North Carolina Health Insurance State Exam Prep

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North Carolina Health Insurance State Exam Prep And Answers Already Passed

Question 1: All of the following are true regarding Key

Employee Disability Income insurance EXCEPT

• Premiums are not tax deductible for the employer.
• Benefits are taxable to the employer.
• The employer owns the policy.
• Benefits are paid to the employer to retrain a new person.

CORRECT ANSWER : B) Benefits are taxable to the employer.

Question 2: How is emergency care covered for a member of an

HMO?

• A member of an HMO can receive care in or out of the HMO

service area, but care is preferred in the service area.

• A member of an HMO may receive care at any emergency

facility, at the same cost as if in his or her own service area.

• HMOs have salaried member physicians, but they do not

cover emergency care.

• An HMO emergency specialist will cover the patient.

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CORRECT ANSWER : A. A member of an HMO can receive

care in or out of the HMO service area, but care is preferred in the service area.

Question 3: After appointing an agent, how long does an insurer

have to file with the Commissioner the form detailing the agent's name, address, and other needed information?

• 15 days
• 30 days
• 45 days
• 60 days

CORRECT ANSWER : B) 30 days

Question 4: Bethany studies in England for a semester. While

she is there, she is involved in a train accident that leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that she receives?

CORRECT ANSWER : None

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Question 5: Which of the following are the main factors taken

into account when calculating residual disability benefits?

a) Present earnings and earnings prior to disability

b) Earnings prior to disability and the length of disability

c) Employee's full-time status and length of disability

d) Present earnings and standard cost of living

CORRECT ANSWER : a) Present earnings and earnings prior to

disability

Question 6: How can a new physician be added to the PPO's

approved list?

a) Fill out the appropriate paperwork and wait the 12 month pre-

certification period.

b) Pay an annual fee for being on the PPO list.

c) New physicians are only added once a year, and are selected

by the PPO's Board of Directors.

d) Agree to follow the PPO standards and charge the appropriate

fees.

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CORRECT ANSWER : d) Agree to follow the PPO standards

and charge the appropriate fees.

Question 7: Under the uniform required provisions, proof of loss

under a health insurance policy normally should be filed within

• 90 days of a loss.
• 20 days of a loss.
• 30 days of a loss.
• 60 days of a loss.

CORRECT ANSWER : a) 90 days of a loss.

Question 8: Which of the following must an insurer obtain in

order to transact insurance within a given state?

a) Business entity license

b) Insurer's license

c) Certificate of authority

d) Producer's certificate

CORRECT ANSWER : c) Certificate of authority