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Efficient Valid CA-Life-Accident-and-Health Test Registration–Pass CA-Life-Accident-and-Health First Attempt
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California Department of Insurance CA Life, Accident and Health or Sickness Examination Sample Questions (Q105-Q110):
NEW QUESTION # 105
In the absence of a coordination of benefits clause, all of the following circumstances might result in recovery of more than 100% of actual health care expenses EXCEPT
- A. a person working for two employers has insurance through both.
- B. an executive has additional coverage through an association policy.
- C. spouses are both employed and eligible for group medical benefits.
- D. a worker's group medical plan includes a carryover deductible provision.
Answer: D
Explanation:
Coordination of Benefits Clause: This clause is designed to prevent an insured from receiving more than
100% of actual expenses when covered by multiple health plans.
Circumstances of Dual Coverage: Without a coordination of benefits clause, multiple coverages could result in overpayment of claims, except when specific plan provisions prevent this.
Carryover Deductible Provision: This provision allows expenses incurred in the last part of a year to be carried over and counted toward the next year's deductible. It does not directly lead to overpayment of claims beyond actual expenses.References: California Insurance Code Sections 10176.10-10176.15 discuss coordination of benefits and prevent duplication of benefits in health insurance coverage.
NEW QUESTION # 106
Regarding the Health Benefit Exchanges, as created by PPACA, all of the following statements are true EXCEPT
- A. an individual whose household income is 400% of the federal poverty level may receive a premium tax credit.
- B. the name of California's Exchange is Covered California.
- C. an individual may only receive a premium tax credit for a plan if purchased through the Exchange.
- D. an individual enrolling in a bronze level plan is not eligible for reduced cost-sharing.
Answer: A
Explanation:
Under the PPACA, individuals whose household income is between 100% and 400% of the federal poverty level (FPL) may be eligible for premium tax credits to help reduce the cost of health insurance purchased through the Exchange. However, individuals at exactly 400% of the FPL or higher do not qualify for these premium tax credits. Therefore, statement C is incorrect as it implies that individuals at exactly 400% FPL are eligible.
NEW QUESTION # 107
Under the hospice care of a long-term care policy, all of the following benefits are available EXCEPT
- A. pain relief.
- B. family counseling.
- C. rehabilitation therapy.
- D. symptom control.
Answer: C
Explanation:
Hospice care under long-term care policies focuses on providing comfort and support to terminally ill patients.
This includes pain relief, symptom control, and family counseling to support both the patient and their loved ones during the end-of-life process. Rehabilitation therapy, which is aimed at recovery and improving function, is not typically included in hospice care benefits since the focus is on palliative rather than curative treatment.Reference
NEW QUESTION # 108
Under the Family and Medical Leave Act (FMLA), how many weeks of unpaid leave is allowed per year for the birth of a child?
- A. 0
- B. 1
- C. 2
- D. 3
Answer: B
Explanation:
Under the Family and Medical Leave Act (FMLA), eligible employees are entitled to up to 12 weeks of unpaid leave per year for certain family and medical reasons, including the birth of a child. This federal law ensures that employees can take time off for significant family and health-related events without fear of losing their jobs.References: U.S. Department of Labor, Family and Medical Leave Act guidelines.
NEW QUESTION # 109
Which type of life insurance coverage has both a savings element and a flexible premium option?
- A. Universal life.
- B. Whole life.
- C. There is currently no insurance product available in the standard market which has both of these features.
- D. Term life.
Answer: A
Explanation:
Universal life insurance is a type of life insurance that includes both a savings element (cash value) and a flexible premium option. Policyholders can adjust their premium payments and death benefits, which allows for greater flexibility compared to whole life insurance, which has fixed premiums and benefits. Universal life policies also accumulate cash value, which can be used for loans or withdrawals.
NEW QUESTION # 110
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