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Free PDF Quiz Virginia Insurance - Virginia-Life-Annuities-and-Health-Insurance Newest Certification Cost

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Virginia Insurance Virginia-Life-Annuities-and-Health-Insurance Exam Questions in Convenient PDF Format

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Virginia Insurance Virginia Life, Annuities, and Health Insurance Examination Series 11-01 Sample Questions (Q11-Q16):

NEW QUESTION # 11
To cancel a health insurance policy, which one of the following must the insured do?

A. Notify the insurer in writing
B. Challenge at least two uniform mandatory provisions
C. Replace the current policy with another

Answer: A

Explanation:
Virginia Code § 38.2-3508 governs cancellation of individual health insurance policies. For the insured to cancel, they must notify the insurer in writing (option A), specifying intent to terminate, typically effective upon receipt or a stated date, per policy terms. This formal notice ensures clarity and protects both parties, aligning with contract law principles. Option B (replace with another policy) is a practical choice but not a legal requirement; cancellation can occur without replacement. Option C (challenge mandatory provisions) is nonsensical; uniform provisions (e.g., grace period, per § 38.2-3503) are standard and unrelated to cancellation. The study guide likely outlines this process in a policyholder rights section, with examples-e.
g., a letter stating "Cancel effective 5/1/2025"-emphasizing written notice as the sole requirement, making A the correct action.

NEW QUESTION # 12
Which of the following is required to hold an appointment with the insurance company it represents?

A. An insured
B. An employee of the insurer
C. An agent
D. A consultant

Answer: C

Explanation:
Virginia Code § 38.2-1833 defines an "appointment" as a formal authorization by an insurer for a licensed agent to act on its behalf in transacting insurance. An insured (option A) is the policyholder or beneficiary and has no role in representing the insurer. An employee of the insurer (option B) may work internally but isn't automatically appointed to sell insurance unless they hold an agent's license and an appointment, which isn't implied here. A consultant (option C), under Virginia Code § 38.2-1837, advises on insurance but doesn't transact it unless also licensed and appointed as an agent, making this a less direct fit. Only an agent (option D), licensed under Virginia Code § 38.2-1819 and appointed per § 38.2-1833, is required to hold an appointment to represent an insurer. The study guide emphasizes that appointments link licensed agents to specific insurers, solidifying D as the correct choice.

NEW QUESTION # 13
When a small employer health insurance plan is offered, it must be available:

A. To all eligible employees who apply
B. Only to employees who provide evidence of insurability
C. To all eligible employees after a 12-month waiting period
D. Only to employees under age 65

Answer: A

Explanation:
Virginia Code § 38.2-3431 et seq., aligned with the ACA, requires small employer health plans (1-50 employees) to offer coverage to all eligible employees who apply, without discrimination based on health status or other factors. "Eligible" typically means full-time employees meeting the employer's criteria (e.g.,
30+ hours/week). Option A reflects this guaranteed issue mandate, ensuring broad access. Option B (12- month waiting period) is false; Virginia and federal law cap waiting periods at 90 days (Virginia Code § 38.2-
3445), not 12 months. Option C (evidence ofinsurability) contradicts guaranteed issue rules for small groups, which prohibit medical underwriting. Option D (under age 65) is incorrect; coverage extends to all eligible employees regardless of age, though Medicare coordination may apply post-65. The study guide likely stresses this inclusivity as a cornerstone of small group market reforms, making A the correct answer.

NEW QUESTION # 14
Who normally bears the cost of excess charges in a Medicare claim?

A. The Centers for Medicare & Medicaid Services
B. The Social Security Administration
C. The service provider
D. The insured

Answer: D

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 # 15
A health maintenance organization (HMO) must offer emergency health services:

A. Sixteen hours a day, seven days per week
B. Twenty-four hours a day, seven days per week
C. Twenty-four hours a day, six days per week
D. Sixteen hours a day, six days per week

Answer: B

Explanation:
Virginia Code § 38.2-4306 mandates that Health Maintenance Organizations (HMOs) provide comprehensive health services, including emergency care, as a core benefit. Emergency services must be available 24 hours a day, 7 days a week (option D) to ensure immediate access to life-saving treatment, aligning with federal and state standards (e.g., ACA requirements under 42 CFR § 422.113). This reflects the HMO's obligation to cover urgent needs-e.g., a heart attack at 2 a.m.-via in-network facilities or out-of-network reimbursement if necessary. Option A (16 hours, 6 days) and Option B (16 hours, 7 days) fall short of the continuous access requirement, limiting coverage unreasonably. Option C (24 hours, 6 days) excludes one day, contradicting the nonstop mandate. The study guide likely emphasizes this 24/7 rule in an HMO benefits section, with examples like ER visits covered anytime, making D the correct standard. This ensures HMOs meet Virginia's consumer protection goals under § 38.2-4300 et seq., distinguishing them from less comprehensive plans.

NEW QUESTION # 16
......

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