ALAHI Arizona Life Accident and Health Insurance Exam - Set 5 - Part 3

Test your knowledge of technical writing concepts with these practice questions. Each question includes detailed explanations to help you understand the correct answers.

Question 41: A child is covered under health plans held by both parents, and the two insurers apply a rule to decide which plan pays first so that the total paid does not exceed the actual charges. Which provision governs this?

Coordination of benefits

Subrogation

Preexisting condition limitation

Stop loss

Question 42: An employee covered under a group health plan is terminated for reasons other than gross misconduct, and wants to keep that same coverage temporarily by paying the full cost personally. Which of the following federal laws provides that right?

The Employee Retirement Income Security Act

The Health Insurance Portability and Accountability Act

The Affordable Care Act

The Consolidated Omnibus Budget Reconciliation Act

Question 43: A former employee elects federal continuation coverage and is surprised that the monthly cost far exceeds what used to be deducted from a paycheck while employed. Which of the following explains the amount a qualified beneficiary may be charged?

Only the employee's former share

Full group cost plus administrative charge

The individual market rate for similar coverage

Double the previous payroll deduction

Question 44: An employee leaving a group health plan is offered the chance to obtain an individual policy from the same insurer without submitting any evidence of insurability, though at individual rates. Which of the following rights is being exercised?

The conversion right

The open enrollment right

The reinstatement right

The coordination right

Question 45: A newly hired employee is told that group health coverage will not begin until a stated number of days of continuous employment have passed, after which enrollment in the plan finally becomes available. Which of the following best describes that requirement?

A free look period

An elimination period

A probationary claim exclusion

A waiting period

Question 46: An individual health policy states that the insurer may not cancel or refuse to renew the coverage while premiums are paid on time, but may raise rates for an entire class of insureds. Which renewal provision is described?

Cancellable

Conditionally renewable

Guaranteed renewable

Noncancellable

Question 47: An insurer will issue health coverage to an applicant with a chronic knee condition only by attaching a document that permanently excludes any treatment related to that knee. Which of the following describes the document attached to the policy?

An impairment rider

A cost of living rider

A rehabilitation rider

A guaranteed insurability rider

Question 48: A health policy provision directs that benefits are payable to the insured, and that any accrued benefits left unpaid at the insured's death go to a named beneficiary or the estate. Which of the following uniform provisions is described?

Change of beneficiary

Time of payment of claims

Payment of claims

Proof of loss

Question 49: A health policy reserves the insurer's right to have a claimant examined by a physician of the insurer's choosing while a claim is pending, at the insurer's expense and where not forbidden by law. Which provision is described?

Entire contract

Physical examination and autopsy

Proof of loss

Legal actions

Question 50: One health plan reimburses a covered charge after the member receives care from any licensed provider, while another collects a fixed amount in advance and delivers care through its own contracted providers. Which of the following pairs of terms describes these two approaches?

Primary and secondary coverage

Contributory and noncontributory

Indemnity and coinsurance

Fee for service and prepaid

Congratulations!

You have completed all 5 question sets. Good job!

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