An employer's group disability insurance contract renews in Idaho. An employee's daughter is 24, unmarried, not a student, and receives about 60 percent of her financial support from the employee. Under Idaho law, may she remain on the parent's contract?

Yes, because she is unmarried, under 25, and receives over half her support from the parent

An issuer delivers a Medicare supplement certificate to an Idaho applicant, who examines it and decides she does not want it. Under Idaho law, how long after delivery may she return it for a premium refund, and who receives the refund?

Within 30 days; the issuer pays the refund directly to her in a timely manner

A large employer's group medical plan in Idaho has a 12-month preexisting condition exclusion. A new hire enrolls when first eligible. She had 8 months of qualifying previous coverage that covered the same services and ended 40 days before her new coverage took effect. How does the exclusion apply to her?

The plan must credit her 8 months of prior coverage, so at most 4 months of exclusion remain

An individual health benefit plan issued in Idaho is terminated because the insured intentionally misrepresented a material fact. Under Idaho's individual market renewability law, how does that termination affect the insured's status afterward?

For 12 months from the termination's effective date, the person is not an eligible individual

A small employer has 10 eligible employees. Four decline the carrier's plan because they have coverage that counts as qualifying existing coverage, and five of the other six enroll. The carrier's minimum participation requirement is 75 percent. Under Idaho's small employer availability law, how does the carrier apply that requirement?

It is met: the four with other coverage are not counted, and five of the remaining six enroll

An individual disability policy issued in Idaho on March 1, 2022 contains the required Time Limit on Certain Defenses provision. The insured becomes disabled on June 10, 2025 and files a claim. While reviewing it, the insurer finds that the applicant gave an honest but inaccurate answer about a past doctor visit on the application. Under that provision, how may the insurer treat the misstatement?

It may not use the misstatement to void the policy or deny this claim, because it was not fraudulent

An Idaho disability policy lapsed when a renewal premium was not paid in time. On April 1 the insurer accepted the late premium without requiring a reinstatement application, which reinstated the policy. Which of these losses is covered under the reinstated policy?

An accidental injury sustained on April 3, two days after reinstatement

An Idaho long-term care policy provides a postconfinement recuperative benefit for care received outside an institution, available only after the insured has received institutional care. The benefit is not advertised or offered as a home health care or home care benefit. What is the most the policy may require as a prior institutional stay?

A prior institutional stay of no more than 30 days

A small employer's health benefit plan in Idaho is coming up for renewal, and the employer wants to keep it. Which of the following is a ground on which the carrier may refuse to renew the plan?

The employer has stopped complying with the carrier's minimum participation requirements

A covered person has asked for external review of a health carrier's final adverse benefit determination in Idaho but has not yet returned the signed authorization that lets the carrier and the person's treating providers release pertinent medical records. Under Idaho law, what is the status of the review?

It is on hold, with no duties owed by the carrier, until the director receives the signed form

