OpenExamsFREE PRACTICE — ANY EXAM

Free Health Producer Practice Questions

138 free questions · Answer explanations · No signup required

View examination details, outline and sources

Loading selected examination banks…

Sample Practice Questions

Try these 10 sample questions from the Health Producer practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1As a condition for issuing an Alaska HRA- or HSA-linked employer plan, what may the insurer require the employer to certify?

    1. A. The amount the employer will contribute to the HRA or HSA
    2. B. Every employee's future medical claims
    3. C. That no employee will use preventive care
    4. D. That the employer will pay every out-of-network charge

    Answer: A

    Explanation: Alaska's ACA filing instructions permit an insurer to require an employer "to certify to the amount the employer will contribute to an HSA or HRA."

    Reference: Aca Filing Guidance — p. 8, Health Reimbursement Accounts and Health Savings Accounts

  2. 2Under a medical plan, an insured must first pay a specified amount of covered costs before the plan begins paying benefits subject to that requirement. What is that amount?

    1. A. The premium paid to keep the policy in force.
    2. B. The copayment charged for each office visit.
    3. C. The deductible for the coverage period.
    4. D. The coinsurance percentage of allowed charges.

    Answer: C

    Explanation: The official glossary defines a deductible as "An amount you could owe during a coverage period (usually one year) for covered health care services before your plan begins to pay." It is an initial covered-cost threshold, unlike a per-service copayment or proportional coinsurance.

    Reference: HealthCare.gov, Glossary of Health Coverage and Medical Terms — Glossary, Deductible

  3. 3A Medicare beneficiary asks which part of Original Medicare generally helps cover physician visits and outpatient care. Which part applies?

    1. A. Part A, the hospital insurance component.
    2. B. Part B, the medical insurance component.
    3. C. Part C, the private-plan alternative.
    4. D. Part D, the prescription drug component.

    Answer: B

    Explanation: Medicare lists: "Part B helps cover: Services from doctors and other health care providers Outpatient care" Physician and outpatient services belong to Part B rather than Part A inpatient hospital benefits.

    Reference: Medicare.gov, Parts of Medicare — Parts of Medicare, Part B

  4. 4An insured returns to work after illness but can perform only some duties and earns less. Which disability benefit feature addresses that reduced income?

    1. A. Residual disability benefits.
    2. B. Total disability benefits.
    3. C. Presumptive disability benefits.
    4. D. Recurrent disability benefits.

    Answer: A

    Explanation: "Residual Benefit(s) - This coverage fills in a gap in income if you are partially disabled and your income is reduced because you cannot perform all the responsibilities of your job." Residual benefits target earnings loss during partial disability. Total, presumptive, and recurrent disability features address different disability conditions.

    Reference: Nevada Division of Insurance, Disability Insurance — Disability insurance, Residual Benefits

  5. 5A health applicant leaves a medical-history field unanswered before signing. Which handling of the application follows the regulator's guidance?

    1. A. Obtain the applicant's truthful written response in the field before signing.
    2. B. Leave the field blank and ask underwriting to infer a negative answer.
    3. C. Have the applicant sign, then add an answer during policy delivery.
    4. D. Put a producer estimate in private notes while leaving the field blank.

    Answer: A

    Explanation: "Omitting or falsifying information can cause the company to deny your claim or cancel your policy. Never leave any blank areas on an application form." The warning against blank or falsified answers requires completing the field truthfully before the application is signed.

    Reference: California Department of Insurance, Quick Tips — Quick Tips, insurance application

  6. 6Under Alaska law, who is responsible for enforcing Title 21's insurance provisions?

    1. A. The director of insurance
    2. B. The attorney general exclusively
    3. C. Each admitted insurer's compliance officer
    4. D. The legislature's finance committee

    Answer: A

    Explanation: AS 21.06.080(a) states: "The director shall enforce the provisions of this title." The other officials or private actors do not receive that statutory duty.

    Reference: As 21 06 — AS 21.06.080(a)

  7. 7Which coverage is excluded from Alaska's statutory definition of transacting health insurance?

    1. A. Disability insurance
    2. B. Stop-loss insurance
    3. C. Workers' compensation insurance
    4. D. Dental-care insurance

    Answer: C

    Explanation: AS 21.12.050(a) states that health insurance includes disability and stop-loss insurance "but does not include workers' compensation insurance."

    Reference: As 21 12 — AS 21.12.050(a)

  8. 8A self-employed consultant wants coverage that pays part of her personal earnings if an illness prevents her from working. Which policy best addresses that loss?

