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North Carolina Health Insurance State Exam Prep Questions with Correct Answers
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North Carolina Health Insurance State Exam Prep
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North Carolina Health Insurance StateExam Prep
Insured Contingent Beneficiary - answer If the insured and primary beneficiary are both
killed in the same accident and it cannot be determined who died first, where are the
death proceeds to be directed under the uniform Simultaneous Death Act?
Reimbursement - answer Which type of policy pays benefits to a policyholder covered
under a Hospital Expense policy?
$25,000 - answerJ has an Accidental Death and Dismemberment policy with a principal
sum of $50,000. While trimming the hedges, J cuts off one of his fingers. What is the
MAXIMUM J will receive from his policy?
payable to the company or another shareholder - answerThe benefits under a Disability
Buy-Out policy are:
off-the -job accident - answerAn accident policy will most likely pay a benefit for a(n)
indemnity - answera payment for damage or loss
continue group health benefits - answerThe COBRA gives workers whose employment
has been terminated the right to
Social Security Disability Income - answerThe percentage of as individual's Primary
Insurance Amount determines the benefits paid in which of the following programs.
100% of the insured's Primary Insurance Amount (PIA) - answerWhat is the maximum
Social Security Disability benefit amount an insured can receive?
PPO's are NOT a type of managed care system - answerWhich of these statements is
INCORRECT regarding a PPO?
Part A covers hospitalization; Part B covers doctor's services - answerWhat does
Medicare Parts A and B cover?
PPO - answerUnder what system do a group of doctors and hospitals in a designated
area contract with an insurer to provide services at a prearranged cost to the insured?
closed panel - answerThe situation in which a group of physicians are salaried
employees and conduct business in an HMO facility is called a(n)
, Her group health plan (if the employer has more than 20 employees, the group health
plan generally pays first) - answerA 66 year-old is covered under a group health plan
while employed with a business that has 40 employees. If she injures herself while
walking in the park, what coverage would be considered primary?
Commercial Insurers - answerWhich of the following reimburses its insureds for covered
medical expenses?
If the employee paid for qualified medical expenses, the reimbursements may be tax-
free - answerWhich of the following statements about Health Reimbursement
Arrangements (HRA) is CORRECT?
Restoration of used benefit - answerWhich provision allows a portion of any used
medical benefits to be restored following a particular amount of benefit has been used,
or after the policy has been in effect for a particular period of time?
Common Accident Deductible - answerIf several family members are injured in the
same accident, only one deductible is applied.
$1,600 - answerM has a Major Medical Insurance policy with a $200 flat deductible and
an 80% Coinsurance clause. If M incurs a $2,200 claim for an eligible medical expense,
how much will M receive in payment for this claim?
Family maximum deductable - answerThis type of deductible provision waives the
deductible for all family members after some of them have satisfied individual
deductibles within the same year
lower than the actual expenses incurred - answerBasic Hospital and Surgical policy
benefits are
Coverage that pays a stated amount per day of a covered hospitalization -
answerWhich of the following BEST describes a Hospital Indemnity policy?
Surgically removing a facial birthmark - answerWhich of the following costs would a
Basic Hospital/Surgical policy likely cover?
carryover provision - answerWhich of the following policy features allows an insured to
defer current health charges to the following year's deductible instead of the current
year's deductible?
Residual Disability - answerR had received full disability income benefits for 6 months.
When he returns to work, he is only able to resume half his normal daily workload.
Which provision pays reduced benefits to R while he is not working at full capacity?
time deductible - answerA disability elimination period is best described as
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