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

1. What is the first step in submitting Medicare claims?

A) The medical provider submits expenses to the patient.
B) The medical provider submits expenses to Medicare.
C) Medicare submits expenses to the Medicare supplement provider.
D) The patient submits expenses to Medicare.

2. An insured is receiving benefits from a group health plan for a total disability. Which of the following happens if the existing plan is terminated?

A) The insured must apply for Social Security benefits.
B) The insured ceases to receive benefits.
C) The insured receives benefits from the terminated plan.
D) The insured must apply for individual health coverage.

3. The type of health care provider that provides both the health care services and the health care coverage is called:

A) a major medical organization.
B) a Preferred Provider Organization.
C) an EPO.
D) a Health Maintenance Organization.

4. A contract in which one party promises to indemnify another against loss that arises from an unknown event is

A) a hold-harmless agreement.
B) a restoration policy.
C) a retrocession agreement.
D) an insurance policy.

5. According to California Insurance Code, an insurance policy must be

A) approved by the Insurance Commissioner.
B) negotiated between the agent and the insured.
C) in writing.
D) economically feasible for the insured.

Solutions: