WLAH Wyoming Life & Accident and Health - Set 1 - 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 married couple's health policy in Wyoming already covers the family, and a new baby is born to them during the current policy period, before the couple has notified the insurer of the birth. From the moment of birth, what is the newborn child's coverage status under the policy?

The newborn has no coverage yet

The newborn is covered only prospectively

The newborn is automatically covered

The newborn needs medical underwriting first

Question 42: A child's parents are divorced, and the child lives with the mother while the father carries the family's group health policy through his employer. The insurer questions whether it must cover the child because the child does not reside with the policyholder-father. What must the insurer do?

Deny coverage until residency changes

Cover the child at reduced benefits

Require the mother to obtain separate coverage

Cover the child despite that residency

Question 43: A study group debates how Wyoming's accident and health law treats coverage for substance use disorder treatment, with one member insisting the law sets a fixed number of covered inpatient treatment days. Which statement most accurately characterizes how Wyoming actually approaches this coverage requirement?

It requires parity with medical benefits

It sets a fixed inpatient day limit

It caps outpatient visits per year

It excludes coverage entirely from policies

Question 44: An insurer wants to deny a claim under an individual accident and health policy that has been in force for several years, citing a minor misstatement the applicant made on the original application. Under Wyoming's time-limit-on-defenses provision, when can the insurer still use that misstatement to deny the claim?

Only during the first policy year

Only if the misstatement was fraudulent

Only if the insured has died

Only with the commissioner's written approval

Question 45: A Wyoming resident enrolls with a health maintenance organization and pays a set monthly amount regardless of how many office visits are used that month, aside from small copayments due at each visit. Which feature of the arrangement does this payment structure illustrate?

Basic health services billed per procedure

Basic health services covered only after deductible

Basic health services on a prepaid basis

Basic health services reimbursed after the fact

Question 46: A proposed accident and health policy form includes language promising that surviving policyholders will receive extra value if enough other policyholders in the same pool let their policies lapse. A compliance reviewer flags this language before the form is filed. Why is this provision prohibited in Wyoming?

Only group policies may use it

It requires prior commissioner approval only

It is allowed if disclosed clearly

Benefits cannot depend on others' lapses

Question 47: A trade association wants to offer its members a group health policy and applies to an insurer for coverage. The insurer reviews whether the association actually functions as a genuine organization with regular activity, rather than existing only to obtain insurance. What is the insurer checking for?

That it is a bona fide association

That the association has no bylaws

That it formed only to buy insurance

That the association excludes retired members

Question 48: An employee working for a small employer whose group health plan is not subject to the federal continuation law loses eligibility for that group coverage. The employer's plan otherwise provides hospital, surgical, and major medical coverage on an expense-incurred basis. What right does Wyoming law give this employee?

Automatic enrollment in Medicare

A state continuation right to remain insured

A right to sue the employer

Immediate conversion with no premium due

Question 49: A member of a group health plan in Wyoming loses eligibility for the group policy after the group's continuation period ends and wants to move into an individual policy without undergoing a new medical examination or answering fresh health questions about current conditions. Which right addresses this situation?

A right to a lower group rate

A right to reinstate the group policy

The right to convert without new evidence

A right to extend the waiting period

Question 50: A group health insurer in Wyoming wants to pay a hospital directly for services rendered to an insured member, rather than reimbursing the member. The insured objects in writing before filing proof of loss and asks to be paid personally instead. What must the insurer do?

Pay the hospital regardless of the objection

Split payment between insured and hospital

Require the hospital to waive its fee

Honor the insured's written objection

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