Resolution Health|Resolution Health Underwriters Exam

RESOLUTION HEALTH UNDERWRITERS EXAM



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Resolution Health Underwriters Exam 2010
 
This is a multiple question exam. With each question, there is only ONE correct answer.
 
 

  1. Who underwrites Gap Cover?
    1. NHRPL
    2. Resolution Underwriters
    3. RICL
    4. SACA Underwriters


  2. The Area of coverage on Goodhealth's Executive Healthcare Plan, means:
    1. The area where the client is residing
    2. The area where the client wishes to have treatment


  3. Name an advantage of Sapmeds to the broker
    1. An annuity income could be generated
    2. Resolution Underwriters does most of the admin work and it's therefore little hassle to the broker
    3. Sapmeds could be offered to a wide range of potential clients
    4. All of the above


  4. Transportation of mortal remains or the cost of a local burial/cremation is covered up to a maximum of $2,250 under the Goodhealth (Aetna Global Benefits) Foundation Plan.
    1. No
    2. Yes


  5. Can the HIV Programme client see his/her confidential information on the internet?
    1. No
    2. Yes


  6. Goodhealth's emergency medical assistance is done by:
    1. SOS International
    2. No one specific


  7. Is the Goodhealth (Aetna Global Benefits) client covered if he/she travels away from his/her area of selected cover?
    1. Yes, he is covered for Accident and Emergency Treatment for temporary business trips or holidays away from his selected Area of Coverage up to 90 days during the Period of Cover and limited to a maximum of 60 days of Treatment per event
    2. No, only where he is covered


  8. Can the HIV Programme client talk to somebody who knows about HIV related topics face to face?
    1. No, the client will have to speak to his GP
    2. Yes, CareWorks has counsellors country wide that you may consult


  9. The Area of coverage on Goodhealth's International Healthcare Plan, means:
    1. The premium is based on where the member resides
    2. Treatment worldwide is included, except for the USA
    3. Area 5 rates are for expats living worldwide that require treatment in the USA
    4. All of the above


  10. Goodhealth's International Healthcare Plan covers expats:
    1. Residing in Africa
    2. Residing anywhere in the world


  11. How many options are there on the Resolution's HIV programme?
    1. Two, Treatment and ACT programme
    2. One, the Treatment programme
    3. Four, Treatment, ACT, ACT and Treatment, and the Peer Facilitator programme
    4. Three, Treatment, Act and Peer Facilitator programme


  12. Goodhealth's Executive Healthcare Plan covers expats:
    1. Residing in Africa
    2. Residing anywhere in the world


  13. Which is correct? Gap Cover provides the insured with two options:
    1. A R50 option (excess of R500/incident) / and a R75 option (no excess)
    2. A R50 option (annual limit of R1m) / and a R75 option (annual limit of R2m)
    3. A R55 option (excess of R750/once off) / and an R85 option (no excess)
    4. a & b


  14. Does Gap Cover not already make provision for the co-payments?
    1. Yes, but only if it's private procedures' co-payments
    2. Yes, but only for individual members. Essential! is specifically for the family
    3. No, unless the insured specifies that he wants it added to the policy
    4. No


  15. What is the Medical Aid Death Benefit's premium?
    1. R55
    2. R85
    3. Depends on which option is chosen
    4. R50


  16. What is the general waiting period with the Sapmeds product?
    1. None
    2. 6 months
    3. 1 month
    4. 3 months


  17. With Sapmeds, what is the maximum entry age?
    1. 65
    2. There is none
    3. 55
    4. 60


  18. Regarding Goodhealth (Aetna Global Benefits); for normal day to day expenses:
    1. The client pays for it himself, and is then reimbursed by Goodhealth
    2. Goodhealth settles the account directly with the medical service provider


  19. Sapmeds could not be used if the insured is already on a Medical Hospital Plan
    1. True
    2. False


  20. If a child is stillborn, would the insured receive any benefits on the Medical Aid Death Benefit policy?
    1. No
    2. Yes, R800


  21. Does Gap Cover still pay out if the insured's medical aid has been depleted?
    1. Yes, but Gap will just ignore the first 100% and then pay the rest up to 300%
    2. No, unless the insured gets pre-authorization from the Bethlehem office
    3. Yes, but Gap will then just cover the first 100% in the place of the medical aid
    4. No, Gap is directly dependent on the medical aid payment


  22. The ACT Programme (part of the HIV Programme) means that:
    1. Voluntary testing will be done after training
    2. The positive people will receive treatment
    3. A comprehensive report will be given to the employer with breakdowns i.t.o. job category, age, region, etc
    4. a and c


  23. When the Goodhealth (Aetna Global Benefits) client has to undergo treatment for which pre-authorisation is required:
    1. The client pays for it himself, and is then reimbursed by Goodhealth
    2. Goodhealth settles the account directly with the medical service provider


  24. The client can select an excess, which means the client will pay x amount per incident, after which Goodhealth (Aetna Global Benefits) will cover the rest.
    1. Yes
    2. No


  25. Are there any general waiting periods to Essential!? If so, how long?
    1. Yip, 3 months
    2. Yip, 1 month
    3. Nope
    4. Yip, depends on the amount of insured people on one policy


  26. Is day-to-day care treatment (i.e. doctor's consultations) covered on the Sapmeds policy?
    1. No
    2. Yes, but only according to a table of certain stated benefits