    1. A. Individual disability income policy
    2. B. Business overhead expense policy
    3. C. Hospital indemnity policy
    4. D. Accidental death and dismemberment policy

    Answer: A

    Explanation: "Insurance that provides income payments to the insured wage earner when income is interrupted or terminated because of illness, sickness, or accident." This describes replacement of her personal work income. The other policies address business overhead, hospital confinement, or accidental death or physical loss.

    Reference: California Department of Insurance, Lines of Insurance — Disability Income Insurance

  9. 9After meeting her deductible, a member owes 20% of the allowed amount for an outpatient service. What type of cost sharing is the 20%?

    1. A. A fixed copayment assessed for the service.
    2. B. A coinsurance percentage of the allowed amount.
    3. C. A monthly premium for continued coverage.
    4. D. A deductible amount owed before plan payment.

    Answer: B

    Explanation: The glossary defines coinsurance as "Your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service." The member's share varies with the allowed amount, unlike a fixed copayment.

    Reference: HealthCare.gov, Glossary of Health Coverage and Medical Terms — Glossary, Coinsurance

  10. 10A beneficiary wants a Medicare-approved private plan that combines hospital and medical benefits and usually drug coverage. Which option describes that arrangement?

    1. A. A stand-alone Part D prescription drug plan.
    2. B. A private Medigap policy beside Original Medicare.
    3. C. A Medicare Advantage plan under Part C.
    4. D. An Original Medicare Part A enrollment alone.

    Answer: C

    Explanation: Medicare explains, "Medicare Advantage offers an alternative to Original Medicare for your health and drug needs. You get benefits through a private health plan that Medicare approved. These “bundled” plans include Part A, Part B, and usually Part D." The private bundled alternative is Medicare Advantage, or Part C.

    Reference: Medicare.gov, Parts of Medicare — Parts of Medicare, Medicare Advantage

Topics in this practice bank

These topics describe the available practice for Health Producer. Review the examination outline and its sources for scope and allocation details.

  • General knowledge I. TYPES OF POLICIES
    • A. Disability income
    • A. Disability income / 1. Individual disability income policy
    • A. Disability income / 2. Business overhead expense policy
    • A. Disability income / 3. Business disability buyout policy
    • A. Disability income / 4. Group disability income policy
    • A. Disability income / 5. Key employee policy
    • B. Accidental death and dismemberment
    • C. Medical expense insurance
    • C. Medical expense insurance / 1. Basic hospital, medical, and surgical policies
    • C. Medical expense insurance / 2. Major medical policies
    • C. Medical expense insurance / 3. Health Maintenance Organizations (HMOs)
    • C. Medical expense insurance / 4. Preferred Provider Organizations (PPOs)
    • C. Medical expense insurance / 5. Point of Service (POS) plans
    • C. Medical expense insurance / 6. Flexible Spending Accounts (FSAs)
    • C. Medical expense insurance / 7. High Deductible Health Plans (HDHPs) and related Health Savings Accounts (HSAs)
    • C. Medical expense insurance / 8. Health Reimbursement Accounts (HRAs)
    • D. Medicare supplement policies
    • E. Group insurance
    • E. Group insurance / 1. Differences between individual and group contracts
    • E. Group insurance / 2. General characteristics
    • E. Group insurance / 3. COBRA
    • F. Individual/Group Long Term Care (LTC)
    • F. Individual/Group Long Term Care (LTC) / 1. Eligibility
    • F. Individual/Group Long Term Care (LTC) / 2. Levels of care
    • G. Other policies
    • G. Other policies / 1. Dental
    • G. Other policies / 2. Vision
    • G. Other policies / 3. Cancer
    • G. Other policies / 4. Critical illness or specified disease
    • G. Other policies / 5. Worksite (employer-sponsored)
    • G. Other policies / 6. Hospital indemnity
    • G. Other policies / 7. Short-term medical
    • G. Other policies / 8. Accident
  • General knowledge II. POLICY PROVISIONS, CLAUSES, AND RIDERS
    • A. Mandatory and optional provisions
    • A. Mandatory and optional provisions / 1. Entire contract
    • A. Mandatory and optional provisions / 2. Time limit on certain defenses (incontestable)
    • A. Mandatory and optional provisions / 3. Grace period
    • A. Mandatory and optional provisions / 4. Reinstatement
    • A. Mandatory and optional provisions / 5. Notice of claim
    • A. Mandatory and optional provisions / 6. Claim forms
    • A. Mandatory and optional provisions / 7. Proof of loss
    • A. Mandatory and optional provisions / 8. Time of payment of claims
    • A. Mandatory and optional provisions / 9. Payment of claims
    • A. Mandatory and optional provisions / 10. Physical examination and autopsy
    • A. Mandatory and optional provisions / 11. Legal actions
    • A. Mandatory and optional provisions / 12. Change of beneficiary
    • A. Mandatory and optional provisions / 13. Misstatement of age or gender
    • A. Mandatory and optional provisions / 14. Change of occupation
    • A. Mandatory and optional provisions / 15. Illegal occupation
    • A. Mandatory and optional provisions / 16. Relation of earnings to insurance
    • B. Other provisions and clauses
    • B. Other provisions and clauses / 1. Insuring clause
    • B. Other provisions and clauses / 2. Free look
    • B. Other provisions and clauses / 3. Consideration clause
    • B. Other provisions and clauses / 4. Probationary period
    • B. Other provisions and clauses / 5. Elimination period
    • B. Other provisions and clauses / 6. Waiver of premium
    • B. Other provisions and clauses / 7. Exclusions and limitations
    • B. Other provisions and clauses / 8. Preexisting conditions
    • B. Other provisions and clauses / 9. Coinsurance
    • B. Other provisions and clauses / 10. Deductibles
    • B. Other provisions and clauses / 11. Eligible expenses
    • B. Other provisions and clauses / 12. Copayments
    • B. Other provisions and clauses / 13. Pre-authorizations and prior approval requirements
    • B. Other provisions and clauses / 14. Usual, reasonable, and customary (URC) charges
    • B. Other provisions and clauses / 15. Lifetime, annual, or per cause maximum benefit limits
    • C. Riders
    • C. Riders / 1. Impairment/exclusions
    • C. Riders / 2. Guaranteed insurability
    • C. Riders / 3. Future increase option
    • D. Rights of renewability
    • D. Rights of renewability / 1. Noncancelable
    • D. Rights of renewability / 2. Cancelable
    • D. Rights of renewability / 3. Guaranteed renewable
  • General knowledge III. SOCIAL INSURANCE
    • A. Medicare (Parts A, B, C, D)
    • B. Medicaid
    • C. Social Security benefits
  • General knowledge IV. OTHER INSURANCE CONCEPTS
    • A. Total, partial, recurrent and residual disability
    • B. Owner’s rights
    • C. Dependent children benefits
    • D. Primary and contingent beneficiaries
    • E. Modes of premium payments
    • F. Nonduplication and coordination of benefits (e.g., primary vs. excess)
    • G. Occupational vs. non-occupational
    • H. Tax treatment of premiums and proceeds of insurance contracts (e.g., disability income and medical expenses, etc.)
    • I. Managed care
    • J. Workers Compensation
    • J. Workers Compensation / 1. Impact on health insurance benefits
    • K. Subrogation
    • L. Cost containment
  • General knowledge V. FIELD UNDERWRITING PROCEDURES
    • A. Completing the application
    • B. Explaining sources of insurability and HIPAA privacy information (e.g., MIB Report, Fair Credit Reporting Act, etc.)
    • C. Initial premium payment and receipt and consequences of the receipt (e.g., medical examination, etc.)
    • D. Submitting application (and initial premium if collected) to company for underwriting
    • E. Policy delivery
    • F. Explaining policy and its provisions, riders, exclusions, and ratings to clients
