HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C1 / S3.1.1)
1. What is the function of the Agency for Integrated Care (AIC)?

A. To smoothen the transition of MOH partners from one care setting to another.
B. To smoothen the transition of MOH stakeholders from one care setting to another.
C. To smoothen the transition of patients and patients’ family doctor from one care
setting to another.
D. To smoothen the transition of patients from one care setting to another.

(C2 / S3.5)
2. Which of the following Medical Expense Insurance is MOST suitable for a client who is a
self-employed?

A. Policy with no deductible

B. Policy with no co-insurance
C. Policy with no expense participation
D. Policy with expense participation

(C5 / S3.1(a))
3. If you know that your client has Long Term Care Insurance, you should also find out
whether

A. he has other sources of disability income

B. the deferred period is right for him
C. the benefits payable are on a serviced-based basis
D. the policy has deductible and co-insurance features

(C11 / S3.3.3)
4. The detection of any early cognitive impairment and morbidity risk are is essential when
underwriting

A. Critical Illness Insurance

B. Disability Income Insurance
C. Long Term Care Insurance
D. Managed Healthcare Insurance

(C6 / S5.3)
5. Group Dental Insurance usually does NOT cover

A. Scaling and polishing of teeth

B. Wisdom tooth extraction
C. Pre-existing conditions
D. Replacement of stolen dentures

(C2 / S3.3)
6. If Mr Tan is buying a policy for himself at $500 and his two sons at $300 each. He is
given a 5% family discount. Calculate the total premium Mr Tan needs to pay.

A. $760
B. $1,045
C. $1,100
D. $1,075

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C11 / S2)
7. Underwriting is an important process because

A. help to protect the insurer against anti-selection and in the preservation of the
insurer’s reserves.
B. to ensure that the premium charged corresponds with the risk involved.
C. the re-insurance limits will not be exceeded.
D. the insurer will make substantial profits.

(C11 / S4.1.1(v))
8. Declaration of a Proposal Form serves a number of purpose as follows:

I. that the applicant has disclosed all material facts truthfully and faithfully in the
proposal form
II. that the applicant has not withheld any material facts
III. that the applicant agrees and authorizes the insurer to release to any medical source,
insurance companies & vice versa any information regarding him at any time
regardless whether proposal is taken up.

A. I & II
B. II & III
C. I & III
D. I , II & III

(C5 / S3.2.1(a)(vi))
9. Definition of performing transferring includes:

I. using the lavatory

II. moving indoors from room to room on level surfaces
III. move from a bed to an upright chair or wheelchair and vice versa.

A. I Only
B. II Only
C. III Only
D. II & III

(C6 / S2.1(g))
10. The insured must survive the survival period before the critical illness benefit becomes
payable. The survival period is a period of time:

A. from the date of policy issue

B. from the date of any reinstatement of the policy
C. from the date of inception
D. from the occurrence of a critical illness

(C7 / S4.1.4)
11. Which one of the following models do the physicians actively continue to develop their
own private practices?

A. Staff Model HMO

B. Group Model HMO
C. Independent Practitioners Association (IPA) HMO
D. Network Model HMO

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C7 / S3.2(a))
12. Under this method, the MHC pre-pay the providers a flat amount for each member’s
medical care usually on a monthly basis.

A. Capitation
B. Discounted-fee-for-service
C. Salary
D. Fee schedule

(C6 / S2.3.1)
13. Mr Tan has a Critical Illness coverage with a 50% acceleration benefit. The life insurance
policy also has a waiver of premium upon total and permanent disability. After a critical
illness claim by Mr Tan, which of the following statement(s) regarding the premium is/are
FALSE?

I. Premium remains unchanged

II. Premium is waived throughout the remaining term of the policy
III. Premium is reduced in proportion to how the basic sum assured is reduced.

A. I & II
B. II & III
C. I and III
D. All of the above

(C4 / S6.2(d))
14. David has a monthly income of $6,000 and has bought a Disability Income policy at 75%
of his monthly income with a 3% escalation benefit. He is disabled and made a claim
successfully on 1-1-2000. What is the amount that he will receive on the 1-3-2001?

A. $4,500
B. $6,000
C. $4,635
D. $4,770

(C2 / S2)
15. Which of the following plans is NOT a plan that reimburses policy owners for expenses
incurred as a result of an illness or accident?

