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Chapter 12
Florida Statutes, Rules, and Regulations Pertinent to Health Insurance
| Question | Answer |
|---|---|
| In order for an employee to be considered eligible for small group insurance, he/she must work at least how many hours per week? | 25 |
| When can a Long-Term Care policy deny a claim for losses incurred because of a pre-existing condition? | Within 6 months of the effective date of coverage |
| Which of the following entities must approve all Medicare supplement advertisements? | Insurance Commissioner or Director |
| Which of the following is NOT among the goals of a Medicare supplement application? | Presuming the applicant is eligible for Medicaid, based on the nature of the policy |
| Which document helps ensure that full and fair disclosure is provided to the recipient of a policy? | Outline of Coverage |
| In a long-term care policy, pre-existing condition limitations | Must appear as a separate paragraph and be clearly labeled. |
| Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the | Notice Regarding Replacement. |
| The FHCC requires insurers who sell health plans 2 small employers 2 offer in those plans a right to elect 2 cont coverage, w/o evidence of insurability, to employees who lose their coverage/are unable to replace it. The rate coverage may NOT exceed | 115% of the regular group rate. |
| which of the following does NOT describe hospice care? | It provides care to people with like expectancies of 1 t o 2 years |
| When may an issuer require an insured to provide genetic information? | Never |
| How long must an insurer retain an advertisement for its long-term care polices? | 3 years |
| In this state, long-term care benefits may be triggered by inability to perform how many activities of daily living? | 3 |
| What is the statue of limitation on lawsuits for health insurance policies? | 5 years |
| A group blanket health policy is best suited for which of the following? | Summer Camp |
| What is knowingly making a misleading representation or incomplete or fraudulent comparisons for the purpose of inducing a person to terminate existing coverage and purchasing new or different coverage that may not be in the persons best interest? | Twisting |
| For which of the following reasons may an insurer terminate a small employer health insurance policy? | Nonpayment of premium |
| The inflation protection feature in long-term care policies issued in this state must provide protection for inflation at what percent annually? | 5% |
| When are HMOs required to file a report of their activities with the Department of Financial Services? | Within 3 months of the end of each fiscal year |
| HMOs that contract with outside physicians to provide health care service to their subscribers compensate those providers on a | Capitation basis |
| Health plan issuers are prevented from collecting genetic information for underwriting purposes or limited in their requests for genetic tests by | The Genetic Information and Nondiscrimination Act. |
Created by:
Hayley92