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Insurance Licensing New York Life, Accident and Health Insurance Agent/Broker Examination Series 17-55 Sample Questions:

1. Under the Affordable Care Act, insurer may refuse to accept an internal appeal on a denied claim if

A) the appeal is filed more than 180 days after the claim denial.
B) the claim is under $500.
C) the insured is unable to pay an appeal fee.
D) the insured has submitted three appeals within the calendar year.

2. The Health Insurance Portability and Accountability Act (HIPAA) ensures that qualified individuals who change jobs will have access to group health insurance with their new employer without

A) any change in the level of benefits they receive.
B) having to satisfy a new preexisting condition period.
C) having any increase in premium costs.
D) having to meet a new deductible.

3. A 65-year-old employee who works for an employer with 24 employees is disabled on the job. The employee has fully recovered and returned to work. Which health coverage is primary?

A) Medicaid
B) workers ' compensation
C) his employer ' s group plan
D) an individual plan

4. Which of the following groups is NOT eligible for the Healthy New York Program?

A) Working uninsured
B) Sole proprietors
C) Large employers
D) Small employers

5. What information must be included in the statement accompanying an insurance claim payment made by an insurer?

A) A list of all claimants involved
B) The agent ' s name and address
C) The coverage under which the payment is being made
D) The reinsurance carrier involved

Solutions: