Free practice exam · no signup needed

Idaho Health Practice Exam

20 exam-style questions drawn from the same bank as our full Idaho Health course (Idaho Disability/Health Producer Exam Prep). Answer all 20, then grade yourself — most state exams require 70% to pass. Explanations for every question are part of the full course.

1. Which of the following most accurately distinguishes short-term disability (STD) from long-term disability (LTD)?
STD is always sold as a group employer-sponsored product; LTD is always sold as an individually underwritten policy outside the employer-group marketSTD pays a lump-sum benefit at the start of the disability; LTD pays a monthly income benefit determined at claim adjudication under the recurrent-disability clauseSTD has a shorter elimination period and a shorter benefit period than LTD; the two are typically coordinated so LTD begins when STD endsSTD pays benefits only for non-occupational sicknesses; LTD pays only for accidental bodily injuries under the standard split-trigger definitions used by most carriers
2. Under Idaho Code 41-4703, a small employer employs an average of how many eligible employees?
1 to 502 to 1001 to 252 to 50
3. A lapsed Idaho disability policy is reinstated on June 1. Under Idaho Code 41-2108 sickness beginning on June 5 is:
Covered only after proof of insurabilityCovered at fifty percent of the benefitCovered, because reinstatement is retroactiveNot covered, sickness needs more than ten days
4. A 67-year-old continues to work and is covered by his employer's HSA-qualified HDHP. He has been receiving Social Security benefits since age 65, which means he is automatically enrolled in Medicare Part A. He wants to keep making HSA contributions. The correct guidance is:
He is ineligible to make HSA contributions because Medicare enrollment of any part disqualifies him, even if his HDHP remains the primary payerHe may continue making HSA contributions because Medicare Part A is hospital-only coverage and does not affect HSA eligibility under the §223(c)(1) other-coverage ruleHe may continue contributing at the age-55 catch-up rate of $1,000 per year only, but not the regular contribution because Medicare Part A blocks the standard limitHe may continue making HSA contributions as long as the employer pays 100% of the HDHP premium, because employer-paid coverage falls under the §223 employer safe harbor
5. The HMO Act of 1973 required an employer that offered health benefits to also offer a federally qualified HMO when one was available in the service area. That dual-choice duty reached employers of at least:
25 workers, though that dual-choice mandate has since been repealed10 workers, though that dual-choice mandate has since been repealed50 workers, though that dual-choice mandate has since been repealed100 workers, though that dual-choice mandate has since been repealed
6. An insured's claim for a high-cost imaging study is denied as 'not medically necessary' after she has already had the scan. She files an internal appeal, which the carrier also denies. Her next step under the ACA-required appeals process is:
Re-file the internal appeal with additional medical records and ask for a different reviewerAccept the denial, because internal appeal is the final administrative step for post-service claimsFile a complaint with the federal court that has jurisdiction over ERISA disputesRequest external review by an Independent Review Organization (IRO) whose decision is binding on the carrier
7. Under the ACA, every non-grandfathered individual and small-group health plan must cover the ten Essential Health Benefits. Which of the following is NOT one of the ten EHB categories?
Maternity and newborn carePediatric services including oral and vision careLong-term custodial nursing-home careMental health and substance-use-disorder services
8. The Part D late-enrollment penalty is calculated as:
A flat $50 per month surcharge for any delay, regardless of length10% of the national base beneficiary premium for every full 12 months the beneficiary was without creditable drug coverage, added permanently to the Part D premiumTwice the standard Part D premium for two years after late enrollment1% of the national base beneficiary premium for every full month the beneficiary was without creditable drug coverage for more than 63 continuous days, added permanently to the Part D premium
9. Credit life proceeds exceed the unpaid indebtedness. Under Idaho Code 41-2307 the excess is payable to:
The insurer as unearned premiumThe Idaho guaranty associationThe creditor as additional compensationA beneficiary named by the debtor or the estate
10. How many of Idaho's required continuing education credits must be in ethics?
SixThreeTwoFour
11. Under standard coordination-of-benefits rules, what is the ceiling on what a secondary major-medical plan will pay on a claim the primary plan has already partly paid?
The amount it would have paid as primary, less what the primary plan paidThe full allowed amount, because secondary coverage restores the member fullyWhatever the provider bills above the primary plan's contracted allowed amountHalf the balance remaining after the primary plan has finished adjudicating
12. An insured's coverage terminated on June 30. In August she receives treatment for a chronic condition that first arose in March, while the policy was still in force. The claim is:
Not payable, because a chronic condition is a categorical contract exclusionPayable, because chronic conditions are treated as continuing covered claimsPayable, because the condition itself arose during the policy period in MarchNot payable, because the care was rendered after the policy period ended
13. Under Idaho Code 41-305, a certificate of authority that is not continued expires on:
March 1June 30January 1March 31
14. A misrepresentation on an application supports rescission only when it is:
RepeatedNotarizedMaterialWritten
15. A 78-year-old policyholder can still bathe, dress, toilet, transfer, eat, and remains continent without assistance. However, her family reports she has been leaving the stove on, becoming lost in her own neighborhood, and forgetting to take medications. Her physician diagnoses moderate Alzheimer's disease and certifies she requires substantial supervision to protect against threats to health and safety. Under a tax-qualified LTC policy, she:
Qualifies only if her physician certifies the condition is reversibleDoes not qualify for benefits because she can perform all six ADLsQualifies for benefits only after she fails at least two ADLs in addition to the cognitive diagnosisQualifies for benefits under the cognitive impairment trigger, even though she fails no ADLs
16. Idaho Code title 41, chapter 55 creates the:
Small employer purchasing allianceLife and Health Guaranty AssociationIndividual High Risk Reinsurance PoolState-based health insurance exchange
17. An insured changes to a MORE hazardous occupation and is then injured. Under Idaho Code 41-2118 the insurer pays:
Half the scheduled benefitWhat the premium buys at the higher rateNothing, the change voids the policyThe full policy benefit as written
18. Under IDAPA 18.04.08, a disability income policy may NOT define disability by reference to:
Loss of earned incomeOwn occupation dutiesActivities of daily livingAny occupation duties
19. A plan charges a $300 emergency-room copay. A member goes to the emergency department with chest pain and is admitted as an inpatient from the ER. On many plans the $300 copay is then:
Converted into coinsurance calculated on the full inpatient allowed amountRefunded only after the member files an appeal within the plan year endWaived, because the emergency-room copay is often dropped upon admissionDoubled, because an admission converts the visit into an inpatient episode
20. An insured loses the sight of one eye. The AD&D policy typically pays:
The full principal sumThe capital sum, commonly halfNothing, since sight is not a limbA monthly income for two years

Want a different set? Refresh the page for 20 new questions — the full course has 500+, each with a complete explanation, plus full-length timed exam simulations and an AI tutor.