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Insurance Licensing Oklahoma Life, Accident, and Health or Sickness Producer Sample Questions:

1. Both husband and wife have group health insurance through their employers. Each spouse is covered under both policies. Under the coordination of benefits provision, how will the benefits be paid if the wife incurs a
$400 covered loss?

A) The primary insurer will pay as much of the claim as the policy permits, then the secondary insurer will pay the remainder of the claim as its policy permits.
B) Only the wife's insurer will pay expenses toward the loss.
C) The husband's insurer will pay as much of the claim as the policy permits, then the wife's insurer will pay the remainder.
D) Only the primary insurer will pay expenses toward the loss under the limits of the plan.

2. Laura has a group medical plan that has an 80% coinsurance provision but no deductible. She recently incurred a $1,000 medical bill. How much will Laura have to pay?

A) $0
B) $1,000
C) $800
D) $200

3. A fraternal benefit society is characterized by all of the following EXCEPT

A) conducted solely for the benefit of its members.
B) incorporated.
C) for profit.
D) without capital stock.

4. Benefits required under the child immunization coverage shall NOT be subject to

A) a prior authorization.
B) a set immunization schedule.
C) an annual maximum number of immunizations.
D) a deductible.

5. Under a Long-Term Care policy, all of the following are Activities of Daily Living EXCEPT

A) talking.
B) dressing.
C) eating.
D) toileting.

Solutions: