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Free LA Health and Accident or Sickness Series 102 Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the LA Health and Accident or Sickness Series 102 practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A Louisiana resident begins presenting health-plan terms to prospects before obtaining a producer license. Which rule controls this conduct?

    1. A. A license is required before acting or holding oneself out as a producer
    2. B. A license is required only after the first application is signed
    3. C. A license is required only when the first premium is collected
    4. D. A license is required only after an insurer appointment is recorded

    Answer: A

    Explanation: R.S. 22:1543(A) states, "No person shall act as or hold himself out to be an insurance producer unless licensed by the Department of Insurance." Presenting plan terms as a producer therefore requires licensure first.

    Reference: Louisiana Laws - Louisiana State Legislature — R.S. 22:1543(A)

  2. 2An insurer raises an applicant's health-policy premium partly because of information in a consumer report. What must the insurer provide under the Fair Credit Reporting Act?

    1. A. An FCRA risk-based pricing notice to the affected applicant
    2. B. An FCRA file-disclosure notice to the affected applicant
    3. C. An FCRA adverse-action notice to the affected applicant
    4. D. An FCRA fraud-alert notice to the affected applicant

    Answer: C

    Explanation: The FTC says, "Section 615(a) of the FCRA requires you to provide a notice of the adverse action to the consumer." A premium increase partly based on a consumer report triggers that notice. The other named FCRA notices address other credit-reporting circumstances.

    Reference: FTC, Consumer Reports: What Insurers Need to Know — FCRA guidance, Adverse Action Notice

  3. 3An applicant's unsafe work environment raises the chance or severity of an insured injury without itself being the event that causes the injury. What insurance term describes the environment?

    1. A. Peril
    2. B. Loss
    3. C. Hazard
    4. D. Risk

    Answer: C

    Explanation: The NAIC defines a hazard as a "circumstance which tends to increase the probability or severity of a loss." A peril is the cause of loss, risk is uncertainty, and a loss is the resulting harm.

    Reference: NAIC Glossary of Insurance Terms — Hazard

  4. 4A worker wants a policy that pays part of lost wages if illness prevents work. Which coverage most directly meets that need?

    1. A. Disability income insurance
    2. B. Comprehensive medical insurance
    3. C. Hospital confinement indemnity
    4. D. Long-term care insurance

    Answer: A

    Explanation: The NAIC describes disability income as a policy that compensates for "a portion of the income they lose" because of disabling illness or injury. Medical, hospital, and long-term-care products address care costs or specified benefits rather than wage replacement.

    Reference: NAIC Glossary of Insurance Terms — Disability Income

  5. 5A Louisiana individual health-policy premium is due on June 1. The policyholder pays it on June 20. Under the statutory grace-period rule, what is the coverage effect?

    1. A. Coverage resumes on June 20 after a gap dating from June 1
    2. B. Coverage remains in effect because payment was within the grace period
    3. C. Coverage resumes at the next monthly premium due date
    4. D. Coverage resumes only after a formal reinstatement review

    Answer: B

    Explanation: R.S. 22:977(A) provides "a grace period of thirty days from the date the premium was due" and states that timely payment keeps coverage in effect. June 20 is within that period.

    Reference: Louisiana Revised Statutes 22:977 — R.S. 22:977(A)

  6. 6For a nonfatal medical condition, what is the shortest expected inability-to-work period that generally meets Social Security's disability-duration standard?

    1. A. 5 consecutive months
    2. B. 6 consecutive months
    3. C. 12 consecutive months
    4. D. 24 consecutive months

    Answer: C

    Explanation: SSA says it generally pays benefits to people "unable to work for a year (12 consecutive months) or more." The question asks for the shortest duration, so a longer duration is not the threshold.

    Reference: Social Security Administration, Disability Benefits Eligibility — Disability Benefits Eligibility, duration

  7. 7A health plan has a $1,000 deductible for a covered service. At the start of the plan year the member has paid none of it, and the next covered service has an allowed amount of $300. Assume no deductible exception. How much of that allowed amount applies to the member's deductible?

    1. A. $0
    2. B. $300
    3. C. $60
    4. D. $240

    Answer: B

    Explanation: HealthCare.gov defines a deductible as an amount owed for covered care "before your plan begins to pay." Because none of the $1,000 deductible was met, the entire $300 allowed charge applies; $60 and $240 would prematurely apply coinsurance.

