Arkansas Health Insurance Practice Exam

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• Key Person Disability Insurance pays benefits to the:
• Which waiting period and benefit combination will likely result in the highest premium for a disability income policy?
• What is the maximum gap in days without previous health insurance that Ron can have when enrolling in a group health plan?
• Which of the following terms describes the time period after the policy is issued, during which the insurer cannot contest the validity of the policy?
• What is one of the primary purposes of health insurance underwriting?
• Which of the following is a primary feature of a major medical policy?
• What types of services are typically excluded from continued coverage?
• Which of the following plans does NOT allow for pre-tax employee contributions?
• Which type of insurance plan typically has lower costs for the insured?
• In health insurance, what does the term "exclusion" refer to?
• How is "implied authority" defined in the context of agency contracts?
• Craig submits a $500 claim for medical expenses with a past due premium of $100. How much does the insurer pay?
• What is the purpose of a Disability Income Benefit?
• What is the key purpose of the Health Insurance Portability and Accountability Act (HIPAA)?
• A pharmacy benefit covers prescription drugs derived from a list called what?
• What is true about Medicaid?
• Which type of insurance offers coverage for long-term care services?
• Which of the following decisions is NOT within the power of a Health Savings Account (HSA) owner?
• Which type of insurance provides coverage for losses arising from certain specified events?
• What document is provided to each employee participating in an employer health plan?
• What is a common requirement for insurance policy renewals?
• Which entity typically authorizes treatment from a specialist?
• Which of the following is NOT a qualification for establishing a health savings account (HSA)?
• Which activity is considered an underwriting duty of an agent?
• In Arkansas, the minimum grace period for monthly-premium health insurance policies is how many days?
• How often must a Commissioner examine each domestic insurance company?
• Which of the following is NOT an unfair claim settlement practice?
• What is the difference between pre-certification and concurrent review?
• What is the primary purpose of a health savings account (HSA)?
• What is NOT included as part of a contract in the entire contract provision?
• Jonas has disability insurance through his employer. The employer pays 75% of the premium, and Jonas pays the other 25%. What is Jonas's tax liability for any benefits paid from the disability plan?
• Major Medical expense plans do NOT provide coverage for which of the following?
• Which document outlines the terms of coverage in an employer-sponsored health plan?
• Maria, the producer, collects required signatures on an application and deposits the check into her personal account. What crime has she committed?
• In an employer-sponsored contributory group Disability Income plan where the employer pays 60% of the premium, what percentage of the benefits paid is taxed to the employee?
• In the context of insurance, which of the following is often a key responsibility of an agent?
• Which condition allows an individual to qualify for benefits from a qualified long-term care policy?
• Fraud in an insurance context can generally lead to what consequence for the producer?
• If Amy has a group medical policy with a $500 deductible and incurs $1,500 in covered healthcare services, how much will her group insurance carrier pay?
• What unethical practice is J guilty of after inducing an insured to surrender a policy through misrepresentation?
• Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called:
• Bill requires some nursing care but not full-time care. Which facility option would best serve him?
• Which type of health insurance policy typically does not require a copay for visits to a primary care physician?
• Shirley has a Medigap policy, which is designed to pay costs associated with:
• This mandatory health policy provision states that the policy, including endorsements and attached papers, constitutes what?
• What does COBRA stand for in the context of health insurance continuation coverage?
• Signatures for an insurance application MUST be obtained by the producer from all of the following sources EXCEPT:
• How is the payout determined if an insured misstates their age on the policy?
• Which of the following is NOT permitted for an insurance producer in Arkansas?
• Group health plans may deny participation based on which of the following criteria?
• An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before:
• What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?
• An individual covered under a Blue Cross Blue Shield plan is called a(n):
• Which type of policy is primarily designed to pay a portion of the medical expenses not covered by Medicare?
• What is the main purpose of the Fair Credit and Reporting Act?
• What is the duration of the grace period for a monthly premium health insurance policy?
• Which of the following health plans typically requires a primary care physician to coordinate care?
• What type of company is owned exclusively by its shareholders?
• What is it called when a producer convinces a prospective insured to buy an insurance policy based on exaggerations?
• Which of the following is NOT categorized as advertising in health insurance?
• If a person is convicted of a crime stemming from a hearing, a fine up to $___________ per violation may be imposed:
• A producer who knowingly submits a false statement in support of a claim may be charged with what?
• What payment method is commonly used to settle healthcare provider claims?
• Which of the following deductibles applies a single deductible to both medical and dental insurance coverage?
• What type of rider on a disability income policy guarantees the right to increase benefits without a medical exam?
