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California Department of Insurance CA Life, Accident and Health or Sickness Examination Sample Questions:

1. The cost of employer-provided group life insurance above $50,000 is

A) taxable to the employer.
B) tax exempt to the employee.
C) tax deductible by the employee.
D) taxable as income to the employee.

2. Characteristics of Preferred Provider Organizations (PPOs) include all of the following EXCEPT

A) primary physicians serve as gatekeepers.
B) employees can see specialists without referrals.
C) benefits are paid for care received by non-network physicians.
D) there are incentives to use network providers.

3. Beginning January 1, 2014, a health insurance issuer that offers health insurance coverage in the individual market must cover 10 essential health benefits. All of the following benefits are essential health benefits EXCEPT

A) maternity and newborn care.
B) laboratory services.
C) prescription drugs.
D) adult dental coverage

4. What happens if an insurer violates the Medical Loss Ratio rule and spends too much money on administrative costs?

A) Insurers that do not meet the Medical Loss Ratio standard will only be required to reduce their spending on administrative costs.
B) Insurers that do not meet the Medical Loss Ratio standard will pay a tax penalty to the Federal government, n
C) Insurers that do not meet the Medical Loss Ratio standard will pay a tax penalty to the Health Benefits Exchange.
D) Insurers that do not meet the Medical Loss Ratio standard will be required to provide rebates to their customers and reduce spending on their administrative costs.

5. All of the following are features of a Preferred Provider Organization (PPO) EXCEPT

A) dependents do not need referrals to see a specialist.
B) providers are paid on a fee-for-service basis.
C) primary care physicians act as gatekeepers.
D) employees have a choice of practitioners.

Solutions: