Free Utah Health Insurance License Practice Test Online

Correct answer: A. Group health insurance

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

• B: 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 for a specific event or period without naming each individual, a different structure than 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's general health coverage.

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, not the annual threshold before the plan starts paying.
• B: The premium is the periodic payment to keep the policy in force; it is unrelated to when claim payment begins.
• D: Coinsurance is the percentage split of costs between insurer and insured after the deductible is met, not the upfront threshold amount.

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

Correct answer: A. HMO

Correct. An HMO typically requires a primary care physician gatekeeper, referrals for specialist care, and limits coverage to in-network providers except in emergencies.

• B: A traditional indemnity plan reimburses a scheduled amount regardless of network and does not use a gatekeeper/referral model.
• C: A PPO generally allows members to see specialists without a referral and offers out-of-network coverage, usually at a higher cost-share, unlike a typical HMO.
• D: A POS plan blends HMO and PPO features and generally allows some out-of-network access, but the gatekeeper/referral, in-network-only structure described is most characteristic of an HMO.

Correct answer: D. An EPO generally does not cover non-emergency out-of-network care at all, while a PPO typically covers out-of-network care at a higher cost-share

Correct. Unlike a PPO, which typically still covers out-of-network care at higher cost-sharing, an EPO generally provides no coverage for non-emergency care received outside its network.

• A: Referral requirements vary by specific plan design rather than being a universal PPO-versus-EPO distinction; the defining feature is out-of-network coverage, not referral rules.
• B: EPOs cover a broad range of major medical services, not only dental care.
• C: EPO plans require premium payment like other health plans; there is no premium-free feature that defines an EPO.