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Xcel Final ExamActual Questions and Answers |Latest 2025 Update with Complete Solution
Which type of plan would be the most appropriate for an individual on Medicare and concerned that Medicare will NOT pay for charges exceeding the approved amount? - ANSWER-Medicare supplement Plan F
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)? - ANSWER-when contribution or participation rules have been violated
What does the word "level: in Level Term describe? - ANSWER-the face amount
A non-contributory health insurance plan helps the insurer avoid - ANSWER-adverse selection
An insured under a Major Medical expense plan with a zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is the insured responsible for? - ANSWER-$200
because this policy has a zero deductible, the insures is only responsible for the 20% coinsurance on this claim, or $200
An insured has a stop-loss limit of $5,000 and an 80/20 coinsurance. The insured incurs $25,000 of covered losses. How much will the insured pay? - ANSWER-$5,000
Typically, Long-Term Disability benefits are coordinated with which benefit plan? - ANSWER-Social Security
The focus of major medical insurance is providing coverage for - ANSWER-medical and hospitalization expenses
because all eligible employees are usually covered, non-contributory plans are desirable from an underwriting standpoint because adverse selection is minimized.
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To qualify for a resident producer license in the state of Michigan, an individual - ANSWER-must complete the required pre-licensing education within 12 months of license application
Under an expense-incurred individual health policy, what is the MAXIMUM length of time after issuance of the policy that an insurer can exclude coverage for a pre-existing condition? - ANSWER-12 months
pre-existing conditions may be excluded for a maximum of 12 months from the date of enrollment.
An insured has a health plan that pays established amounts in accordance with a list of injuries, surgical procedures, or other losses. This list is called a - ANSWER-benefit schedule
benefits schedule set predetermined limits or maximums on how much money and insured can be reimbursed for a covered loss.
Who is the individual paid on a fee-for-service basis? - ANSWER-Provider
Which of the following is NOT an illegal inducement? - ANSWER-Giving the insured an article of merchandise printed with the producer's name costing $5
$5 or less of tokens or merchandise to applicants is allowed.
Making a statement that is false or maliciously critical of the financial condition of an insurer is known as - ANSWER-defamation
Which of the following is NOT a required provision in an accident and health insurance policy? - ANSWER-change of occupation
the change of occupation provision is considered an OPTIONAL provision
Which of these statements about Medicaid is CORRECT? - ANSWER-Funded by federal, sate, and local taxes
Medicaid is funded by federal, state, and local taxes but is administered by each state.
All of these are considered key factors in underwriting life insurance EXCEPT - ANSWER-Marital Status
Correct: tobacco use, health history, age
The time limit for filing claim disputes is addressed in which provision of an accident and health policy? - ANSWER-legal actions
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