A. MediShield
B. Medical Expense Insurance
C. Managed Healthcare Scheme
D. Hospital Cash Insurance

(C6 / S4.3)
16. Which of the following are services provided under the 24-hour Worldwide Emergency
Assistance Service in the Medical Expense Benefits under Travel Insurance?

I. medical advice
II. referral to doctors, specialists and hospitals
III. hospital deposit guarantees

A. I & II only
B. I & II only
C. II & III only
D. I, II & III

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C6 / S3.3.1)
17. Which of the following is/are benefit/s offer under stand-alone Hospital Cash Insurance

I. double payment if insured stays in the intensive Care Unit (ICU)

II. triple payment if insured is hospitalized overseas due to accident
III. free accidental death benefit

A. I & II only
B. I & III only
C. II & III only
D. I, II & III

(C15 / S2.1)
18. Mr Tan is aged 30. He has income and expenditure of $5,500 and $2,500 respectively.
He wants to maintain his income to age 65 62 should he be disabled. Assuming that the
interest rate is 4% and inflation is 2%, what is the maintenance cost?

A. $551,771
B. $638,123
C. $749,958
D. $814,149

(C5 / S7 & C6 / S5)

19. Long Term Care Insurance is similar to Group Dental Care in that they:

I. do not cover pre-existing conditions

II. can be issued on standalone or rider basis
III. do not pay in addition to other insurance

A. I only
B. II only
C. I and II
D. II and III

(C4 / S7 & C5 / S7)

20. Disability Income is similar to Long Term Care in that:

I. If insured recovers from the disability, payment will stop but policy will not be
terminated.
II. the premiums payable remain the same through the policy period.
III. they cover hospitalization charges.

A. I & II
B. I only
C. II and III
D. I, II and III

(C10 / S3)
21. Which one of the following statements about the parameters in pricing of Health
insurance is TRUE:

A. Increase in proportion of females in a group will reduce the premiums.

B. Increase in morbidity experience will reduce premiums.
C. Increase in persistency will decrease premiums.
D. Increase in participation rate will increase premiums.

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C5 / S3.2.2)
22. In Long Term Care insurance, the deferred period is defined as a period of time:

A. that he is unable to perform a specified numbers of ADLs.

B. from the inception of the policy or any reinstatement of the policy
C. after the insured becomes a nursing insured due to accident, chronic disease or
permanent health defect.
D. from the time the insured is hospitalised.

(C3 / S2.1)
23. With effect from 1st January 2010, the required minimum amount of medical insurance for
each S Pass holder and Work Permit holder is __________.

A. $5,000
B. $10,000
C. $15,000
D. $20,000

(C4 / S11)
24. Disability Income will not terminate when the insured:

A. changes his occupation.

B. resides outside Singapore for a specified period of time.
C. is unemployed for a period of time.
D. has not paid up his premiums due after the grace period.

(C7 / S6.1)
25. Managed Healthcare offers the following benefits:

I. Primary Care
II. Preventive Care
III. Emergency Care
IV. Specialist Care

A. I , II, III
B. I, II , IV
C. I, III, IV
D. All the above

(C8 / S4.1)
26. Mr Tan is 60 years old and is unable to pay his hospital bill. He can seek assistance from:

A. Interim Disability Programme for the Elderly (IDAPE)

B. Eldershield
C. Medifund
D. Mediguard

(C1 / S4)
27. Healthcare services for the elderly are mostly run by:

A. Interim Disability Programme for the Elderly (IDAPE)

B. Voluntary Welfare Organisations
C. Eldercare Fund
D. Mediguard

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C1 / S2)
28. Government's healthcare philosophy is based on:-

I. to nurture a healthy nation by promoting good health

II. promote personal responsibility and avoid over-reliance in state welfare
III. rely on competition and market forces to improve service and raise efficiency

A. I and II
B. I and III
C. II and III
D. I, II and III

(C4 / S12)
29. Which of the following documents is NOT a requirement by insurer when a claim is made
under Disability Income Insurance?