• Which of the following best defines a copayment?
• What type of insurance provides income for employees who are disabled and unable to work?
• When illustrating dividends, what must an advertisement state?
• What is the primary purpose of health insurance underwriting?
• What type of care does Medicare not cover?
• All insurers in Arkansas must be members of which organization to transact insurance?
• In Arkansas, inflation protection must be offered to applicants for a(n):
• Under health insurance regulations, what is required for an insured to maintain their coverage after termination of employment?
• A nonparticipating policy will:
• A long-term care policy typically provides all of the following levels of care EXCEPT?
• Medicare Supplement Insurance is guaranteed issue if the policy effective date is within how many months of the insured's Medicare Part B?
• What does the term "deductible" refer to in health insurance?
• What is the primary intent of disability insurance?
• What does treatment for heart disease within the past year indicate when applying for health insurance?
• Which uniform optional provision covers a claim scenario with an unpaid premium?
• An HMO that operates with a central facility involving a partnership of physicians is known as what?
• What benefit may be available if a health insurance policyholder experiences a covered loss?
• Which type of business insurance is designed to cover the expenses required to continue operations while the owner is disabled?
• Which of the following is NOT an example of utilization review?
• What does an indemnity plan typically provide to the insured?
• Under a contract of adhesion, how must the terms be treated by the parties involved?
• Which statement is correct regarding an applicant for life and health insurance?
• What constitutes defamation in the insurance industry?
• The DO NOT CALL registry offers exemptions for calls placed from all of the following EXCEPT:
• On what date would Sonya have health insurance coverage if her policy's effective date is May 30?
• What type of coverage is typically offered through a Multiple Employer Welfare Arrangement (MEWA)?
• The requirement that an insured must report an accident to the insurance company within a certain time frame is typically referred to as what?
• An example of rebating in insurance would be?
• In contrast to a guaranteed renewable policy, a noncancellable policy:
• What is a professional liability for which producers can be sued for mistakes of putting a policy into effect called?
• How will Medicare function for a 70-year-old insured with kidney failure covered by a spouse’s large-group employer plan?
• The application process for health insurance requires which of the following?
• How much does Medicare Part B typically pay for physician fees?
• What aspect of the application process is correct when applying for life or health insurance?
• In a participating health insurance contract, what indicates ownership?
• A Medicare Supplement policy must not provide benefits that:
• What is an essential characteristic of a fraternal benefit society?
• What term describes an insurer's capability to manage unpredictable payouts to policyholders?
• Which type of insurance is designed primarily to cover healthcare services and hospitalizations?
• What does the principle of Utmost Good Faith require from the insured?
• When can a beneficiary change occur?
• Which factor is typically NOT considered in underwriting a health insurance risk?
• According to life insurance contract law, when does insurable interest exist?
• What process pertains to analyzing an applicant's personal information to determine insurance eligibility?
• What should policyholders do to ensure their claims are processed in a timely manner?
• What is typically not covered under a basic health insurance policy?
• A health insurance policy that allows an insurer to change the policy owner's premiums, but NOT cancel the policy is called a(n):
• Which of the following typically does NOT affect an insured's premium rates?
• Under what conditions can a group health policy renewal be denied according to HIPAA?
• In insurance, what is a primary purpose of an endorsement?
• In insurance terminology, what does the term 'aleatory' refer to?
• Field underwriting performed by the producer primarily involves:
• What is the minimum penalty under the McCarran-Ferguson Act for obtaining personal information without a legitimate reason?
• A producer who provides incorrect information on a policy application may be guilty of what?
• What does a limited policy usually cover?
• A person covered by an individual health plan is considered to be:
• An example of an unfair claims settlement practice is:
• What is implied authority in the context of an agency contract?
• What is the main purpose of group health insurance policies?
• What term describes a situation where both parties of a contract may NOT receive the same value?
• With whom is a producer legally allowed to share commissions?
• Medicare A does not cover medical benefits for treatment in a skilled nursing facility beyond what duration?
• If there is no Section 125 Plan in place, how are an employee's payroll contributions to an HSA treated for tax purposes?
• What percentage of a participant's income are group long-term disability benefit amounts typically limited to?
• What is required before conducting an HIV-related test on a proposed insured?
• Insurable interest does NOT occur in which of the following relationships?
• What term describes the requirement for clear and complete information to be provided when replacing insurance policies?
• Which type of clause describes the statement: "We have issued the policy in consideration of the representations in your applications and payment of the first-term premium"?
• In terms of tax, how are premiums for personally owned disability income insurance treated?
• What must an insured do if the insurer does not provide forms after notice of loss is given?
