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WEST VIRGINIA HEALTH INSURANCE EXAM
NEWEST 2024-2025 ACTUAL EXAM COMPLETE 150
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS ) |ALREADY GRADED A +
In order to be eligible for coverage by an HSA, an individual must also be covered by what type of health plan? - ANSWER- High Deductible Health Plan (HDHP)
Can an insured who belongs to a POS plan use an out-of- network physician? - ANSWER- Yes, but the copays and deductibles may be higher
What will determine the length of the grace period in a health insurance policy? - ANSWER- The mode of the premium payment
How will changing one's occupation to be more hazardous affect the health insurance policy in force? - ANSWER- Claim benefits will be reduced to what the premium would have bought for a more hazardous occupation
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Under an individual disability income policy, the benefits must be paid on at least what schedule? - ANSWER- monthly
According to the Reinstatement provision, once a lapsed policy is reinstated, how soon will coverage be available for accidents?
- ANSWER- immediately
What is a probationary period in group health insurance? - ANSWER- The period of time that must lapse before an employee is eligible for group health coverage
Which health insurance provision describes the insured's right to cancel coverage? - ANSWER- Renewal provision
The insured on a health policy misstated his age on the insurance application. If this misrepresentation is discovered, what will happen to the policy? - ANSWER- The benefit amount payable under the policy will be adjusted to the insured's correct age.
After the elimination period, a totally disabled insured qualified for benefits from a disability income policy that has a waiver of premium rider. What will happen to the premium that was paid into the policy during the elimination period? - ANSWER- Premium will be refunded 2 / 3
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What is the purpose of the coinsurance provision and health insurance policies? - ANSWER- To prevent overutilization of the policy benefits
What health policy provision describes the insured right to cancel coverage? - ANSWER- Renewability provision
What are usual/reasonable and customary charges based on? - ANSWER- Average charge for a given procedure in the specific geographic area
What health policy provision prevents the insured from bringing a lawsuit against the insurance company for at least 60 days after proof of losses provided? - ANSWER- Legal actions
If a health insurance policy has a 31 day grace, period, what does that mean? - ANSWER- The policy remains in effect for 31 days after the premium is due and not paid
According to the time limit on certain defenses provision in health insurance policies, when can an insurer contest fraudulent missstatements on a health insurance application? - ANSWER- Anytime while the policy is in force
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