LH Chapter 29 FL Manual
Quiz by Brian Morton
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10 questions
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- Q1Which 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 premiumIt is granted only at the option of the agentIt permits the insured to reject the policy within 10 days of the policy delivery and receive a full refundIt can be waived only by the insurance company60sEditDelete
- Q2All of the following statements about the Outline of Coverage for health insurance policies are correct EXCEPTPrincipal benefits also shown on the policy need not be includedIt is to include a summary statement of principal exclusionsIt must include any right the insurer reserves to change the premiumsPrincipal benefits also shown on the policy need not be included60sEditDelete
- Q3If a health insurance company tests a person for AIDS/HIV which of the following must be signed?Notice of informed consentAIDS/HIV underwriting disclosure formAIDS/HIV rate disclosure formOutline of coverage60sEditDelete
- Q4All of the following are correct about the required provisions of a health insurance policy EXCEPTClaim forms must be sent to the insured within 15 days of notice of claimA grace period of 31 days is found in an annual pay policyA reinstated policy provides immediate coverage for an illnessThe entire contract clause means the policy, endorsements, and attachments constitute the entire contract60sEditDelete
- Q5A health insurance proof-of-loss form must be given to the insurer within how many days after a loss?90 daysImmediately15 days20 days60sEditDelete
- Q6At 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 loss60 days after filing proof of loss60 days from date of loss120 days after filing proof of loss60sEditDelete
- Q7Florida’s “mini-COBRA” applies to employers with?Less than 20 employees20 or more employeesLess than five employeesFive or more employees60sEditDelete
- Q8All of the following provisions are required by the Florida Employee Health Care Access Act EXCEPTCarriers must use a “modified community rating” methodologyCoverage must always be renewed by carriersSmall employer means an employer with 1-50 employeesAll small group health benefit plans must be issued on a “guarantee-issue” basis60sEditDelete
- Q9Individual and group health insurance policies and HMO contracts can be canceled for all of the following reasons EXCEPTFraud or intentional misrepresentation of a material factThe insurer ceases to offer coverage in the marketFailure to pay premiumsThe insured develops a serious illness60sEditDelete
- Q10Which of the following practitioners is NOT defined as a “physician” under Florida law?Dentist preforming surgery in an officeOptometrist rendering services at an eye clinicSurgeon in an ambulatory surgical centerSports therapist performing services in a health club60sEditDelete