• What is a possible consequence if an insurer fails to provide proof of loss forms in a timely manner?
• A nonparticipating company in the insurance industry is commonly referred to as what?
• What document typically provides details of an agent's agency agreement?
• What is often a requirement for obtaining long-term care insurance?
• What is the maximum penalty Ken may face for obtaining Consumer Information Reports under false pretenses?
• If Tyler submits a claim for benefits on June 1 after being disabled on May 1, when are his premiums waived due to the waiver of premium rider?
• From an insurance perspective, which of the following is the main risk associated with disability?
• Which of the following is a legal entity created for the sole purpose of providing affordable group health coverage?
• Which action can the Arkansas Insurance Department NOT take?
• Who is the individual typically compensated on a fee-for-service basis in the health insurance context?
• In group health insurance, who typically pays the premium?
• What is the nature of the reinstatement provision in a health insurance policy?
• What type of disability is defined as less than total impairment yet considered a permanent impairment?
• What is the primary purpose of a Medicare Supplement Policy?
• In an employer-sponsored group accident and health plan, who is issued the master contract?
• An insurance producer must notify the commissioner of a change in legal name, email, or address within what time frame?
• What must a health insurer do after a claim is submitted?
• To which risk classification does a nonsmoker, in excellent health and average weight belong?
• Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), what limitations exist on a terminated employee's benefits?
• What is the maximum duration of the Contestable Period in a health insurance policy?
• What provision allows an insurer to deduct unpaid insurance premiums from a claim payment?
• According to the IRS, what is the threshold for medical expenses to be tax deductible?
• What is an example of a policy exclusion?
• Which type of insurance typically offers coverage for mental health treatment?
• The authority granted to a licensed producer is provided via the:
• Which of the following is NOT a source of information for underwriters to evaluate risks?
• A medical provider that accepts Medicare Assignment is required to do what?
• A group Disability Income plan that pays tax-free benefits to covered employees is considered:
• What type of health insurance policies can exclusively cover low frequency diseases?
• In comparing an HMO to a PPO, what characteristic does a PPO provide?
• What does the Group Life underwriting risk selection process help insurance companies protect against?
• What type of life insurance policy offers a return of divisible surplus?
• What is NOT a function of an insuring clause?
• What does Medicare Part B cover?
• Life insurance policies will generally cover losses incurred from which of the following activities?
• What does the term "maximum benefits" refer to in health insurance?
• What tax payment is required for employer contributions made to Health Savings Accounts (HSAs)?
• Which type of insurance is designed to provide services that are necessary or appropriate in alternative settings to acute care hospitals?
• In the context of health insurance, which of the following is a common responsibility of an insurer?
• What kind of injury would typically NOT be covered under a health insurance policy?
• What is a key advantage of being a policyholder in a mutual insurance company?
• Which is NOT considered to be included in a health benefit plan?
• A dread disease policy is classified as which type of insurance?
• What period refers to when accumulated value in an annuity is paid out?
• What action is NOT allowed by an insurance company in a health policy with a guaranteed renewable premium benefit?
• Ambiguities in an insurance policy are always resolved in favor of which party?
• Which type of insurance company is commonly associated with policyholders benefiting from profit distribution?
• What does Medicare Part D cover?
• Under HIPAA, when can a group health policy renewal be denied?
• What does Medicare Part A primarily cover?
• Written notice for a health claim must be given to the insurer within how many days after the occurrence of the loss?
• What is an example of rebating in insurance practices?
• What is a common reason for underwriting denial in health insurance applications?
• Which type of plan would typically cover long-term healthcare needs?
• Which is the best way to describe controlled business?
• If a health insurance claim is not promptly paid, legal action may be taken against the insurer after how many days from the date proof of loss is furnished?
• Which component of health insurance helps manage healthcare costs while ensuring quality of care?
• What is the minimum number of employees an employer must have for a terminated employee to qualify for COBRA?
• What type of renewable policy is Richard's insurance considered to be?
• Which entity is typically considered a possible applicant and contract policyholder for group health benefits?
• Which type of insurance policy requires a premium to be paid before coverage is effective?
• The Federal Employees Benefit Program includes which type of health plans?
• Which of the following is a primary purpose of health insurance?
• Which statement best describes a conditional insurance contract?
• What is the characteristic of an optional renewability clause in an insurance policy?
• Which of the following accurately describes a "conditional renewal" policy?
• Benefits provided by a Medicare Supplement policy must NOT:
• Why are dividends from a mutual insurer not taxable?
• What characterizes an insurance policy as a unilateral contract?
• What does field underwriting by the producer involve?
