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AHIP AHM-510 Exam - Topic 6 Question 41 Discussion

Indigo Health Plan advertised a specific individual health insurance policy through a direct mail advertisement that provided detailed information about the product. In order to comply with the NAIC Model Rules Governing Advertisements of Accident and Sickness Insurance, Indigo must disclose whether the advertised policy contains any exceptions, reductions, or limitations. Thus, Indigo disclosed in the advertisement that one policy provision limits coverage for dental exams to $50 per exam and to one exam per calendar year. This information indicates that, with respect to the definitions in the NAIC Model Rules, Indigo's advertisement is an example of an
B) Invitation to contract, and it discloses a policy provision known as a reduction
A) Invitation to contract, and it discloses a policy provision known as an exception
C) Invitation to inquire, and it discloses a policy provision known as an exception
D) Invitation to inquire, and it discloses a policy provision known as a reduction

AHIP AHM-510 Exam - Topic 6 Question 41 Discussion

Actual exam question for AHIP's AHM-510 exam
Question #: 41
Topic #: 6
[All AHM-510 Questions]

Indigo Health Plan advertised a specific individual health insurance policy through a direct mail advertisement that provided detailed information about the product. In order to comply with the NAIC Model Rules Governing Advertisements of Accident and Sickness Insurance, Indigo must disclose whether the advertised policy contains any exceptions, reductions, or limitations. Thus, Indigo disclosed in the advertisement that one policy provision limits coverage for dental exams to $50 per exam and to one exam per calendar year. This information indicates that, with respect to the definitions in the NAIC Model Rules, Indigo's advertisement is an example of an

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Suggested Answer: B

by Raina at May 10, 2022, 01:56 AM

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Jolene
11 months ago
I thought exceptions were more about what’s not covered, not limits like this.
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Nadine
11 months ago
It's a reduction in coverage for sure, not an exception.
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Alberta
11 months ago
Wait, are they really limiting dental exams to just $50? That seems low!
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Elly
11 months ago
I agree, it’s clearly stating a limitation on coverage.
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Lezlie
11 months ago
This is definitely an invitation to contract with an exception.
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Wenona
12 months ago
Hmm, I'm not sure about this one. I'll have to think it through carefully.
upvoted 0 times
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Ailene
12 months ago
Yep, this is true. The ASBR has to have a connection to the backbone to function properly.
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Lashandra
12 months ago
The Getting Started Guide is usually a good place to start for basic information, but for more advanced procedures, the Reference Guide is probably the best bet.
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