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

  8. 8An employee loses qualifying Louisiana group major-medical coverage after employment ends. The employee met the statute's three-month prior-coverage condition. What right must the group policy provide, subject to its other statutory conditions?

    1. A. Conversion to an individual medical policy
    2. B. A Medicare special-enrollment opportunity
    3. C. Continuation of the existing group medical coverage
    4. D. A Marketplace special-enrollment opportunity

    Answer: C

    Explanation: R.S. 22:1046(B) says qualifying employees "shall be entitled to continue their hospital, surgical, and medical insurance under that group policy." Other enrollment routes may exist under other rules, but the specified Louisiana group-policy duty is continuation.

    Reference: Louisiana Revised Statutes 22:1046 — R.S. 22:1046(B)-(C)

  9. 9A Medicare beneficiary needs the Medicare program component that provides prescription drug benefits. Which part is it?

    1. A. Part A
    2. B. Part D
    3. C. Part B
    4. D. Part C

    Answer: B

    Explanation: CMS identifies "Medicare Prescription Drug Benefit (Part D)." Part A is hospital insurance, Part B supplementary medical insurance, and Part C Medicare Advantage.

    Reference: CMS, Overview of Medicare — Overview of Medicare, four programs

  10. 10An employer pays the full premium for an employee's accident-and-health disability plan. The employee receives ordinary disability payments because of sickness. How are those payments generally treated for federal income tax?

    1. A. Excluded from the employee's income
    2. B. Deducted from the employee's income
    3. C. Included in the employee's income
    4. D. Deferred until the employee retires

    Answer: C

    Explanation: IRS Publication 525 says, "you must report as income any amount you receive" through an accident or health plan paid for by the employer. The employer-funded condition controls the tax result stated in the question.

    Reference: IRS Publication 525, Taxable and Nontaxable Income — Sickness and Injury Benefits

Topics in this practice bank

These topics describe the available practice for LA Health and Accident or Sickness Series 102. Review the examination outline and its sources for scope and allocation details.

