Virginia Health Exam Study Guide, Questions with accurate answers. 100% verified. Graded A

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Virginia Health Exam Study Guide, Questions with accurate answers. 100% verified. Graded A A life insurance policy would be considered a wagering contract WITHOUT - ✔✔insurable interest Wh... ich require an offer, acceptance, and consideration? - ✔✔contract What is the consideration given by an insurer in the Consideration clause of a life policy? - ✔✔Promise to pay a death benefit to a named beneficiary Which is NOT considered to be an element of an insurance contract? - ✔✔negotiating Insurance policies are considered aleatory contracts because - ✔✔performance is conditioned upon a future occurrence Which of these arrangements allows one to bypass insurable interest laws? - ✔✔investor-Originated Life Insurance Which of the following consists of an offer, acceptance, and consideration? - ✔✔contract Which of these is considered a statement that is assured to be true in every respect? - ✔✔warranty In an insurance contract, the insurer is the only party who makes a legally enforceable promise. What kind of contract is this? - ✔✔unilateral If a contract of adhesion contains complicated language, to whom would the interpretation be in favor of? - ✔✔insured In regards to representations or warranties, which of these statements is TRUE? - ✔✔If material to the risk, false representations will void a policy When must insurable interest be present in order for a life insurance policy to be valid? - ✔✔When the application is made Life and health insurance policies are - ✔✔Unilateral contracts Insurance contracts are known as ____ because certain future conditions or acts must occur before any claims can be paid. - ✔✔Conditional A policy of adhesion can only be modified by whom? - ✔✔Insurance company Stranger Originated Life Insurance (STOLI) has been found to be in violation of which of the following contractual elements? - ✔✔Legal Purpose (Insurable Interest) Which of these is NOT a type of agent authority? - ✔✔principle A life insurance arrangement which circumvents insurable interest statutes is called - ✔✔Investor-Originated Life Insurance Insurance policies are offered on a "take it or leave it" basis, which make them - ✔✔contracts of adhesion Taking receipt of premiums and holding them for the insurance company is an example of - ✔✔Fiduciary responsibility Which of these is considered a statement that is assured to be true in every respect? - ✔✔warranty An accident policy will most likely pay a benefit for a(n) - ✔✔off the job accident The federal income tax treatment of employer-provided group Medical Expense insurance can be accurately described as - ✔✔Employee's premiums paid by the employer is tax-deductible to the employer as a business expenditure The provision in a Group Health policy that allows the insurer to postpone coverage for a covered illness 30 days after the policy's effective date is referred to as the - ✔✔waiting period Which of the following characteristics is associated with a large group disability income policy? - ✔✔No medical underwriting Which of these circumstances is a Business Disability Buy-Sell policy designed to help in the sale of a business? - ✔✔Business owner becoming disabled What is issued to each employee of an employer health plan? - ✔✔Certificate Which statement is true regarding a minor beneficiary? - ✔✔Normally, a guardian is required to be appointed in the Beneficiary clause of the contract G is an accountant who has ten employees and is concerned about how the business would survive financially if G became disabled. The type of policy which BEST addresses this concern is - ✔✔Business Overhead Expense P is a new employee and will be obtaining non-contributory group Major Medical insurance from her employer. Which of the following actions must she take during the open enrollment period? - ✔✔Sign an enrollment card T is covered by an Accidental Death and Dismemberment (AD&D) policy that has an irrevocable beneficiary. What action will the insurance company take if T requests a change of beneficiary? - ✔✔Request of the change will be refused When an employee is required to pay a portion of the premium for an employer/employee group health plan, the employee is covered under which of the following plans? - ✔✔Contributory All students attending a large university could be covered by - ✔✔Blanket Policy The benefits under a Disability Buy-Out policy are - ✔✔payable to the company or another shareholder Which contract permits the remaining partners to buy-out the interest of a disabled business partner? - ✔✔Disability Buy-Sell Which of the following claims are typically excluded from Medical expense policies? - ✔✔self inflicted injuries Which of the following statements BEST describes how a policy that uses the "accidental bodily injury" definition of an accident differs from one that uses the "accidental means" definition? - ✔✔less restrictive Which type of policy pays benefits to a policyholder covered under a Hospital Expense policy? - ✔✔reimbursement If the insured and primary beneficiary are both killed in the same accident and it cannot be determined who died first, where are the death proceeds to be directed under the Uniform Simultaneous Death Act? - ✔✔Insured's contingent beneficiary The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers (and their families) whose employment has been terminated the right to (COBRA) - ✔✔continue group health benefits An accident policy will most likely pay a benefit for a(n) - ✔✔OFF THE JOB ACCIDENT What kind of Accidental Death and Dismemberment (AD&D) insurance beneficiary requires his/her consent when a