  27. Premium Waiver has the following options
    1. R25 for R1500 p/m
    2. R35 for R2500 p/m
    3. R60 for R3500 p/m
    4. All of the above


  28. There are two Goodhealth (Aetna Global Benefits) plans available, Executive Healthcare Plan and International Healthcare Plan.
    1. Yes
    2. No


  29. Is there any limit to the amount a Goodhealth (Aetna Global Benefits) client can claim?
    1. No, every claim will be assessed after incident
    2. The client is not limited
    3. The client is able to claim up to an annual maximum of US$ l ,500,000 under Foundation and US$ l, 000,000 under Major Medical, and certain Benefits have sub-limits
    4. The client is limited to what he can proof


  30. If the insured needs more cover than what one Premium Waiver policy can provide, he/she could take out more than one policy. For example, if the insured wants to cover a premium of up to R5000/month, he/she could take out options 1 and 3.
    1. True
    2. False


  31. Please name an exclusion(s) to Essential!.
    1. Three month waiting period
    2. 12 month pre-existing exclusion
    3. Aids / HIV
    4. All of the above


  32. If you (a Sapmeds client) get into an accident, how would the ambulance personnel know whether they can take you to a private hospital and not the public hospital?
    1. They will take your word for it, and Sapmeds would pay the hospital at a later stage
    2. You will have a Sapmeds membership card which you must show
    3. You will always have to be diagnosed and get pre-auth before you will be hospitalised
    4. They will always take you to a public hospital, unless you can show that you're on another medical scheme


  33. Will the Goodhealth (Aetna Global Benefits) client be covered for any illnesses or injuries he has had before joining the Executive Healthcare Plan?
    1. Yes, the client will be covered for everything
    2. No, cover for all pre-existing conditions is excluded during the first two years of membership


  34. Goodhealth (Aetna Global Benefits) premiums are paid:
    1. Monthly
    2. Quarterly
    3. Annually
    4. All of the above


  35. Gap Cover will pay…
    1. 3 Times of whatever the doctors would charge you
    2. 100% of your hospital bill
    3. Exactly 300% of the NHRPL
    4. A stated benefit as difference between the NHRPL and the private tariffs up to 300%


  36. What is the waiting period on the Medical Aid Death Benefit policy?
    1. General 3 month waiting period
    2. There are none
    3. 12 months


  37. Gap has the following exclusions:
    1. General 3 month waiting period; Pre-existing conditions excluded for minimum 12 months;
    2. Maximum entry age of 65;
    3. a & b
    4. None of the above


  38. What does the insured have to do if his/her spouse and children want to be covered by the Gap policy?
    1. Take out a policy for each, the Spouse policy and the Dependent policy respectively
    2. Complete an additional dependants form or the additional dependents section on the normal app.
    3. Just take out a policy for each


  39. A broker needs to be accredited as follows in order to do business with Resolution Underwriters:
    1. Investments
    2. Short Term
    3. Health
    4. Long term


  40. What happens if there is a difference between Essential!'s stated benefit and the co-payment amount by a medical scheme for a specific procedure?
    1. Then the insured would either receive the difference, or would have to pay the difference, depending on whether the amount is more or less than the stated benefit
    2. There is a fixed excess of R750 that would always be payable
    3. There won't be a difference because the stated benefits are directly related to Resolution's co-payment structure
    4. The insured would only receive the amount as stipulated by his/her medical scheme's co-payment structure


  41. With Sapmeds there are 5 Plan Options to choose from
    1. True
    2. False, there are 7e


  42. Regarding Premium Waiver; for the Redundancy cover the incident limit would be paid for
    1. 12 months
    2. 6 months
    3. 1 month
    4. 3 months


  43. How many people are covered under one Medical Aid Death Benefit policy?
    1. A family of five
    2. Just the main member


  44. Please explain what support the HIV Programme client can expect?
    1. Only ARV's
    2. None
    3. Whatever his family gives him
    4. Counselling, regular calls from Careworks and medication


  45. Regarding Gap Cover. What happens if the insured's medical aid already covers more than the 100% of the NHRPL? For example, Resolution's Prestige Plan that covers 200% of the NHRPL.
    1. Gap will cover not cover this, because of legislative reasons
    2. Gap will cover the next 100% to make the total cover 300%
    3. Gap will cover the next 200% to make the total cover 400%
    4. Gap will still cover up to the next 300% to make the total cover 500%


  46. Can the Goodhealth (Aetna Global Benefits) client seek Treatment anywhere in the world?
    1. Only in the USA
    2. Only in the UK
    3. Only, within the geographical area chosen
    4. Only in Africa or India


  47. Essential! is a Short Term Insurance product. What does this mean? Please choose the correct option:
    1. Any broker would be able to sell this product.
    2. Because underwriting was done during application, Resolution Underwriters has to pay no matter what
    3. When the insured claims, the doctor will be paid within 30 days
    4. A stated benefit would be paid into the insured's account according to a table of benefits


  48. Goodhealth's premiums are:
    1. Rand based
    2. Dollar based
    3. Pound based
    4. All of the above


  49. The HIV programme can be sold to individuals.
    1. No, only to groups
    2. Yes


  50. What does the HIV Treatment programme include?
    1. Pathology for monitoring of disease progression
    2. Cost of ARV's for those needing treatment
    3. Accidental Exposure Prophylaxis
    4. All of the above
 



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chronic authorisation application

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