  • Louisiana Insurance Regulation
    • Requirements (22:1543)
    • Types of licenses (22:1547, 1962(F))
    • Types of licenses (22:1547, 1962(F)) > Individual producer (22:1542(6), 1546(A))
    • Types of licenses (22:1547, 1962(F)) > Business entity 1546(B))
    • Types of licenses (22:1547, 1962(F)) > Resident versus nonresident (22:1546, 1548, 1560)
    • Types of licenses (22:1547, 1962(F)) > Temporary (22:1553)
    • Maintenance and duration
    • Maintenance and duration > Expiration (22:1547(B))
    • Maintenance and duration > Renewal (22:1547(C))
    • Maintenance and duration > Change of name, address, telephone number (22:1547(G))
    • Maintenance and duration > Assumed names (22:1552)
    • Maintenance and duration > Reporting of actions (22:1563)
    • Maintenance and duration > Continuing education requirements including exemptions and penalties (37:XI:10.703, .705 & Rule 10.711)
    • Maintenance and duration > Inactivity due to extenuating circumstances
    • Maintenance and duration > Inactivity due to military service
    • Disciplinary actions
    • Disciplinary actions > Hearings (22:1968, 2191, 2193-2195, 2197, 2198, 2204-2208)
    • Disciplinary actions > Cease and desist order (22:1969)
    • Disciplinary actions > Fines, License probation, suspension, revocation, or refusal to issue or renew (22:1554)
    • Disciplinary actions > Penalties with or without suspension of license (22:1969, 1970)
    • State regulation
    • State regulation > Commissioner's general duties and powers (22:2, 1967)
    • State regulation > Company regulation
    • State regulation > Company regulation > Certificate of authority (22:65, 66, 331, 332)
    • State regulation > Company regulation > Unfair claims settlement practices (22:1964(14))
    • State regulation > Company regulation > Appointment (22:1558)
    • State regulation > Company regulation > Termination of appointment (22:1559)
    • State regulation > Company regulation > Policy Forms (22:864)
    • State regulation > Company regulation > Annual Reports (22:571)
    • State regulation > Company regulation > State of domicile
    • State regulation > Producer regulation
    • State regulation > Producer regulation > Controlled business (22:1544(C))
    • State regulation > Producer regulation > Shared commissions (22:1557)
    • State regulation > Producer regulation > Payment to unlicensed entities (22:1562)
    • State regulation > Producer regulation > Commissions, compensations, fees ((22:1542 (3); 22:1557)
    • State regulation > Producer regulation > Appointments (22:1547)
    • State regulation > Unfair trade practices (22:1964)
    • State regulation > Unfair trade practices (22:1964) > Misrepresentation (22:1964(1, 18))
    • State regulation > Unfair trade practices (22:1964) > False advertising (22:1964(2))
    • State regulation > Unfair trade practices (22:1964) > Defamation (22:1964(3))
    • State regulation > Unfair trade practices (22:1964) > Boycott, coercion and intimidation (22:1964(4))
    • State regulation > Unfair trade practices (22:1964) > False financial statements (22:1964(5))
    • State regulation > Unfair trade practices (22:1964) > Unfair discrimination (22:1964(7); 22:34)
    • State regulation > Unfair trade practices (22:1964) > Rebating (22:1964(8)
    • State regulation > Unfair trade practices (22:1964) > Refusing to insure (22:1964(7)(f))
    • State regulation > Unfair trade practices (22:1964) > Misrepresentation for replacement of limited benefit policies (22:1964(27))
    • State regulation > Examination of books and records (22:1967, 1981-1995)
    • State regulation > Insurance fraud and reporting requirements (22:1964(13, 27), 1921–1929)
    • State regulation > Privacy of Consumer Financial Information (37:XIII.9903– .9953)
  • Licensing and Regulation
    • Federal Regulation
    • Federal Regulation > Fair Credit Reporting Act
    • Federal Regulation > Felony Convictions and Written Consent (18 USC Sections 1033 and 1034)
    • Federal Regulation > Privacy (Gramm Leach Bliley)
    • Federal Regulation > National Do Not Call List
    • Federal Regulation > Affordable Care Act
  • General Insurance Concepts
    • Risk
    • Risk > Methods of Handling Risk (e.g., Avoidance, Retention, Sharing, Reduction, Transfer)
    • Risk > Elements of Insurable Risks
    • Risk > Definitions (e.g., Risk, Hazard, Peril, Loss)
    • Classifications of Insurers
    • Classifications of Insurers > Mutual, Stock
    • Classifications of Insurers > Admitted, Non-Admitted
    • Classifications of Insurers > Foreign, Domestic, Alien
    • Elements of a Contract
    • Elements of a Contract > Consideration
    • Elements of a Contract > Competent Parties
    • Elements of a Contract > Legal Purpose
    • Elements of a Contract > Offer
    • Elements of a Contract > Acceptance
    • Authority and Powers of Producers
    • Authority and Powers of Producers > Express
    • Authority and Powers of Producers > Implied
    • Authority and Powers of Producers > Apparent
    • Authority and Powers of Producers > The Law of Agency
    • Legal Interpretations Affecting Contracts
