Chapter 16 State Portion: Specific To Accident And Health Insurance

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| By Vivian Tayor
Vivian Tayor, Insurance & Finance
Vivian, with over a decade of financial and insurance leadership, founded Celevi CE, an elite continuing education organization, aiming to empower industry experts with trust and respect.
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1. Newborn children are automatically covered fro:  

Explanation

Newborn children are automatically covered for 30 days. This means that for the first 30 days of their life, they have insurance coverage without any additional steps or enrollment required. This coverage can include medical expenses, hospital stays, and other necessary healthcare services. After the initial 30 days, additional steps may need to be taken to continue the coverage.

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Chapter 16 State Portion: Specific To Accident And Health Insurance - Quiz

This quiz covers specific regulations in Accident and Health Insurance, focusing on legal requirements such as grace periods, continuing education, and penalties for non-compliance. It assesses knowledge crucial for insurance professionals adhering to state-specific guidelines.

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2.  Barbara pays her $75.00 premium every week. What is her Grace Period?  

Explanation

The grace period refers to the amount of time after the due date during which an insurance premium can still be paid without any penalty or coverage lapse. In this case, Barbara pays her premium every week, so her grace period would likely be shorter than the grace period for monthly or annual payments. The correct answer of 7 days suggests that Barbara has one week to pay her premium after the due date before any penalties or consequences occur.

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3. John willfully failed to provide evidence requested by the Commissioner. If convicted of a misdemeanor, what fine may John be subject to pay?

Explanation

John may be subject to pay a fine of $1000.00 if convicted of a misdemeanor for willfully failing to provide evidence requested by the Commissioner.

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4.  An HMO provides Health services to members known as:  

Explanation

An HMO provides health services to its members, who are referred to as subscribers. This term is commonly used in the healthcare industry to refer to individuals who have enrolled in a specific health insurance plan or program. Subscribers are the individuals who have signed up for the HMO and are entitled to receive the healthcare services and benefits provided by the HMO.

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5. Carl's policy lapsed. Which of the following would reinstate his policy?  

Explanation

Carl’s policy lapsed, which means it expired or was terminated due to non-payment. To reinstate his policy, Carl would need to take action to rectify the situation. Out of the given options, the most likely action that would reinstate his policy is if Carl’s insurance company accepted his late payment. By accepting the payment, the insurance company would acknowledge that Carl has fulfilled his financial obligations and would reinstate his policy. The other options - sending a written notice, being issued a reinstatement application, or contacting his agent - may be steps that Carl could take in the process of reinstating his policy, but they alone would not reinstate the policy.

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6. How does the Commissioner achieve his or her job?  

Explanation

The Commissioner achieves his or her job by being appointed by the Governor. This means that the Governor selects and appoints the Commissioner to the position. It is not mentioned whether the Commissioner is elected by the public, appointed by the majority, or elected by the Government representatives, so these options can be eliminated. Therefore, the correct answer is that the Commissioner is appointed by the Governor.

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7. When can Medicare Supplement policies are marketed if they limit coverage by a medical condition?

Explanation

Medicare Supplement policies cannot be marketed if they limit coverage by a medical condition. This is because it goes against the rules and regulations set by Medicare. These policies are designed to provide additional coverage and fill in the gaps of Medicare, but they cannot discriminate based on pre-existing medical conditions. Therefore, it is never permissible to market Medicare Supplement policies that limit coverage by a medical condition.

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8.  Mary is medically uninsurable. Which of the following would be able to offer her coverage?  

Explanation

The Maryland Health insurance Plan would be able to offer coverage to Mary because it is specifically designed for individuals who are medically uninsurable. This plan provides health insurance options for those who have been denied coverage due to pre-existing conditions or other health issues. Therefore, Mary would be eligible for coverage under this plan.

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9.  Harold is not satisfied with his policy, and he wants a refund. Within how many days from receiving his policy, can Harold surrender it for a refund?  

Explanation

Harold can surrender his policy for a refund within 10 days from receiving it. This means that if he decides he is not satisfied with the policy, he has a 10-day window to request a refund. After this time period, he may not be eligible for a refund.

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10. A producer must complete 24 hours of Continuing Education Credits in order to renew their license. How many of those credits must include Ethics?

Explanation

To renew their license, a producer must complete 24 hours of Continuing Education Credits. Out of these 24 hours, 3 credits must include Ethics.

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11. What is the Free Look period for Medicare Supplement policies?  

Explanation

The correct answer is 30 days. The Free Look period for Medicare Supplement policies allows individuals to review their policy after purchasing it and decide if they want to keep it or cancel it. During this period, individuals have the option to cancel the policy and receive a full refund of any premiums paid. This gives policyholders a chance to thoroughly review the policy terms and conditions and ensure it meets their needs.

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12. Jim pays his premium monthly. What is his Grace Period?  

Explanation

The grace period refers to the amount of time after the due date of a premium payment during which the policyholder can make the payment without any penalties or consequences. In this case, Jim's grace period is 10 days, meaning that he has 10 days after the due date to pay his premium without any negative effects on his policy.

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13. What is a party that renders services from an insurance contract called?  

Explanation

An insurance carrier is a party that renders services from an insurance contract. They are responsible for providing insurance coverage and handling claims on behalf of the insured. The insurance carrier may also be referred to as an insurance company or insurer. They collect premiums from the insured in exchange for the promise to pay out benefits in the event of a covered loss or claim.

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14. Within what time frame must an insured give written notice regarding a claim?  

Explanation

An insured must give written notice regarding a claim within a time frame of 20 days. This means that the insured has 20 days from the occurrence of the event for which they are making a claim to provide written notice to the insurance company. It is important for the insured to adhere to this time frame in order to ensure that their claim is processed and handled in a timely manner. Failing to provide notice within the specified time frame may result in the claim being denied or delayed.

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15. How many days must an insured provide, prior to the termination of their insurance contract?

Explanation

An insured must provide a notice of 5 days prior to the termination of their insurance contract. This means that they need to inform the insurance company at least 5 days before they wish to cancel the contract. This notice period allows the insurance company to process the request and make necessary arrangements for the termination.

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Newborn children are automatically covered fro:  
 Barbara pays her $75.00 premium every week. What is her Grace...
John willfully failed to provide evidence requested by the...
 An HMO provides Health services to members known as:  
Carl's policy lapsed. Which of the following would reinstate his...
How does the Commissioner achieve his or her job?  
When can Medicare Supplement policies are marketed if they limit...
 Mary is medically uninsurable. Which of the following would be...
 Harold is not satisfied with his policy, and he wants a refund....
A producer must complete 24 hours of Continuing Education Credits in...
What is the Free Look period for Medicare Supplement policies?...
Jim pays his premium monthly. What is his Grace Period?  
What is a party that renders services from an insurance contract...
Within what time frame must an insured give written notice regarding a...
How many days must an insured provide, prior to the termination of...
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