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

1. A health insurance issuer offering coverage in the individual market must provide premium rebates if its medical loss ratio (MLR) is less than what percentage?

A) 80%
B) 85%
C) 70%
D) 75%

2. Policies covered under the California Life and Health Insurance Guarantee Association include all of the following EXCEPT

A) self-funded group life.
B) deferred annuities.
C) individual health.
D) disability income.

3. A commonly used cost containment measure for emergency hospital care under a major medical expense plan is the

A) inpatient fee.
B) premium tax.
C) pre-admission test.
D) deductible.

4. All of the following qualify as "background information" as defined in Section 1729.2 of the California Insurance Code, EXCEPT

A) a misdemeanor or felony conviction or a filing of felony criminal charges in state or federal court.
B) an administrative action regarding a professional or occupational license.
C) any admission, or judicial finding or determination, of fraud, misappropriation or conversion of funds, misrepresentation, or breach of fiduciary duty.
D) misdemeanor charges filed, not resulting in a conviction.

5. All of the following statements apply to the child coverage in a family policy EXCEPT

A) children are covered until reaching a specified age.
B) child coverage is convertible to whole life coverage.
C) coverage applies only to children born before the policy is issued.
D) child coverage is term insurance.

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