Life and Health California Exam California Health and Life Insurance Regulations 2

Question 1

California Insurance Code Section 10291.5 prohibits life and disability insurers from unfairly discriminating based on which of the following?

Accepted Answer

Applicant's HIV antibody test results, marital status, or sexual orientation

Answer

California law specifically prohibits discrimination in life and disability insurance underwriting based on HIV status, marital status, or sexual orientation.

Question 2

Under California's 'Independent Medical Review' (IMR) system, a patient may request an IMR when:

Accepted Answer

Their health plan denies, modifies, or delays care based on medical necessity

Answer

California's IMR process allows patients to have disputed medical necessity decisions reviewed by independent medical experts at no cost, overriding the health plan's decision if found appropriate.

Question 3

Under California's 'timely access to care' standards for HMOs, urgent care appointments must be available within:

Accepted Answer

48 hours

Answer

California's timely access regulations require HMOs to provide urgent care appointments within 48 hours of a patient's request.

Question 4

The California Life and Health Insurance Guarantee Association (CLHIGA) protects policyholders of insolvent insurers up to what limit for individual health insurance claims?

Accepted Answer

$300,000

Answer

CLHIGA provides protection of up to $300,000 for individual health insurance claims when a member insurer becomes insolvent.

Question 5

Under California law, a 'replacement' transaction in life insurance occurs when a new policy is purchased and within 5 years an existing policy is:

Accepted Answer

Lapsed, surrendered, converted, reduced, or used as collateral for the new policy

Answer

California defines a replacement as a transaction where a new policy is purchased and within 5 years an existing life policy is lapsed, surrendered, reduced, converted, assigned, or used as collateral.

Life and Health California Exam Practice Test

Life and Health California Exam Practice Test

Life and Health California Exam California Health and Life Insurance Regulations 2