group plan Answer: C.