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1.An employer's group disability insurance contract renews in Idaho. An employee's daughter is 24, unmarried, not a student, and receives about 60 percent of her financial support from the employee. Under Idaho law, may she remain on the parent's contract?
Answer: B. Yes, because she is unmarried, under 25, and receives over half her support from the parent
Idaho Code Sec. 41-2210(3) requires every new or renewing group or blanket disability contract delivered in Idaho to let an unmarried child who is under age 25 and gets more than half of his or her financial support from the parent stay on the parent's contract. The daughter meets each of those conditions, so she may remain. The section contains no full-time student requirement and no age 23 cutoff. Its separate allowance for an unmarried child of any age who is medically certified as disabled and financially dependent is an additional route, not a condition this daughter must satisfy.
Source
Idaho Code Sec. 41-2210(3) (Required provision in group and blanket policies)
Choose an answer to see the explanation.
2.An issuer delivers a Medicare supplement certificate to an Idaho applicant, who examines it and decides she does not want it. Under Idaho law, how long after delivery may she return it for a premium refund, and who receives the refund?
Answer: A. Within 30 days; the issuer pays the refund directly to her in a timely manner
Idaho Code Sec. 41-4407 requires a Medicare supplement policy or certificate to carry a notice, prominently printed on the first page or attached, that the applicant may return it within 30 days of delivery and receive a premium refund if not satisfied for any reason. The refund must be paid directly to the applicant by the issuer in a timely manner. For these policies the section sets no shorter window, and it does not route the refund through the agent or apply it to other coverage.
Source
Idaho Code Sec. 41-4407 (Notice of free examination)
Choose an answer to see the explanation.
3.A large employer's group medical plan in Idaho has a 12-month preexisting condition exclusion. A new hire enrolls when first eligible. She had 8 months of qualifying previous coverage that covered the same services and ended 40 days before her new coverage took effect. How does the exclusion apply to her?
Answer: C. The plan must credit her 8 months of prior coverage, so at most 4 months of exclusion remain
Idaho Code Sec. 41-2221(1)(c) requires a large employer's health benefit plan to waive the preexisting condition period for the time a person was covered by qualifying previous coverage that paid for the same services, provided that coverage was continuous to a date no more than 63 days before the new coverage started. Her 40-day gap is inside that limit, so her 8 months count against the 12-month exclusion and no more than 4 months can remain. A gap shorter than 63 days does not defeat the credit, and the credit offsets the months she was covered rather than erasing the exclusion. Under Sec. 41-2221(2)(d), qualifying previous coverage includes any other group or individual health insurance policy, so it need not come from the same employer.
Source
Idaho Code Sec. 41-2221(1)(c) (Crediting of preexisting condition waiting period)
Choose an answer to see the explanation.
4.An individual health benefit plan issued in Idaho is terminated because the insured intentionally misrepresented a material fact. Under Idaho's individual market renewability law, how does that termination affect the insured's status afterward?
Answer: C. For 12 months from the termination's effective date, the person is not an eligible individual
Idaho Code Sec. 41-5207(1)(b) lets an individual carrier refuse renewal for fraud or intentional misrepresentation of material fact, and it adds that a person terminated on that ground is not deemed an eligible individual for 12 months from the effective date of the termination. The same paragraph says the person is not deemed to have qualifying previous coverage under chapters 22, 47 or 52 of title 41, so the ended plan cannot count as prior coverage. The bar runs for 12 months, not permanently. The five-year period in the section is a different rule: under Sec. 41-5207(2) it keeps a carrier that nonrenews all of its individual plans from writing new individual business.
Source
Idaho Code Sec. 41-5207(1)(b) (Renewability of coverage)
Choose an answer to see the explanation.
5.A small employer has 10 eligible employees. Four decline the carrier's plan because they have coverage that counts as qualifying existing coverage, and five of the other six enroll. The carrier's minimum participation requirement is 75 percent. Under Idaho's small employer availability law, how does the carrier apply that requirement?
Answer: A. It is met: the four with other coverage are not counted, and five of the remaining six enroll
Idaho Code Sec. 41-4708(3)(e)(iii) bars a small employer carrier from considering employees or dependents who have qualifying existing coverage when it decides whether the applicable participation percentage is met. Leaving out the four covered elsewhere, five of the six remaining eligible employees enroll, about 83 percent, which clears a 75 percent requirement. Counting all ten to reach 50 percent is the calculation the statute forbids. The participation rule sets no condition about the employer's share of the premium, so a larger contribution is not what decides the result here. And under Sec. 41-4708(3)(f)(i), a carrier that offers coverage to a small employer must offer it to all eligible employees and their dependents, not to only part of the group.
Source
Idaho Code Sec. 41-4708(3)(e)(iii) (Availability of coverage, preexisting conditions, portability)
Choose an answer to see the explanation.
6.An individual disability policy issued in Idaho on March 1, 2022 contains the required Time Limit on Certain Defenses provision. The insured becomes disabled on June 10, 2025 and files a claim. While reviewing it, the insurer finds that the applicant gave an honest but inaccurate answer about a past doctor visit on the application. Under that provision, how may the insurer treat the misstatement?
Answer: C. It may not use the misstatement to void the policy or deny this claim, because it was not fraudulent
