pg. 1 Florida Life, Health and Variable Annuities Latest Exam 2025/2026 Complete 150 Actual Exam Questions and Correct Detailed Answers (Verified Answers) Graded A+
What is included under the miscellaneous expense benefit? - Correct Answer - anesthesia (Surgical expenses and Post Op are covered under the Surgical policy. Physician fees are covered under the Basic Physicians expense policy)
Which is not true concerning a Hospital Fixed-Rate plan? - Correct Answer
- Benefits are paid directly to the hospital
In a health insurance policy, what term describes a situation where a policyowner transfers a portion of his or her rights in an insurance policy to the hospital? - Correct Answer - Right of assignment
The term FIRST DOLLAR often is used to describe benefits payable by which type of policy? - Correct Answer - A Hospital Indemnity policy (These policies pay first, no deductibles or co-insurance. Have largely been replaced by major medical policies which use deductibles and co-insurance to keep the premiums down and avoid small claims)
Which of the following statements concerning a noncancellable policy is/are true?
- The premiums can not be raised except by class. 1 / 3
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- The premiums can not be raised.
- The benefits may changed only by class.
- The benefits can not be changed. - Correct Answer - 2 & 4 (Nothing can
be changed, not even the premium, and not even over time due to age)
Many major medical policies include a provision whereby when expenses reach a certain dollar amount, the insured no longer shares in the cost of
expenses: the insurer pays 100% of remaining covered charges. This is
referred to as the: - Correct Answer - stop-loss limit
Which of the following is not a mandatory health insurance provision? - Correct Answer - Coinsurance provision
An individual has how many days in which to notify the company of a claim? - Correct Answer - 20 days
Extensions of Benefit is a term used in the health insurance industry which relates to claims that occurred while a policy was in force and then later the policy is no longer in effect but the insured is still disabled. If an HMO terminates coverage, how long will the HMO be responsible for the insured's disability? - Correct Answer - Until 12 months have expired or another carrier assumes coverage, whichever is earliest
Under the "relation of earnings to insurance" provision, the insurance company may take into account the insured's average monthly earnings for the past_____ months. - Correct Answer - 24 (If total disability income payments exceed the insured's average earnings over the last 24 months, the insurance company will only pay that proportionate amount of benefits as his earnings bear. Huh? If he had a policy that was going to pay him 60% of his previous earnings, they will pay him 60% of his last 24 months average earnings) 2 / 3
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Dread disease, a travel accident, vision care, and hospital indemnity
policies are all examples of: - Correct Answer - Limited risk policies
Florida law requires HMOs and EPOs to provide direct access to dermatologists, without a referral, how many times with-in a 12 month period? - Correct Answer - Five times
Disability Buy-Out plans feature: - Correct Answer - Long elimination plans
up to two years (A disability buy-out plan funded with disability insurance has a long elimination period of generally two years. The elimination period begins the day of the disability. Then the disability policy will provide a lump sum to buy the disabled partner out. They want to make sure that the partner is not going to recover and come back to work)
When MUST the Office of Insurance Regulation conduct a market conduct examination on domestic insurers? - Correct Answer - at least once every five years
Who underwrites the risk for children covered by the Florida Health Kids Corporation? - Correct Answer - commercial health insurers (Private" just means not publicly owned. Insurance companies are the ones who write the policies and take on the risk of children cover by the Florida Healthy Kids Corporation. The premiums are paid for through a combination of local, state, federal and family money. "Family money" means the family pays a piece of the premium, which is why this plan is also said to be voluntary)
When individual disability benefits are paid directly to the individual who has paid the premium, a question of taxation arises. Which would be the most appropriate response? - Correct Answer - The premium was not tax deductible and the benefit is tax free (Individual premiums are not
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