EXAMFX Health Insurance 2

Question 1

Under HIPAA, a pre-existing condition exclusion period for a new group health plan is limited to a maximum of how many months?

Accepted Answer

12 months

Answer

HIPAA limits pre-existing condition exclusion periods to 12 months (18 months for late enrollees) for group health plans.

Question 2

A health insurance policy that pays a fixed dollar amount per day of hospitalization, regardless of actual expenses, is called a:

Accepted Answer

Hospital indemnity policy

Answer

A hospital indemnity policy pays a predetermined flat daily benefit regardless of actual hospital charges.

Question 3

Which provision in a health insurance policy allows the insured to continue coverage after leaving a group plan by converting to an individual policy without proving insurability?

Accepted Answer

Conversion privilege

Answer

The conversion privilege allows a departing group member to obtain individual coverage without a medical exam or evidence of insurability.

Question 4

An HMO that employs physicians directly and provides services at HMO-owned facilities uses which model?

Accepted Answer

Staff model

Answer

The staff model HMO employs physicians as salaried staff who work exclusively at HMO-owned facilities.

Question 5

The 'free-look' period required for individual health insurance policies in most states is typically:

Accepted Answer

10 days

Answer

Most states require a 10-day free-look period allowing the insured to return the policy for a full premium refund.

(EXAMFX) Exam FX Insurance Practice Test

(EXAMFX) Exam FX Insurance Practice Test

EXAMFX Health Insurance 2