Under Idaho Code Sec. 41-2106(1)(a), once two years have passed from the date of issue, a misstatement in the application, other than a fraudulent one, cannot be used to void the policy or to deny a claim for a disability that begins after that two-year period. The policy was issued March 1, 2022, the disability began June 10, 2025, and the misstatement was honest, so the insurer cannot rely on it for either purpose. The provision says nothing about refunding premium or about the next premium due date, so the choices built on those conditions misstate it. A fraudulent misstatement is excepted from this protection, which is why the honest nature of the answer matters here.
Source
Idaho Code Sec. 41-2106(1)(a) (Time limit on certain defenses)
Choose an answer to see the explanation.
7.An Idaho disability policy lapsed when a renewal premium was not paid in time. On April 1 the insurer accepted the late premium without requiring a reinstatement application, which reinstated the policy. Which of these losses is covered under the reinstated policy?
Answer: D. An accidental injury sustained on April 3, two days after reinstatement
Under the reinstatement provision required by Idaho Code Sec. 41-2108(1), accepting the premium without asking for an application reinstates the policy, and the reinstated policy covers accidental injury sustained after the reinstatement date and sickness that begins more than 10 days after that date. An injury on April 3 meets the injury test. A sickness beginning April 6 starts only five days after reinstatement, so it falls inside the 10-day window and is excluded. An injury on March 28 and a sickness that began on March 30 both arose before the April 1 reinstatement, so neither is a loss the reinstated policy covers.
Source
Idaho Code Sec. 41-2108(1) (Reinstatement)
Choose an answer to see the explanation.
8.An Idaho long-term care policy provides a postconfinement recuperative benefit for care received outside an institution, available only after the insured has received institutional care. The benefit is not advertised or offered as a home health care or home care benefit. What is the most the policy may require as a prior institutional stay?
Answer: C. A prior institutional stay of no more than 30 days
Idaho Code Sec. 41-4605(4)(b)(ii) provides that a long-term care policy or rider that conditions noninstitutional benefits on the prior receipt of institutional care may not require a prior institutional stay longer than 30 days. Postconfinement, postacute care and recuperative benefits are among the benefits that Sec. 41-4605(4)(a)(iii) allows to carry a prior institutionalization requirement, so a total ban is wrong here. The flat ban in Sec. 41-4605(4)(b)(iii) reaches only a benefit advertised, marketed or offered as home health care or home care. Sec. 41-4605(4)(b)(i) does require such conditions to be clearly labeled in a separate paragraph, but labeling does not lift the 30-day limit.
Source
Idaho Code Sec. 41-4605(4)(b)(ii) (Disclosure and performance standards for long-term care insurance)
Choose an answer to see the explanation.
9.A small employer's health benefit plan in Idaho is coming up for renewal, and the employer wants to keep it. Which of the following is a ground on which the carrier may refuse to renew the plan?
Answer: D. The employer has stopped complying with the carrier's minimum participation requirements
Idaho Code Sec. 41-4707(1) makes a small employer health benefit plan renewable at the small employer's option, except in the cases the section lists. Noncompliance with the carrier's minimum participation requirements is one of those cases, in paragraph (c). A costly diagnosis, high claims and a carrier's wish for a bigger premium increase do not appear among the listed cases, so none of them allows the carrier to refuse renewal. Even when a carrier discontinues a particular product under paragraph (g), it must act uniformly without regard to an affected employer's claims experience or any health status-related factor of an employee or dependent.
Source
Idaho Code Sec. 41-4707(1)(c) (Renewability of coverage)
Choose an answer to see the explanation.
10.A covered person has asked for external review of a health carrier's final adverse benefit determination in Idaho but has not yet returned the signed authorization that lets the carrier and the person's treating providers release pertinent medical records. Under Idaho law, what is the status of the review?
Answer: D. It is on hold, with no duties owed by the carrier, until the director receives the signed form
Idaho Code Sec. 41-5905(2)(d) requires the carrier's notice of the right to external review to include an authorization form, or another document the director approves, through which the covered person allows the carrier and treating providers to disclose pertinent protected health information, including medical records. Until the director receives that form duly executed, the statute stays the external review process, and the carrier has no obligations under the chapter. So the review does not proceed on a partial record, is not deemed withdrawn, and does not end with the denial standing by default; it waits for the form.
Source
Idaho Code Sec. 41-5905(2)(d) (Notice of right to external review)
Choose an answer to see the explanation.

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The scored exam is free, 20 questions in 30 minutes, and needs an account. These 10 do not.

1.An employer's group disability insurance contract renews in Idaho. An employee's daughter is 24, unmarried, not a student, and receives about 60 percent of her financial support from the employee. Under Idaho law, may she remain on the parent's contract?

2.An issuer delivers a Medicare supplement certificate to an Idaho applicant, who examines it and decides she does not want it. Under Idaho law, how long after delivery may she return it for a premium refund, and who receives the refund?

4.An individual health benefit plan issued in Idaho is terminated because the insured intentionally misrepresented a material fact. Under Idaho's individual market renewability law, how does that termination affect the insured's status afterward?

7.An Idaho disability policy lapsed when a renewal premium was not paid in time. On April 1 the insurer accepted the late premium without requiring a reinstatement application, which reinstated the policy. Which of these losses is covered under the reinstated policy?

9.A small employer's health benefit plan in Idaho is coming up for renewal, and the employer wants to keep it. Which of the following is a ground on which the carrier may refuse to renew the plan?

The other 305 questions are $29.