change of beneficiary is made? - ✔✔Irrevocable beneficiary CANT MAKE CHANGES WITHOUT THIS PERSONS CONSENT Which statement is TRUE regarding a group accident & health policy issued to an employer? - ✔✔The employer receives the policy and each employee is issued a certificate Which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party? - ✔✔Subrogation WHAT IS NOT TRUE ABOUT group health insurance - ✔✔An individual policy is given to each member An insurance company would MOST likely pay benefits under an Accidental Death and Dismemberment policy for which of the following losses? - ✔✔Loss of eyesight due to an accidental injury Which mode of payment is NOT used by health insurance policies? - ✔✔SINGLE PREMIUM T is covered by two health insurance plans: a group plan through his employer and his spouse's plan as a dependent. Under the Model Group Coordination of Benefits provision, when T files a claim, his employer's plan is considered the - ✔✔PRIMARY CARRIER M purchased an Accidental Death and Dismemberment (AD&D) policy and named his son as beneficiary. M has the right to change the beneficiary designation at anytime. What type of beneficiary is his son? - ✔✔Revocable A policyowner's rights are limited under which beneficiary designation? - ✔✔Irrevocable The difference between group insurance and blanket health policies is - ✔✔Blanket health policies do not issue certificates The reason for a business having a Business Overhead Expense Disability Plan is to cover - ✔✔fixed business expenses On an Accidental Death and Dismemberment (AD&D) insurance policy, who is qualified to change the beneficiary designation? - ✔✔POLICY OWNER How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy? - ✔✔If the primary beneficiary dies before the insured Group/voluntary long-term care policy premiums are typically deducted from the employee's income and - ✔✔are less costly as compared to individual long term care coverage How does group insurance differ from individual insurance? - ✔✔Premiums are lower A Business Overhead Expense policy would cover which of the following if a business owner becomes disabled? - ✔✔Utilities and office rent S is employed by a large corporation that provides group health coverage for its employees and their dependents. If S dies, the company must allow his surviving spouse and dependents to continue their group health coverage for a maximum of how many months under COBRA regulations? - ✔✔36 The Coordination of Benefits provision - ✔✔prevents an insured covered by two health plans from making a profit on a covered loss A Business Overhead Expense policy - ✔✔covers business expenses such as rent and utilities The Health Insurance Portability and Accountability Act (HIPAA) gives privacy protection for - ✔✔health info Which of these types of coverage is best described as a short term medical policy? - ✔✔interim coverage Which of the following reimburses its insureds for covered medical expenses? - ✔✔Commercial insurers Medicare is intended for all of the following groups EXCEPT - ✔✔Those enrolled as a full-time student What does Medicare Parts A and B cover? - ✔✔Part A covers hospitalization; Part B covers doctor's services The situation in which a group of physicians are salaried employees and conduct business in an HMO facility is called a(n) - ✔✔closed panel What is the maximum Social Security Disability benefit amount an insured can receive? - ✔✔100% of the insured's Primary Insurance Amount (PIA) A 66 year-old is covered under a group health plan while employed with a business that has 40 employees. If she injures herself while walking in the park, what coverage would be considered primary? - ✔✔Her group health plan Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures? - ✔✔Commercial insurer Which of the following statements is true about most Blue Cross/Blue Shield organizations? - ✔✔They are nonprofit organizations Medicare Part A and Part B do NOT pay for - ✔✔dental work J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a predetermined price. What type of plan does J belong to? - ✔✔Health Maintenance Organization The health insurance program which is administered by each state and funded by both the federal and state governments is called - ✔✔Medicaid Which type of provider is known for stressing preventative medical care? - ✔✔Health Maintenance Organizations (HMO's) Which of the following does Social Security NOT provide benefits for? - ✔✔Dismemberment Medicare - ✔✔is a hospital and medical expense insurance program Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured? - ✔✔PPO Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)? - ✔✔More physicians to choose from A medical care provider which typically delivers health services at its own local medical facility is known as a - ✔✔HMO All of the following statements about Major Medical benefits are true EXCEPT - ✔✔Benefits have no maximum limit is NOT a limited benefit plan? - ✔✔life insurance policies An insured covered by a group Major Medical plan is hospitalized after sustaining injuries that resulted from an automobile accident. Assuming the plan had a $1,000 deductible and an 80/20 Coinsurance clause, how much will the INSURED be responsible to pay with $11,000 in covered medical expenses? - ✔✔3000 Which of the following statements BEST describes dental care indemnity coverage? - ✔✔Services are reimbursed after insurer receives the invoice Comprehensive Major Medical policies usually combine - ✔✔Major Medical with Basic Hospital/Surgical coverage Which of the following health insurance coverages is BEST suited for meeting the expenses of catastrophic illness? - ✔✔Major Medical [Show More]

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