UHC Ethics and Compliance Questions and Answers 100% Correct

UHC Ethics and Compliance Questions and Answers 100% Correct

What is considered the most common type of specified disease insurance policy? - Cancer

Minimum participation standards exist for a group health insurance plans in order to - Prevent Adverse Selection

How does underwriting differ between group life and individual life insurance? - Medical questions must be answered on individual life insurance

when handling premiums for an insured an agent is acting in which capacity? - Fiduciary

what is the term used to describe the frequency and severity of certain illnesses and accidents? - Morbidity

Which of the following describes the statement "The more times an event is repeated, the more predictable the outcome becomes"? - Law of large numbers

In order to be considered "currently insured" under Social Security, an individual must be credited with? - 6 quarters of coverage during the last 13-quarter period

How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application? - 2 Years

Which of the following does the California Insurance Code NOT require an insurance policy to specify? - Insurer's financial rating

Which of the following is NOT required in the content of a policy? - Probability of loss

Which of the following pieces of information is NOT gathered during the personal financial planning process? - An individual's civic organization memberships

Which of the following is not considered to be an unfair claims settlement practice? - Advising a claimant to hire an attorney

When an applicant applies for insurance, the process by which the insurer determines whether to issue a policy is called? - Underwriting

How is a Medicare claim submitted? - Expenses are submitted to Medicare by the health provider

According to the PPACA, the medical enrollment tier that has 80%

actuarial value is called: - Gold

Employer contributions to qualified plans are - Tax-deductible by the employer

Employee participation in a noncontributory group life plan must be - 100%

What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code? - Presentation of policy features that includes non-guaranteed elements

Which of the following is NOT a characteristic of a preferred provider organization (PPO)? - Primary physicians serve as gatekeepers

John owns an insurance policy that gives him the right to share in the insurer's surplus. What kind of policy is this? - Participating

a life agent who has misappropriated fiduciary funds to his own use.What is Pete guilty of? - Theft

If an insured dies because of an accident, which type of life insurance rider will provide additional coverage? - Accidental death rider

Tom is shopping for a policy that covers two people and would pay the face amount ONLY when the first person dies. The type of life policy he is looking for is called a - Joint life policy

Which of these statements is NOT true concerning recurrent disabilities?

• The insurer continues coverage after a new elimination period

An insurer owned by its policyholders is called a? - Mutual Insurer

Medicare Part B Covers? - Physician Expenses

Which of these is NOT a relevant factor in the health insurance principle of morbidity? - Intelligence

Which of these factors do not affect the rates of medical insurance? - Race

Which of the following types of life insurance is normally associated with a mortgage loan? - Decreasing term

which of the following is not included in comprehensive major medical plans? - First-Dollar Coverage

Moral hazard is described as the - Increased chance of a loss because of an insured's dishonest tendencies

Which principle is accurately described with the statement "Insureds are entitled to recover an amount NOT greater than the amount of their loss"? - Indemnity

What time period allows an insured's life insurance policy to remain in force even if the premium was not paid on the due date? - Grace Period

How long must life agents keep their transaction records? - 5 Years

What does the insurance term indemnity refer to? - Make whole

Individual health insurance coverage typically excludes injuries at an employee's workplace because? - It's covered by the state Worker's Compensation program

which of the following refers to a condition that may increase the chance of a loss? - Hazard

Life insurance surplus must be distributed to policy-owners at what frequency? - Annually

According to PPACA, what is a health benefits exchange? - An entity to which individuals and small businesses can have access to affordable health coverage

According to the California Insurance Code, which of the following is NOT an example of an insurable event? - An insured suffers a financial loss in the state lottery

at what point does a self-insured group qualify for stop-loss coverage? - When claims exceed a specified limit in a set period of time

The conditions, times, and circumstances under which an insured is NOT covered by a health policy are called? - Exclusions