Free Colorado Health Insurance Practice Exam Online

Correct answer: B. Group health insurance

Correct. Group health insurance is written under a single master policy issued to the group sponsor (such as an employer), with covered members receiving certificates of coverage evidencing their participation.

• A: Individual health insurance is underwritten and issued to a single applicant, not to an employer group under one master contract.
• C: Blanket accident insurance covers a defined class of persons (such as a bus tour or sports team) for a specific event or period without naming each individual, which is a different structure than standard employer group health.
• D: Credit health insurance covers loan payments if a debtor becomes disabled and is tied to a specific loan, not to an employer group's general health coverage.

Correct answer: B. Underwriting and pricing based more heavily on the individual applicant's own risk profile, subject to applicable guaranteed-issue rules

Correct. Individual coverage is priced and issued based more directly on the individual applicant (subject to ACA guaranteed-issue and community rating rules for major medical plans), whereas group coverage spreads risk and pricing across the group as a whole.

• A: Some individual underwriting still occurs where permitted; the market is not entirely underwriting-free, though ACA rules require guaranteed issue for major medical individual plans.
• C: Individual policies can typically be renewed, subject to the policy's own renewability provisions and premium payment.
• D: Individual premiums are not universally lower than group premiums; group plans often benefit from employer subsidies and pooled risk, which frequently makes them cheaper for the individual.

Correct answer: C. Deductible

Correct. The deductible is the amount the insured must pay out of pocket for covered expenses before the insurer begins paying benefits.

• A: A copayment is a fixed dollar amount paid at the time of service (e.g., $30 per office visit), not the annual threshold before the plan starts paying.
• B: Coinsurance is the percentage split of costs between insurer and insured after the deductible is met, not the upfront threshold amount itself.
• D: The premium is the periodic payment to keep the policy in force; it is unrelated to the point at which claim payment begins.

Correct answer: B. Coinsurance

Correct. Coinsurance is the percentage-based cost-sharing arrangement, such as an 80/20 split, applied to covered expenses after the deductible has been satisfied.

• A: A copayment is a flat fee per service, not a percentage split of costs.
• C: An elimination period is a waiting period before disability income benefits begin, unrelated to a percentage cost split on medical claims.
• D: A pre-existing condition exclusion limits or denies coverage for a condition that existed before the policy's effective date; it is not a percentage cost-sharing arrangement.

Correct answer: B. Issue the applicable health benefit plan to the eligible applicant who applies and agrees to pay premiums, without medical underwriting

Correct. C.R.S. § 10-16-105 requires carriers to guarantee-issue individual (and small employer) health benefit plans to eligible applicants who apply and agree to pay the required premium and meet other reasonable, non-health-based plan terms.

• A: Guaranteed issue rules prohibit denying individual major medical coverage based on health status or pre-existing conditions.
• C: Under community rating rules that accompany guaranteed issue, premiums cannot be varied based on an individual's claims or health history; allowed rating factors are limited (such as age, geography, tobacco use, and family composition).
• D: Guaranteed issue does not permit insurers to impose a health-based waiting period as a way to screen out otherwise eligible applicants.