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Free PDF Virginia-Life-Annuities-and-Health-Insurance - Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Marvelous Test Price
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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q112-Q117):
NEW QUESTION # 112
Who normally bears the cost of excess charges in a Medicare claim?
- A. The service provider
- B. The Centers for Medicare & Medicaid Services
- C. The insured
- D. The Social Security Administration
Answer: C
Explanation:
Detailed Answer in Step-by-Step Solution:
* Excess charges in Medicare occur when a provider charges more than the Medicare-approved amount, and the insured (D) is responsible for the difference unless covered by supplemental insurance.
* The Social Security Administration (A) and CMS (B) administer Medicare, not pay claims.
* Providers (C) may charge excess but don't absorb it unless they accept assignment.
The Virginia study guide explains that Medicare beneficiaries bear excess charges unless a provider accepts Medicare assignment or a Medigap policy covers them. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Medicare Basics."
NEW QUESTION # 113
The period of time during which a new employee is ineligible for group health insurance coverage is called a:
- A. Probationary period
- B. Contributory period
- C. Participation period
- D. Grace period
Answer: A
Explanation:
Virginia Code § 38.2-3445, aligned with ACA rules, allows group health plans to impose a probationary period (option C)-also called a waiting period-before new employees become eligible for coverage, capped at 90 days. This delay, set by the employer, ensures employment stability before benefits begin. Option A (participation period) isn't a standard term; it might confuse with minimum participation rules for group plans. Option B (grace period) is the post-due-date window for premium payment (e.g., 31 days), not eligibility. Option D (contributory period) implies employee premium contributions but isn't a defined phase.
The study guide likely explains this as an employer tool, with examples like a 30-day wait, making C the precise term.
NEW QUESTION # 114
What is a condition for which medical advice or treatment was recommended by or received from a provider of health care service within six months preceding the effective date of an individual long-term care policy?
- A. Long-term care condition
- B. Covered illness
- C. Pre-determined risk
- D. Pre-existing condition
Answer: D
Explanation:
Virginia Code § 38.2-5205 mandates that long-term care (LTC) policies define pre-existing conditions, typically as conditions for which medical advice or treatment was recommended or received within six months before the policy's effective date. Option B (pre-existing condition) matches this definition exactly, as it identifies prior health issues that may affect coverage (e.g., exclusions or waiting periods). Option A (covered illness) is vague and implies a condition already insured, not necessarily pre-existing. Option C (long-term care condition) isn't a standard term; LTC policies cover specific needs (e.g., ADLs), not a category tied to this timeframe. Option D (pre-determined risk) suggests underwriting factors, not a specific medical history definition. The study guide likely details this six-month lookback as a common LTC standard, with examples like a recent stroke diagnosis, emphasizing disclosure requirements and potential coverage limits, confirming B as the answer.
NEW QUESTION # 115
What is the effect on a life insurance policy if the insured fails to repay the full value of loans taken against the policy?
- A. The premium is increased.
- B. The death benefit is reduced.
- C. The policy lapses immediately.
- D. Dividends are suspended.
Answer: B
Explanation:
Virginia Code § 38.2-3205 governs policy loans in life insurance. When an insured borrows against the policy' s cash value and fails to repay the loan (principal plus interest), the outstanding amount is deducted from the death benefit upon the insured's death. Option C correctly states this reduction. Option A is false; premiums are fixed unless the policy is adjustable, and loans don't alter them. Option B is incorrect; dividends depend on insurer performance and policy terms, not loan repayment, though they might be applied to reduce the loan if elected. Option D is wrong; immediate lapse occurs only if the loan exceeds the cash value and premiums aren't paid, not simply from non-repayment. The study guide likely stresses that the death benefit is the primary adjustment mechanism, ensuring the insurer recovers the loan while honoring the policy, making Cthe accurate choice.
NEW QUESTION # 116
Which is an example of an endodontic service?
- A. Root canals
- B. Crowns
- C. Dentures
- D. Fillings
Answer: A
Explanation:
Detailed Answer in Step-by-Step Solution:
* Endodontic services involve treatment of the tooth's interior (pulp and roots), with root canals (C) being a primary example.
* Crowns (A) and fillings (D) are restorative, not endodontic. Dentures (B) are prosthetic, unrelated to endodontics.
The Virginia study guide classifies root canals as an endodontic procedure, distinct from restorative or prosthetic dental services, per standard dental insurance definitions. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Dental Insurance."
NEW QUESTION # 117
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