    • G. Replacement
    • H. Contract law
    • H. Contract law / 1. Elements of a contract
    • H. Contract law / 2. Insurable interest
    • H. Contract law / 3. Warranties and representations
    • H. Contract law / 4. Unique aspects of the insurance contract
    • H. Contract law / 4. Unique aspects of the insurance contract / a. Conditional
    • H. Contract law / 4. Unique aspects of the insurance contract / b. Unilateral
    • H. Contract law / 4. Unique aspects of the insurance contract / c. Adhesion
    • H. Contract law / 4. Unique aspects of the insurance contract / d. Aleatory
  • Alaska laws, rules and regulations I. COMMON TO LIFE, HEALTH (ACCIDENT AND HEALTH), PROPERTY, CASUALTY AND PERSONAL LINES INSURANCE
    • A. Director of Insurance
    • A. Director of Insurance / 1. Broad powers
    • A. Director of Insurance / 2. Adoption of regulations
    • A. Director of Insurance / 3. Examination of records
    • A. Director of Insurance / 4. Notice and hearing
    • A. Director of Insurance / 5. Penalties
    • B. Definitions
    • B. Definitions / 1. Admitted (authorized) and nonadmitted companies
    • B. Definitions / 2. Domestic, foreign, and alien
    • B. Definitions / 3. Stock and mutual
    • B. Definitions / 4. Premiums
    • B. Definitions / 5. Transacting insurance
    • B. Definitions / 6. Certificate of Authority
    • B. Definitions / 7. Fraternal benefit societies
    • C. Licensing
    • C. Licensing / 1. License required
    • C. Licensing / 2. Maintenance of license
    • D. Marketing Practices
    • D. Marketing Practices / 1. Unfair practices
    • D. Marketing Practices / 3. Fiduciary responsibilities
    • D. Marketing Practices / 4. Compensation of licensees
    • D. Marketing Practices / 5. Required records and record retention
    • D. Marketing Practices / 6. Advertising
    • D. Marketing Practices / 7. Controlled business
    • D. Marketing Practices / 8. Duty to report fraudulent claims/Immunity from reporting fraudulent claims
    • D. Marketing Practices / 9. Alaska Insurance Guaranty Association
    • C. Licensing / 1. License required / a. Insurance producer
    • C. Licensing / 1. License required / b. Managing general agent
    • C. Licensing / 1. License required / e. Firm licenses
    • C. Licensing / 1. License required / f. Compliance Officer (Designated Responsible Producer)
    • C. Licensing / 1. License required / g. Resident
    • C. Licensing / 1. License required / h. Nonresident licensees
    • C. Licensing / 1. License required / i. Exceptions
    • C. Licensing / 1. License required / j. Producer appointments
    • C. Licensing / 1. License required / k. Employment contracts
    • C. Licensing / 2. Maintenance of license / a. Renewal
    • C. Licensing / 2. Maintenance of license / b. Denial, Nonrenewal, Suspension or Revocation
    • C. Licensing / 2. Maintenance of license / c. Continuing education
    • D. Marketing Practices / 1. Unfair practices / a. Unfair claims methods and practices
    • D. Marketing Practices / 1. Unfair practices / b. Rebating
    • D. Marketing Practices / 1. Unfair practices / c. Twisting
    • D. Marketing Practices / 1. Unfair practices / d. Misrepresentation
    • D. Marketing Practices / 1. Unfair practices / e. Defamation
    • D. Marketing Practices / 1. Unfair practices / f. Unfair discrimination
    • D. Marketing Practices / 1. Unfair practices / g. Boycott, coercion, and intimidation
    • D. Marketing Practices / 6. Advertising / a. Health Discount Plans
  • Alaska laws, rules, and regulations II. PERTINENT TO HEALTH (ACCIDENT AND HEALTH) INSURANCE ONLY
    • A. Definition of health and disability insurance
    • B. Discrimination against medical providers
    • B. Discrimination against medical providers / 1. Acupuncture coverage
    • B. Discrimination against medical providers / 2. Certified nurse midwives
    • B. Discrimination against medical providers / 3. Mammograms
    • C. Individual disability required provisions
    • D. Group insurance
    • D. Group insurance / 1. Group disability
    • E. Other required provisions for individual or group accident, health, and disability
    • E. Other required provisions for individual or group accident, health, and disability / 1. Newly born/adopted/dependent children
    • E. Other required provisions for individual or group accident, health, and disability / 2. Alcoholism and drug abuse treatment
    • F. Medicare supplement
    • F. Medicare supplement / 1. Policy provisions
    • F. Medicare supplement / 2. Disclosure provisions
    • F. Medicare supplement / 3. Replacement requirements
    • F. Medicare supplement / 4. Minimum standards
    • F. Medicare supplement / 5. Standards for marketing
    • G. Small Employer Health Insurance
    • H. Large Group Health Insurance
    • I. Long Term Care
    • J. Affordable Care Act
    • J. Affordable Care Act / 1. Exchanges/Marketplace (Section 1321)
    • J. Affordable Care Act / 2. Taxes and subsidies (Section 1401, 1402)
    • J. Affordable Care Act / 3. Essential health benefits (Section 1302)
    • J. Affordable Care Act / 4. Employer notification responsibilities (Section 1511-1515)
    • J. Affordable Care Act / 3. Essential health benefits (Section 1302) / a. Mental health parity
    • J. Affordable Care Act / 3. Essential health benefits (Section 1302) / b. Pediatric services
    • J. Affordable Care Act / 3. Essential health benefits (Section 1302) / c. Preventive services

How to use these free practice questions

Choose an answer, check the explanation, and review your progress by chapter. Practice questions and explanations are free to access without signing up.

These are independent study questions, not actual examination items. For examination requirements and official information, view Health Producer details.