A. Hospital Bill
B. Clinical Abstract Form
C. Copies of Medical Certificates
D. All available Laboratory and Tests results

(C9 / S5.12)
30. Under the Change of Occupation provision, the insurer is permitted to change which of
the following when the insured changes to a less hazardous occupation:-

A. increase the maximum benefit amount

B. reduce the premium rate
C. decline the insurance coverage
D. cancel the policy

(C5 / S3.2.1(a)(v))
31. In Long Term Care insurance, ‘Mobility’ refers to:-

A. ability to move from a be to upright chair or vice-versa

B. ability to move indoors from room to room on level surfaces
C. ability to use the lavatory
D. ability to put on or take off all garments

(C7 / S6.5)
32. When making a claim under Managed Healthcare, the documents to be provided are:-

A. original itemised medical bill

B. claimant's NRIC
C. letter from employer
D. letter from Attending Physician confirming the necessity of the treatment

(C11 / S4.3)
33. A medical examination is normally required for:-

A. Long Term Care Insurance

B. Basic Medical Expense Insurance
C. Major Medical Expense Insurance
D. Managed Healthcare

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C8 / S2.1.1 (j))

34. Withdrawal limit for buying an integrated private shield from a CPF member’s Medisave
account is ________ per insured member per policy year if the insured member is below
81 years old (age next birthday), or ________ if he is 81 years old (age next birthday)
and above, to pay for the premiums of any of the CPF approved medical insurance
schemes.

A. $600, $800
B. $800, $1,150
C. $1,150, $2,500
D. $2,500, 3,500

(C8 / S3.1)
35. Which of the following is NOT an increased in the insured’s coverage under an
ElderShield Supplement?

A. Increase the monthly payout

B. Extend the payout method
C. Combination of A and B
D. Reduce the deferred period

(C9 / S4.2k)
36. Which statement(s) is/are TRUE about Moratorium Underwriting?

I. Insured do not need to make any medical declaration when they apply for coverage
II. Pre-existing conditions can be covered after a continuous period (e.g. 5 years) from
the coverage start date, reinstatement date, or date of upgrade of plan, whichever is
later
III. For a specified number of years, the insured must not experienced any symptom,
seek consultation, or receive treatment or medication for the condition
IV. Insurer will also have a list of pre-existing conditions that are permanently excluded
from coverage, e.g. stroke, kidney failure and cancer, etc.

A. I, II & III
B. II, III & IV
C. I, III & IV
D. All of the above

(C11 / S3.4.7 & C15 / S3)

37. Employer X wanted to buy Medical Expense Insurance for his 5 employees. The
following is required:

I. A group factfind form will need to be completed

II. Employees will be required to go for medical examination
III. Each employee will need to complete a health declaration form

A. I only
B. II only
C. I & III
D. I, II & III

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C4 / S14)
38. The underwriter will look at the following factors when underwriting Group Disability
Income Insurance:

I. Age of individual employee in the company

II. Nature of the company’s business
III. Nature of work of each employee

A. I only
B. I & II only
C. II & III only
D. I, II & III

(C11 / S6.2.1)
39. Several options under modification of cover include:

I. Charge extra premiums

II. Increase expense participation on the policy
III. Reduce premium-paying period

A. I only
B. II only
C. I & II only
D. I, II & III

(C15 / S2.1)
40. Miss X’s monthly income and expenses are $4,000 and $3,000 respectively. She is 32
yrs old, single and would like to provide for herself till retirement (55 yrs old) in the event
of disability. She has an existing $100,000 Critical Illness cover. Given an inflation rate of
2% and interest rate of 4%, calculate the maintenance cost needed in the event of critical
illness.

A. $431,123
B. $558,519
C. $614,520
D. $780,152

(C11 / S3.3.5)
41. Which of the following is the strong factor for underwriting Managed Healthcare covers?

A. Age and Gender Demographics

B. Insured Company’s Nature of Business
C. Group Size
D. Expected Persistency

(C13 / S2.1.1(a))
42. The fact find form will enable the representative to:-

A. Comply with the “Know Your Client” requirement under MAS Notice 120.
B. Ask for a new fact find form if the information is within 3 or 6 months from date of
signing.
C. Have a reasonable basis for recommending the cheapest product to him.
D. Measure if client is aware of the facts about policies that he is going to purchase.

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C13 / S2.1.1(b))
43. For Individual Business, which of the following must be provided to the insurer at the
close of a sale by the representatives?

