Free Washington Health Insurance Practice Exam Online

Correct answer: D. 72 hours

RCW 48.43.530 requires expedited appeal resolution within 72 hours when the enrollee's health or ability to regain maximum function is at serious risk, which is correct.

• A: 10 business days is far longer than the expedited timeline RCW 48.43.530 sets for cases of serious risk.
• B: 5 calendar days is longer than the expedited timeline RCW 48.43.530 sets for cases of serious risk.
• C: 24 hours is shorter than the specific expedited timeline set in RCW 48.43.530.

Correct answer: D. Expertise in health care coverage, finance, actuarial science, or health delivery systems

RCW 43.71.020 requires board members to have expertise in health care coverage, finance, actuarial science, or health care delivery systems, which is correct.

• A: RCW 43.71.020 does not require board members to hold a Washington insurance producer license.
• B: The statute does not require board members to have held prior elected office.
• C: The statute does not impose a Thurston County residency requirement on board members.

Correct answer: D. Maternity services, including diagnosis of pregnancy, prenatal care, delivery, and care for complications of pregnancy

RCW 48.43.041 requires non-catastrophic individual health benefit plans to include maternity services such as diagnosis of pregnancy, prenatal care, delivery, and care for complications of pregnancy, which is correct.

• A: RCW 48.43.041 does not mandate cosmetic surgery coverage in individual health benefit plans.
• B: Long-term care coverage is not among the mandatory benefits RCW 48.43.041 requires of individual health benefit plans.
• C: Adult dental coverage is not a mandatory benefit under RCW 48.43.041.

Correct answer: A. As a self-sustaining public-private partnership separate and distinct from the state

RCW 43.71.020 establishes the Exchange as a self-sustaining public-private partnership that is separate and distinct from the state, which is the correct description of its legal structure.

• B: The Exchange is not organized as a division of the Health Care Authority; the statute deliberately places it outside direct state agency structure while the Health Care Authority administrator sits on its board only as a nonvoting ex officio member.
• C: The Exchange is not a bureau of the Office of the Insurance Commissioner; the insurance commissioner likewise participates only as a nonvoting ex officio board member, not as the Exchange's parent agency.
• D: The Exchange is not a private for-profit insurer; it is a nonprofit public-private entity created to operate the state's health benefit marketplace, not to sell insurance itself.

Correct answer: B. The insurance commissioner and the health care authority administrator

RCW 43.71.020 names the insurance commissioner and the health care authority administrator as the two nonvoting ex officio board members, which is correct.

• A: The governor appoints the Exchange board's voting members but does not sit on the board, and the lieutenant governor has no statutory board role under RCW 43.71.020.
• C: Neither the attorney general nor the state treasurer holds a statutory seat on the Exchange board under this section.
• D: The secretary of health and the superintendent of public instruction are not designated ex officio members of the Exchange board under RCW 43.71.020.