A health insurance issuer offering coverage in the individual market must provide premium rebates if its
medical loss ratio (MLR) is less than what percentage? -
✔✔
80%
According to the California Insurance Code, all of the following Long--Term Care (LTC) insurance sales
are considered unnecessary EXCEPT -
✔✔
a replacement LTC policy with equal benefits for a lower
premium
All of the following types of insurance pay benefits in addition to those paid by other insurance policies
held by the insured EXCEPT -
✔✔
medical expense
The most common type of specified disease insurance policy is -
✔✔
cancer
After the deductible is satisfied, what percentage of a reasonable charges does Medicare Part B pay? -
✔✔
80%
Which of the following statements concerning the usual coordination of benefits provision is correct? -
✔✔
when two plans both have the provision, coverage as an employee is primary to coverage as a
dependent
Which health insurance provision protects an insured from the expense of a catastrophic illness? -
✔✔
stop-loss
Which insurance contract provision addresses the problem of overinsurance? -
✔✔
coordination benefits
Relevant factors in the health insurance principle of morbidity include all of the following EXCEPT -
✔✔
intelligence
To reach currently insured status under the Social Security system, an individual must be credited with a
MINIMUM of -
✔✔
6 quarters of coverage during the last 13-quarter period
In health insurance, the result of rising morbidity rates is -
✔✔
increased premiums