    • Legal Interpretations Affecting Contracts > Reasonable Expectations
    • Legal Interpretations Affecting Contracts > Indemnity
    • Legal Interpretations Affecting Contracts > Good Faith
    • Legal Interpretations Affecting Contracts > Fraud
    • Legal Interpretations Affecting Contracts > Warranties, Representations, Misrepresentations, and Concealment
  • Health and Accident Insurance Basics
    • Field Underwriting
    • Field Underwriting > Application Procedures
    • Field Underwriting > Warranties and Representations
    • Policy Delivery
    • Policy Delivery > Effective Date of Coverage
    • Policy Delivery > Policy Review
    • Policy Delivery > Premium Collection
    • Policy Delivery > Statement of Good Health
    • Definitions of Perils
    • Definitions of Perils > Accidental Injury
    • Definitions of Perils > Sickness
    • Types of Losses and Benefits
    • Types of Losses and Benefits > Loss of Income from Disability (Short-Term/Long-Term Disability)
    • Types of Losses and Benefits > Medical Expense
    • Types of Losses and Benefits > Long-Term Care Expense
    • Types of Losses and Benefits > Prescriptions
    • Limited Health Insurance Policies
    • Limited Health Insurance Policies > Accidental Death and Dismemberment
    • Limited Health Insurance Policies > Hospital Indemnity
    • Limited Health Insurance Policies > Critical Illness/Dread Disease
    • Limited Health Insurance Policies > Vision Care
    • Limited Health Insurance Policies > Hearing
    • Limited Health Insurance Policies > Dental
    • Limited Health Insurance Policies > Credit Disability
    • Classification of Risks
    • Classification of Risks > Preferred
    • Classification of Risks > Standard
    • Classification of Risks > Substandard
  • Individual Accident and Health Insurance Policy Provisions
    • Uniform Required Provisions
    • Uniform Required Provisions > Time Limit on Certain Defenses
    • Uniform Required Provisions > Grace Period
    • Uniform Required Provisions > Reinstatement
    • Uniform Required Provisions > Claim Forms
    • Uniform Required Provisions > Proof of Loss
    • Uniform Required Provisions > Time of Payment of Claims
    • Uniform Required Provisions > Physical Examinations and Autopsy
    • Uniform Required Provisions > Legal Actions
    • Uniform Required Provisions > Entire Contract
    • Uniform Required Provisions > Payment of Claims
    • Uniform Required Provisions > Change of Beneficiary
    • Uniform Required Provisions > Notice of Claim
    • Uniform Optional Provisions
    • Uniform Optional Provisions > Change of Occupation
    • Uniform Optional Provisions > Misstatement of Age/Sex
    • Uniform Optional Provisions > Illegal Occupation
    • Uniform Optional Provisions > Intoxicants, Narcotics, or Other Controlled Substances
    • Other General Provisions
    • Other General Provisions > Right to Examine/Free Look
    • Other General Provisions > Insuring Clause
    • Other General Provisions > Consideration Clause
    • Other General Provisions > Renewability Clause
    • Other General Provisions > Coinsurance
    • Other General Provisions > Probationary Period
    • Other General Provisions > Elimination Period
    • Other General Provisions > Exclusions
  • Disability Income and Related Insurance
    • Benefits Determination for Disability
    • Benefits Determination for Disability > Pure Loss of Income
    • Benefits Determination for Disability > Indemnity
    • Qualifications of Disability
    • Qualifications of Disability > Total (Own Occupation, Any Occupation)
    • Qualifications of Disability > Partial
    • Qualifications of Disability > Permanent
    • Qualifications of Disability > Presumptive
    • Qualifications of Disability > Recurrent
    • Qualifications of Disability > Residual
    • Qualifications of Disability > Inability to Perform Duties
    • Qualifications of Disability > Occupational versus Non-Occupational
    • Individual Disability Income Insurance
    • Individual Disability Income Insurance > Basic Total Disability Plan
    • Individual Disability Income Insurance > Cost of Living Rider
    • Individual Disability Income Insurance > Future Increase Option Rider
    • Individual Disability Income Insurance > Change of Occupation
    • Individual Disability Income Insurance > Other Cash Benefits
    • Individual Disability Income Insurance > Refund Provisions
    • Individual Disability Income Insurance > Exclusions
    • Individual Disability Income Insurance > Waiver of Premium
    • Individual Disability Income Insurance > Probationary Period
    • Individual Disability Income Insurance > Elimination Period
    • Individual Disability Income Insurance > Benefit Limits
    • Unique Aspects of Individual Disability Underwriting
    • Unique Aspects of Individual Disability Underwriting > Occupational Considerations
    • Unique Aspects of Individual Disability Underwriting > Benefit Limits
    • Unique Aspects of Individual Disability Underwriting > Policy Issuance Alternatives
    • Group Disability Income Insurance
    • Group Disability Income Insurance > Short-Term Disability
    • Group Disability Income Insurance > Long-Term Disability
