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Exam 15: Health-Care Reform; Individual Health Insurance Coverages

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Question 21

Multiple Choice

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Jan needed health insurance.She met with an agent who described the provisions of a health insurance policy.Jan purchased the policy.When she received the policy,she noted that several provisions were different from the provisions the agent described.She was not satisfied with the policy and immediately sent it back to the agent with a note stating her reasons for returning the policy.Jan is guaranteed a premium refund because of which policy provision?

A) waiting period
B) time limit on certain defenses
C) ten-day right to examine the policy
D) waiver-of-premium provision

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Question 22

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All the following are common exclusions in a major medical insurance policy EXCEPT

A) routine dental care.
B) surgeons' fees.
C) expenses covered by workers compensation laws.
D) cost of eyeglasses.

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Question 23

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Which of the following statements about disability and disability income insurance is (are) true? I.Most disability income policies replace 100 percent of gross earnings. II.The probability of being disabled before age 65 is much higher than commonly believed.

Beth's disability income insurance policy provides benefits for accidental death,dismemberment,and loss of sight.The maximum amount payable under this benefit is known as the

Beginning in 2014,the Affordable Care Act requires that most U.S.citizens and legal residents have qualifying health insurance or pay a financial penalty.This provision of the Affordable Care Act is known as the

Which of the following statements about eligibility requirements for qualified Health Savings Accounts (HSAs) is (are) true? I.Only individuals who are eligible for Medicare benefits can establish a qualified HSA. II.Applicants must be covered by a high deductible health plan and not be covered by any other comprehensive health plan to establish a qualified HSA.

Because of the Affordable Care Act,beginning in 2014,all new medical expense plans that offer individual and group coverage must accept all individuals and employers in the state who apply for coverage.These insurers are required to continue to renew the coverage at the option of the individual or plan sponsor.Thus,under the Affordable Care Act,the renewal provision is

Which of the following statements about high deductible health insurance plans is (are) true? I.Coverage under a high deductible health plan is necessary to establish a qualified health savings account (HSA) . II.High deductible health plans provide a maximum limit on annual out-of-pocket expenses.

After all of the provisions of the Affordable Care Act are implemented,which of the following statements will be true? I.Health insurers cannot use pre-existing conditions exclusions. II.Health insurers cannot impose annual benefit limits and lifetime benefit limits.

Dirk suffered a heart attack and was rushed to the hospital where heart surgery was performed.His total bill for medical services was $50,000.Dirk has a major medical policy with a $1,000 calendar-year deductible and a $5,000 out-of-pocket limit.His coinsurance percentage is 20 percent.The out-of-pocket limit applies to coinsurance only.Assuming this hospitalization was the first medical care that Dirk received during the year and that all of the hospital services were eligible for coverage under the policy,how much of the $50,000 bill will the insurer pay?

All of the following statements about long-term care insurance are true EXCEPT

Greta purchased a long-term care policy.Greta's eligibility for benefits under the policy may be triggered by

Barb was injured in an auto accident.She was totally disabled and collected disability income benefits for 8 months.She would like to return to work on a part-time basis to see if her recovery is complete.During this period,her insurer will pay reduced disability income benefits.This type of disability is called

Which of the following statements regarding health care expenditures in the United States is (are) true? I.As a nation,the U.S.spends significantly more per-person on health care than most other industrialized nations. II.Health care expenditures in the U.S.are high because everyone is covered by a health insurance plan.

All of the following statements about the tax treatment of Health Savings Accounts (HSAs) are true EXCEPT

Which of the following statements about health savings accounts (HSAs) is true?

Which of the following statements about provisions in individual health insurance policies is true?

Which of the following statements is (are) true regarding the calendar-year deductible used in most individual medical expense policies? I.Once the deductible is satisfied,no additional deductible is payable during the calendar year. II.A carryover provision helps to avoid paying two deductibles in a short period of time.

One provision of the Affordable Care Act provides the creation in each state of a transparent and competitive insurance marketplace where individuals and small firms with fewer than 100 employees can purchase affordable and qualified health coverage.This marketplace is called a(n)

The Affordable Care Act includes a provision designed to help small employers make health insurance coverage available to their employees.This provision allows small employers to directly reduce their federal income tax by a percentage of the employer's contribution to funding health care for employees.This subsidy,in the form of reduction of income taxes,is called a