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How many eligible employees must be included in a contributory health insurance plan? Aman works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim, YWThe insurance through his company is primary. What is the period of coverage for events such as death or divorce under COBRA? VV36 Twenty-five days after a health insurance policy is delivered, the policyowner decides that she would like to return the policy and receive a refund of premium. Which of the following is true? An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits? VVNo benefits For the purpose of insurance, risk is defined as VV The uncertainty or chance of loss. Which of the following is an example of a producer's fiduciary duty? VV The trust that a client Which of the following is NOT true of basic medical expense plans? Vv Coverage for Which of the following is NOT a feature of a noncancellable policy? VV The insurer may What is the best way to change an application? VVStart over with a fresh application Ona major medical insurance policy, the amount that an insured must pay on a claim before the insurer will pay is known as Vv Deductible. Under which of the following disability income plans would the benefits be subject to income tax? ¥WGroup Under the Affordable Care Act, a special enrollment period allows an individual to enroll in a qualified health plan within how many days of a qualifying event? VV60 days Which of the following individuals must pass a written examination to be licensed as a life insurance agent? V/A resident of New York wishing to transact business in New York When an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply? VV Case management provision An individual applies for a life policy. Two years ago he suffered a head injury from an accident, so he cannot remember parts of his past, but is otherwise competent. He has also been hospitalized for drug abuse, but does not remember this when applying for insurance. The insurer issues the policy and learns of his history one year later. What will probably happen? VVThe policy will not be affected. The purpose of managed care health insurance plans is to /¥ Control health insurance claims expenses. To attain currently insured status under Social Security, a worker must have earned at least how many credits during the last 13 quarters? V6 credits If seeking repayment of Medicaid funds per the Medicaid Estate Recovery Act would cause a hardship to survivors, states may VV Waive the estate recovery requirement. The insuring clause of a disability policy usually states all of the following EXCEPT V/V The method of premium payment. Which of the following statements regarding Business Overhead Expense policies is NOT true? VV Benefits are usually limited to six months. At what point must an Outline of Coverage be delivered? /VAt the time of application or upon delivery of the policy Pertaining to insurance, what is the definition of a fiduciary responsibility? / V Promptly forwarding premiums to the insurance company Which of the following persons would qualify for Medicare Part A? /W Anyone who has permanent kidney failure A rating method in which the premium is the same for all covered persons, regardless of age, sex, or health status is referred to as // Community rating What is the purpose of Medigap policies? //To cover expenses for Medicare deductibles and coinsurance Under which of the following circumstances may the uniform individual accident and sickness policy provisions be changed? /VIf the change is more favorable to the policyholder In an HMO policy, one of the main responsibilities of the primary care physician (PCP) as a gatekeeper is to do which of the following? / /Help control costs NY Series 17-52 Questions and Answers Graded A+NY Series 17-52 Questions and Answers Graded A+NY Series 17-52 Short term J/Vless than 2 years NY Series 17-52 Questions and Answers Graded A+NY Series 17-52 Questions and Answers Graded A+NY Series 17-52 