    • Group Disability Income Insurance > Coordination of Benefits (Workers' Compensation Benefits and Social Insurance)
    • Group Disability Income Insurance > At-Work Benefits
    • Business Disability Insurance
    • Business Disability Insurance > Key Employee Disability Income
    • Business Disability Insurance > Disability Buy-Sell Policy
    • Business Disability Insurance > Business Overhead Expense
    • Social Security Disability
    • Social Security Disability > Qualification for Disability Benefits
    • Social Security Disability > Definition of Disability
    • Social Security Disability > Waiting Period
  • Medical Plans
    • Medical Plan Concepts
    • Medical Plan Concepts > Fee-for-Service
    • Medical Plan Concepts > Prepaid
    • Medical Plan Concepts > Specified Coverage
    • Medical Plan Concepts > Comprehensive Coverage
    • Medical Plan Concepts > Dependent Coverage
    • Provisions and Clauses
    • Provisions and Clauses > Deductibles
    • Provisions and Clauses > Stop-Loss Provision
    • Provisions and Clauses > Impairment Rider
    • Types of Medical Plans
    • Types of Medical Plans > Basic Plans
    • Types of Medical Plans > Major Medical Insurance
    • Types of Medical Plans > Health Maintenance Organizations (HMOs)
    • Types of Medical Plans > Preferred Provider Organizations (PPOs)
    • Types of Medical Plans > Point-of-Service (POS) Plans
    • Cost Containment in Health Care Delivery
    • Cost Containment in Health Care Delivery > Managed Care
    • Cost Containment in Health Care Delivery > Preventive Care
    • Cost Containment in Health Care Delivery > Outpatient Benefits
    • Cost Containment in Health Care Delivery > Utilization Management
    • Cost Containment in Health Care Delivery > Preauthorization
    • Cost Containment in Health Care Delivery > Gatekeeper
    • Health Insurance Portability and Accountability Act (HIPAA)
    • Health Insurance Portability and Accountability Act (HIPAA) > Eligibility Requirements
    • Health Insurance Portability and Accountability Act (HIPAA) > Terms
    • Health Insurance Portability and Accountability Act (HIPAA) > Privacy
    • Health Insurance Portability and Accountability Act (HIPAA) > Portability
  • Group Health Insurance
    • Characteristics of Group Health Insurance
    • Characteristics of Group Health Insurance > Group Contract
    • Characteristics of Group Health Insurance > Certificate of Coverage
    • Characteristics of Group Health Insurance > Eligible Groups
    • Characteristics of Group Health Insurance > Contributory versus Non-Contributory
    • Employer Group Health Insurance
    • Employer Group Health Insurance > Underwriting Criteria
    • Employer Group Health Insurance > Eligibility for Insurance
    • Employer Group Health Insurance > Conversion of Coverage
    • Employer Group Health Insurance > Open Enrollment
    • Employer Group Health Insurance > Probation Period
    • Employer Group Health Insurance > Coordination of Benefits
    • COBRA
    • COBRA > Eligibility
    • COBRA > Duration of Coverage
    • COBRA > Premium
  • Health Insurance for Senior Citizens and Special Needs Individuals
    • Medicare
    • Medicare > Administration
    • Medicare > Eligibility
    • Medicare > Part A
    • Medicare > Part B
    • Medicare > Part C
    • Medicare > Part D
    • Medicare > Medicare Select
    • Medicare Supplement Insurance
    • Medicare Supplement Insurance > Open Enrollment
    • Medicare Supplement Insurance > Types of Plans
    • Medicare Supplement Insurance > Standardized Plan Benefits
    • Other options for individuals with Medicare
    • Other options for individuals with Medicare > Employer Group Health Plans
    • Other options for individuals with Medicare > Medicaid
    • Long-Term Care Policies
    • Long-Term Care Policies > Eligibility for Benefits
    • Long-Term Care Policies > Benefit Periods and Amounts
    • Long-Term Care Policies > Exclusions
    • Long-Term Care Policies > Guaranteed Insurability Rider
    • Long-Term Care Policies > Cost of Living Rider
    • Levels of Long-Term Care
    • Levels of Long-Term Care > Skilled
    • Levels of Long-Term Care > Intermediate
    • Levels of Long-Term Care > Custodial
    • Types of Long-Term Care
    • Types of Long-Term Care > Home Health
    • Types of Long-Term Care > Adult Daycare
    • Types of Long-Term Care > Respite Care
  • Federal Tax Considerations for Health Insurance
    • Health Insurance Premiums and Benefits
    • Health Insurance Premiums and Benefits > Individual
    • Health Insurance Premiums and Benefits > Group
    • Health Insurance Premiums and Benefits > Disability Income
    • Health Insurance Premiums and Benefits > Business Disability Insurance
    • Health Insurance Premiums and Benefits > Medical Expense
    • Health Insurance Premiums and Benefits > Long-Term Care
    • Consumer-Driven Health Plans
    • Consumer-Driven Health Plans > Health Savings Accounts (HSAs)
    • Consumer-Driven Health Plans > Health Reimbursement Accounts (HRAs)
    • Consumer-Driven Health Plans > Flexible Spending Accounts (FSAs)

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