Chapter 8 : Missouri Health State Law

When a misrepresentation is made for the purpose of inducing insured to lapse insurance to purchase another policy is:

Suzy is on her happily married parents' insurance policies. Which parent would be her primary insurance?

The purpose ______ is to help states join together to regulate insurance producers and to protect consumers.

A _____ LTC policy can only cancel for nonpayment of premium. Premiums cannot increase for any reason.

A policy is required to cover at least 6 sessions per year with a licensed professional of mental health.

A small employer group is any corporation, partnership, or association with _______ eligible employees.

Per the MO Life and Health Insurance Guaranty Assoc Act a ____ insurer is placed under an order of rehabilitation.

One of the penalties for violating a Cease and Desist Order is a fine of up to:

Which is NOT a standard specific to heath insurance advertising:

Health plans must provide coverage for clinical trials for prevention, detection or treatment of Phase IV cancer only

If there is an unintentional lapse on a LTC policy, the insured has a minimum of ____ days before cancellation.

Failure to appear, testify, or obey subpoena from the DOI may result in all of the following, EXCEPT:

MO health plans must cover general anesthesia and hospital charges for dental care to children under 10 years old.

Pre-existing Conditions cannot be excluded after a ___ month period.

Your license must be renewed every __ years and requires __ hours of Continuing Education to be completed.

Knowingly providing False Testimony is a class E felony.

When certifying admission, the insurer must notify the provider by telephone or electronically w/i ___ of certification

A utilization review id undertaken to compare requests for service to determine all of the following, EXCEPT:

For an Examination of Records, policy records must be maintained for ___ years and claim records for ___ years.

All are characteristics of Defamation, EXCEPT:

Immunizations must be provided with no cost-sharing from birth to age ___.

Unfair and Deceptive Practices are committed in conscious disregard of MO Unfair Trade Practice Act.

In order to obtain a license, an individual must pass an exam, submit an app and pay a $50 fee.

Mammography for women ages 35 to 39 without medical history of breast cancer must be covered for:

MO health plans must cover PKU testing and products up to age 6. The annual benefit max is no less than ____ per child.

Non-renewal of a policy requires a 60 day advanced written notice from the insurer.

Group plans must provide coverage for in-network chiropractic care but may be limited to 26 office visits/yr.

With a LTC policy, if the applicant is 80+ years old, the insurer must obtain one of the following, EXCEPT

Julia and Jon have separated. Jon can still stay on Julie's health plan as long as he notifies the insurer w/i 60 days.

All of the following are grounds for the denial, suspension, revocation, or non-renewal of a producer license, EXCEPT:

All MO health plans must offer coverage for Type I diabetes only

The Department of Insurance has the power to make laws.

The Director of Insurance conducts an Examination of Records at least once every 2 years.

Which of the following IS A REQUIRED disclosure on a Medicare Supplement plan?

Process of paying, giving, or allowing any valuable consideration not stated in the contract as inducement for purchase.

Adopted children do not have to be covered in MO on the same basis as other dependents.

One entrusted to care for or act on behalf of another is known as a ______ Responsibility.

During an Expedited Review determination must be given within ___ hours after the request for review.

In a Medicare Supplement policy first yr commission cannot be more than _____ of the second year premium?

The lifetime maximum for chemotherapy cannot be less than ______.

Enrollees, but not providers on their behalf, have the right to appeal for certain necessary coverages.

If a LTC applicant reject the non-forfeiture benefits, insured is required to provide a contingent benefit upon lapse

An insolvent insurer is placed under court order of liquidation.

Individuals employed in an executive, administrative or managerial role are EXEMPT from the licensing requirements.

For substance abuse/alcoholism the min. standards/benefit period are __ days for residential treatment, __for outpatient

All of the following are true of the Director of Insurance in Missouri, EXCEPT:

Which of the following is required before an insurance company can transact insurance in MO.

Nonresidents who move to MO must apply for a resident license within 30 days in MO.

A producer must notify the DOI of change in legal name or address within:

What is the limiting age for dependent children?