Practice Test Geeks(EXAMFX) Exam FX Insurance Practice Test
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Health Insurance Flashcards

7 cards from real EXAMFX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Health Insurance flashcards as text

  1. Which type of health insurance plan requires members to receive care from a designated primary care physician and generally does NOT cover out-of-network providers except in emergencies?

    Answer: HMO

    HMOs require members to use network providers and obtain PCP referrals, with out-of-network coverage only for emergencies.

  2. A health insurance policy's 'out-of-pocket maximum' is best described as:

    Answer: The cap on the insured's cost-sharing after which the insurer pays 100% of covered expenses

    Once the insured reaches the out-of-pocket maximum, the insurer covers 100% of additional in-network covered costs for the remainder of the year.

  3. The COBRA qualifying event of a covered employee's death entitles surviving dependents to how many months of continuation coverage?

    Answer: 36 months

    Death of the covered employee is a qualifying event that entitles surviving dependents to 36 months of COBRA continuation coverage.

  4. Under the 'time of payment of claims' provision, health insurers must pay claims immediately after receiving:

    Answer: Written proof of loss

    The time of payment of claims provision requires the insurer to pay claims promptly upon receipt of written proof of loss.

  5. A guaranteed renewable health insurance policy means:

    Answer: The insurer must renew the policy but may increase premiums for an entire class of insureds

    Guaranteed renewable policies cannot be cancelled by the insurer as long as premiums are paid, but the insurer may raise rates on a class-wide basis.

  6. Which of the following statements about a Health Reimbursement Arrangement (HRA) is correct?

    Answer: HRAs are owned and funded solely by the employer

    HRAs are employer-funded accounts used to reimburse employees for qualified medical expenses; employees cannot contribute to them.

  7. Under the 'notice of claim' provision, an insured is generally required to notify the insurer of a claim within how many days of an occurrence?

    Answer: 20 days

    The NAIC model policy requires the insured to give written notice of claim within 20 days of a covered occurrence or as soon as reasonably possible.