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LH Chapter 29 FL Manual

Quiz by Brian Morton

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10 questions
Show answers
  • Q1
    Which of the following applies to the 10-day free-look privilege in a health insurance contract?
    It allows the insured an additional 10 days to pay the initial premium
    It is granted only at the option of the agent
    It permits the insured to reject the policy within 10 days of the policy delivery and receive a full refund
    It can be waived only by the insurance company
  • Q2
    All of the following statements about the Outline of Coverage for health insurance policies are correct EXCEPT
    Principal benefits also shown on the policy need not be included
    It is to include a summary statement of principal exclusions
    It must include any right the insurer reserves to change the premiums
    Principal benefits also shown on the policy need not be included
  • Q3
    If a health insurance company tests a person for AIDS/HIV which of the following must be signed?
    Notice of informed consent
    AIDS/HIV underwriting disclosure form
    AIDS/HIV rate disclosure form
    Outline of coverage
  • Q4
    All of the following are correct about the required provisions of a health insurance policy EXCEPT
    Claim forms must be sent to the insured within 15 days of notice of claim
    A grace period of 31 days is found in an annual pay policy
    A reinstated policy provides immediate coverage for an illness
    The entire contract clause means the policy, endorsements, and attachments constitute the entire contract
  • Q5
    A health insurance proof-of-loss form must be given to the insurer within how many days after a loss?
    90 days
    15 days
    20 days
  • Q6
    At what point in time can a policyholder file suit against a health insurance company for failure to pay a claim?
    120 days from date of loss
    60 days after filing proof of loss
    60 days from date of loss
    120 days after filing proof of loss
  • Q7
    Florida’s “mini-COBRA” applies to employers with?
    Less than 20 employees
    20 or more employees
    Less than five employees
    Five or more employees
  • Q8
    All of the following provisions are required by the Florida Employee Health Care Access Act EXCEPT
    Carriers must use a “modified community rating” methodology
    Coverage must always be renewed by carriers
    Small employer means an employer with 1-50 employees
    All small group health benefit plans must be issued on a “guarantee-issue” basis
  • Q9
    Individual and group health insurance policies and HMO contracts can be canceled for all of the following reasons EXCEPT
    Fraud or intentional misrepresentation of a material fact
    The insurer ceases to offer coverage in the market
    Failure to pay premiums
    The insured develops a serious illness
  • Q10
    Which of the following practitioners is NOT defined as a “physician” under Florida law?
    Dentist preforming surgery in an office
    Optometrist rendering services at an eye clinic
    Surgeon in an ambulatory surgical center
    Sports therapist performing services in a health club

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