There must be at least 100 employees in order to qualify for OBRA large-group status. The act
states that plans must provide primary coverage for disabled individuals under age 65 who are
not retired. - ANS-According to OBRA, what is the minimum number of employees required to
constitute a large group?
A. 100
B. 15
C. 20
D. 50
A. 2 years
Under an Own Occupation plan, if the insured cannot perform his/her current job for a period of
up to two years, disability benefits will be issued, even if the insured would be capable of
performing a similar job during that two-year period. After that, if the insured is capable of
performing another job utilizing similar skills, benefits will not be paid. - ANS-An insured was
involved in an accident and could not perform her current job for 3 years. If the insured could
reasonably perform another job utilizing similar skills after 1 month, for how long would she be
receiving benefits under an "own occupation" disability plan?
A. 2 years
B. 1 month
C. She would not receive any benefits.
D. 3 years
A. 36 months
The maximum period of coverage under COBRA is 36 months, in the event of the covered
employee's death or divorce. - ANS-What is the period of coverage for events such as death or
divorce under COBRA?
A. 36 months
,B. 60 days
C. 31 days
D. 12 months
A. A construction worker pays a higher premium and receives a poorer classification of
disability.
In disability income policies, the insured's occupation is a critical underwriting factor. The more
hazardous the applicant's occupation, the higher the premium the insurance company will
charge. - ANS-Underwriting for disability insurance is unique due to the type of risk involved.
Which of the following situations illustrates this?
A. A construction worker pays a higher premium and receives a poorer classification of
disability.
B. A stunt person pays a low premium and receives a superior classification of disability.
C. An attorney pays a higher premium and receives a poorer classification of disability.
D. A secretary pays a higher premium and receives a superior classification of disability.
A. Actual charge
Actual Charge is the amount a physician or supplier bills for a particular service or supply. -
ANS-What is the amount a physician or supplier bills for a particular service or supply?
A. Actual charge
B. Assignment
C. Coinsurance
D. Approved amount
A. Adjust the benefit in accordance with the increased risk
A part of the premium rating concerns the hazard of occupation. - ANS-If the insured under a
disability income insurance policy changes to a more hazardous occupation after the policy has
been issued, and a claim is filed, the insurance company should do which of the following?
A. Adjust the benefit in accordance with the increased risk
,B. Cancel the policy
C. Increase the premium
D. Exclude coverage for on-the-job injury
A. Amy will be given the option to continue her coverage under the group plan, but will have to
pay premiums for her coverage.
If a group member dies, the surviving spouse must be given the choice of continuing coverage
under the group plan. The coverage must be the same. The group policyholder will be in charge
of collecting the required premium from the surviving spouse. - ANS-Andy and Amy, both 53
years of age, are married. Amy is covered under Andy's family health insurance plan at work. If
Andy dies unexpectedly, which of the following is true regarding Amy's health coverage?
A. Amy will be given the option to continue her coverage under the group plan, but will have to
pay premiums for her coverage.
B. Amy will be given the option to continue her coverage under the group plan, and will not have
to pay premiums for her coverage.
C. The group coverage will terminate 90 days after Andy's death. Amy will now have to buy an
individual policy and provide evidence of insurability.
D. The group coverage will terminate 90 days after Andy's death. Amy will now have to buy an
individual policy, but will not have to provide evidence of insurability.
A. Attending physician
Home health care is care provided in one's home and could include occasional visits to the
person's home by registered nurses, licensed practical nurses, licensed vocational nurses, or
community-based organizations like hospice. Home health care might include physical therapy
and some custodial care such as meal preparations. - ANS-Occasional visits by which of the
following medical professionals will NOT be covered under LTC's home health care?
A. Attending physician
B. Registered nurses
C. Licensed practical nurses
D. Community-based organization professionals
, A. Automatic enrollment
There are 3 types of enrollment periods for Medicare Part A: initial enrollment period, general
enrollment period and special enrollment period. - ANS-Which of the following is NOT an
enrollment period for Medicare Part A applicants?
A. Automatic enrollment
B. Initial enrollment
C. Special enrollment
D. General enrollment
A. Blanket Policy.
A single policy covering several certificate holders without naming the insured individually is a
blanket policy. - ANS-A group policy used to provide accident and health coverage on a group of
persons being transported by a common carrier, without naming the insured persons individually
is called
A. Blanket Policy.
B. Activity policy.
C. Specified disease policy.
D. Certificate of Coverage Policy.
A. Blanket.
A policy that covers all of the participants without naming them individually is a blanket policy. -
ANS-The First Street Church plans to sponsor a summer camp for the youth of their
congregation. They would like to purchase insurance that would pay benefits should one of the
youth get injured while participating in the camp activities. The type of policy they would likely
need is a/an
A. Blanket.
B. Limited Sickness.
C. Accidental Death and Dismemberment.
D. Limited Accident.
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