• Part A Hospital expense coverage provided under Medicare is automatically made available to each of the following EXCEPT:
• What components are included in the entire contract of an insurance policy?
• Which of the following is NOT an element of a valid contract?
• What is the term for a policy where the insurer can cancel mid-term?
• What is one of the main objectives of health insurance regulation?
• What does not constitute a valid reason for an insurance claim denial?
• How many days must written proof of loss be furnished to the health insurer after the date of loss?
• Simon purchased a fixed immediate annuity. What will his payment amount depend on?
• What is necessary for insurable interest to exist in an insurance policy?
• In health insurance, what does the term "underwriting" refer to?
• What is typically required to receive a referral to a specialist in managed care organizations?
• What type of insurer allows policyholders to participate in profits through dividends?
• Which term describes the sum paid by an employer into an employee's HSA?
• Which of the following best describes the purpose of Credit Accident and Health Plans?
• What is a basic benefit provided by a Medicare Supplement plan?
• What does the term "premium mode" refer to in health insurance?
• Which approach estimates a person's earning potential for dependents?
• What is the purpose of respite care?
• Which of the following is NOT a reason for the commissioner to deny or refuse a producer license application?
• Which of these is typically NOT a source of underwriting information for insurance?
• When can an individual enroll in a Part C Medicare Advantage Plan?
• What is the primary purpose of the Coordination of Benefits provision?
• Which of the following signatures is not required on an individual insurance application?
• In group health care, what is the purpose of the coordination of benefits provision?
• What are the two major requirements for compliance with the Reinstatement Clause?
• Which provision in a disability income policy applies if the cause of an injury is unexpected and accidental?
• An insurer must furnish to a claimant forms for filing proof of loss within how many days upon receiving a notice of claim?
• Maria is a Preferred Provider Organization (PPO) subscriber and received care from an out-of-network provider. Which of the following is the likely result?
• Which of the following is NOT considered a key factor in underwriting health insurance?
• Which disability policy provision addresses concerns about the decreasing value of benefits over time?
• What term is used when the principal grants authority to an agent in writing?
• Who is responsible for assembling the policy forms for insured individuals?
• Which organization sells insurance exclusively among its members?
• Which life insurance policy issued by a mutual insurer offers a return of divisible surplus?
• The waiver of premium provision does NOT include which of the following?
• Who regulates an insurer's claim settlement practices?
• The time limit for filing claim disputes is addressed in which provision of an accident and health policy?
• How does a major medical plan with first dollar coverage affect benefits paid?
• Which term describes the specific sum a health insurance plan requires to be paid before any benefits are applied in a calendar year?
• In a business partnership where life insurance policies are taken out on each partner, who receives the proceeds if one partner dies after the business is dissolved?
• What type of health plan generally allows the insured to see specialists without a referral?
• Who owns a mutual insurance company?
• Which of the following is considered to be a POS plan?
• What do you call a producer who sells insurance in Arkansas but resides in another state?
• The type of authority indicated by a producer's deeds and actions is known as what?
• Before suspending or revoking a producer's license, what is the required action by the commissioner?
• In Arkansas, which action is considered an unfair trade practice?
• In a health insurance policy, what is the term for the maximum amount an insurer will pay for a covered loss?
• How is a health provider reimbursed if there is no agreement with the insurance company?
• An accident and health policy that provides reimbursement benefits typically pays them to whom?
• What is typically included in the exclusions section of a health insurance policy?
• Which of the following is NOT a qualifying event for Medicare?
• What is the term used for the intentional withholding of material facts that affect an insurance policy's validity?
• What type of health insurance policy allows the insurer to terminate coverage for reasons other than the insured's health?
• Which act governs the regulation of health insurance practices in the United States?
• When COBRA is elected for the continuation of health coverage, what happens to the premium?
• In what form do disability income policies typically pay benefits?
• What is meant by an insurer's liquidity?
• What is one definition of replacement in insurance terms?
• Which long-term care benefit is most suitable for a stroke victim needing home-based speech therapy?
• The monthly benefit for an individual disability income policy is usually limited to a percentage of the insured's income in order to avoid what?
• What is the purpose of the Grace Period provision in an insurance policy?
• What happens if the annuitant dies before the annuity start date?
• According to Arkansas law, when must a producer deliver the outline of coverage to a Medicare supplement applicant?
• What type of disability allows for claims to be payable to a disabled income insured even if they can still work?
• What factor is primarily considered when underwriting life insurance policies?
• Medical Expense Insurance is designed to cover which of the following situations?
• What does the elimination period in an individual disability policy refer to?