I. Your Guide to Health Insurance

II. Fact Find Form
III. Product Summary
IV. Our Advice and Reasons Why Form

A. I, II, III
B. II, III & IV
C. I, III & IV
D. All of the above

(C13 / S2.2.1(a))
44. Which of the following should an Insurance Executive perform, during the Pre-Sales
Stage for Corporate Business?

I. Disclose your status.

II. Disclose name of insurer.
III. Use the Group Fact Find Form.
IV. Do a needs analysis using “Our Advice & Reasons Why” Form.

A. I, II & IV
B. I, II & III
C. II & III
D. All of the above

(C13 / S3)
45. Penalties for representatives who have not submitted the completed fact find form and
our advice & reasons why form include:-

A. Termination of contract for both LIA & GIA members

B. 3 months suspension for representatives of LIA members only.
C. Counselling for representatives of both LIA & GIA members
D. Re- training on Life Insurance

(C15 / S2.1)
46. Which of the following product is often associated with providing maintenance costs for a
client?

A. Disability Income Insurance

B. Critical Illness
C. Hospital Cash Insurance
D. Managed Healthcare Insurance

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

(C14 / S4.1.5(ii))
47. Mrs Tan was recently hospitalized for 8 days for an operation. Her total bill incurred was
$2,400 for Room & Board and surgery of $20,000. She has received $11,000
reimbursement from her company group Hospital & Surgical Policy Plan. Her own policy
covers for room & board of $250 per day and surgery of $10,000. Assuming, no
deductibles nor co-insurance under her policy, how much can Mrs. Tan receive from her
own insurer?

A. $12,000
B. $11,400
C. $22,400
D. $30,000

(C15 / S3)
48. Which of the following method is fairer in determining the sum assured for group health
insurance?

A. Employee’s Salary X Performance Factor

B. Employee’s Salary X Standard Factor
C. According to Rank
D. Lower position; higher sum assured.

(C12 / S4.1.1)
49. Before the fact find, what must you disclose?

A. Your business name and address

B. Which agency you belong to
C. Your remuneration
D. Any actual or potential conflict of interest

(C15 / S3)
50. Employer wants to take into account the length of the service when buying a group
insurance for his staff. Which method of will you recommend?

A. According to rank
B. Number of times of the employee’s basic salary
C. Utilisation
D. Capitation

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HEALTH INSURANCE MOCK QUESTIONS – (Fourth Edition – June 2010) - Paper C

Answers – Set C

1. D 26. C
2. C 27. B
3. C 28. D
4. C 29. A
5. D 30. B
6. B 31. B
7. B 32. A
8. D 33. A
9. C 34. B
10. D 35. D
11. C 36. D
12. A 37. C
13. A 38. D
14. C 39. C
15. D 40. B
16. D 41. A
17. D 42. A
18. C 43. B
19. B 44. C
20. B 45. C
21. C 46. A
22. A 47. B
23. C 48. B
24. A 49. D
25. D 50. A

Q6. Total premium = $500 + $300 + $300 = $1,100

Discount 5% = 5% X $1,100 = $55
Total premium Mr Tan needs to pay = $1,100 - $55 = $1,045

Q14. For Y2000, disability benefit per month = 75% X $6,000 = $4,500
For Y2001, disability benefit per month = $4,500 + 3% X $4,500 = $4,635

Q18. Yearly expenses = $2,500 X 12 = $30,000

No. of years = 65 – 30 = 35
Net interest = 4% – 2% = 2%
Maintenance Cost = $30,000 X 24.9986 (Table A2, i=2%, Year=35)
= $749,958

Q40. Yearly expenses = $3,000 X 12 = $36,000

No. of years = 55 – 32 = 23
Net interest = 4% – 2% = 2%
Fund Required = $36,000 X 18.2922 (Table A2, i=2%, Year=23)
= $658,519
Maintenance Cost = $658,519 – $100,000 = $558,519

Q47. Total bills = $2,400 + $20,000 = $22,400

Group H&S = $11,000
Own Policy = $250 X 8 + $10,000 = $12,000
After taking into Group H&S = $22,400 – $11,000 = $11,400
Since this figure is lower than $12,000, the amount payable by insurer will be $11,400

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