Insurance Licensing Updated Virginia-Life-Annuities-and-Health-Insurance Exam Questions and Answers by xanthe

Coinsurance is a cost-sharing arrangement where, after the deductible is met, the insured pays a percentage of covered expenses and the insurer pays the rest. A common split is 80/20, where the insurer pays 80% and the insured pays 20% until the maximum out-of-pocket limit is reached.

Exact Extract (Virginia Health Insurance Study Guide): “Coinsurance—after the deductible has been satisfied, the insured and insurer share covered expenses in a stated ratio (e.g., 80/20).”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Major Medical Policy Provisions

Detailed Answer in Step-by-Step Solution:

Health insurance covers claims incurred during the policy period (A), not after termination (B), unless extended benefits (e.g., COBRA) apply, which is not indicated here.

Claims above the deductible (C), regardless of amount, are payable if covered.

Mental or nervous disorder claims (D) are typically covered unless excluded by the policy, which is not specified.

Thus, claims after termination (B) are the exception.

The Virginia study guide states that health insurance liability ends upon policy termination, barring specific continuation provisions, making post-termination claims generally non-payable. Reference: Virginia Life, Annuities, and Health Insurance study guide, section on "Health Insurance Coverage Terms."

Virginia Code § 38.2-3100 et seq. governs deferred annuities, where a surrender charge (option A) is a penalty for early withdrawal, starting high (e.g., 7-10%) and declining over a surrender period (e.g., 7-10 years) until it reaches zero. Option B (front-end sales load) is a one-time fee deducted upfront, not diminishing over time. Option C (guaranteed interest rate) is a fixed return (e.g., 2%), stable or adjustable, not disappearing. Option D (expense charge) covers ongoing costs (e.g., mortality and expense fees), typically level, not phased out. The study guide likely illustrates this with a table—e.g., 10% year 1, 9% year 2, 0% year 10—emphasizing surrender charges as a liquidity deterrent, making A the matching feature.

Eligibility for long-term care benefits is based on inability to perform Activities of Daily Living (ADLs). Functional assessment measures this ability. Exact extract: “Functional assessments measure the insured’s ability to perform ADLs such as bathing, dressing, eating, continence, and transferring.”