Question 1

Which of the following applies to the 10-day free-look privilege in a health insurance contract?

Accepted Answer

It permits the insured to reject the policy within 10 days of the policy delivery and receive a full refund

Answer

It allows the insured an additional 10 days to pay the initial premium

Answer

It is granted only at the option of the agent

Answer

It can be waived only by the insurance company

Question 2

All of the following statements about the Outline of Coverage for health insurance policies are correct EXCEPT

Accepted Answer

Principal benefits also shown on the policy need not be included

Answer

It is to include a summary statement of principal exclusions

Answer

It must include any right the insurer reserves to change the premiums

Question 3

If a health insurance company tests a person for AIDS/HIV which of the following must be signed?

Accepted Answer

Notice of informed consent

Answer

AIDS/HIV underwriting disclosure form

Answer

AIDS/HIV rate disclosure form

Answer

Outline of coverage

Question 4

All of the following are correct about the required provisions of a health insurance policy EXCEPT

Accepted Answer

A reinstated policy provides immediate coverage for an illness

Answer

Claim forms must be sent to the insured within 15 days of notice of claim

Answer

A grace period of 31 days is found in an annual pay policy

Answer

The entire contract clause means the policy, endorsements, and attachments constitute the entire contract

Question 5

A health insurance proof-of-loss form must be given to the insurer within how many days after a loss?

Accepted Answer

90 days

Answer

Immediately

Answer

15 days

Answer

20 days

Question 6

At what point in time can a policyholder file suit against a health insurance company for failure to pay a claim?

Accepted Answer

60 days after filing proof of loss

Answer

120 days from date of loss

Answer

60 days from date of loss

Answer

120 days after filing proof of loss

Question 7

Florida’s “mini-COBRA” applies to employers with?

Accepted Answer

Less than 20 employees

Answer

20 or more employees

Answer

Less than five employees

Answer

Five or more employees

Question 8

All of the following provisions are required by the Florida Employee Health Care Access Act EXCEPT

Accepted Answer

Coverage must always be renewed by carriers

Answer

Carriers must use a “modified community rating” methodology

Answer

Small employer means an employer with 1-50 employees

Answer

All small group health benefit plans must be issued on a “guarantee-issue” basis

Question 9

Individual and group health insurance policies and HMO contracts can be canceled for all of the following reasons EXCEPT

Accepted Answer

The insured develops a serious illness

Answer

Fraud or intentional misrepresentation of a material fact

Answer

The insurer ceases to offer coverage in the market

Answer

Failure to pay premiums

Question 10

Which of the following practitioners is NOT defined as a “physician” under Florida law?

Accepted Answer

Sports therapist performing services in a health club

Answer

Dentist preforming surgery in an office

Answer

Optometrist rendering services at an eye clinic

Answer

Surgeon in an ambulatory surgical center

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