Accident and health insurance agent (California) Accident and Health full analysis: what the $39 report shows
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A real question from the full analysis
This is how each question you miss appears in the report. The question, the right answer, the explanation and the source are real. The answer shown as yours is an example, not anyone's data.
A major medical plan sold in California sets a $50,000 yearly cap on inpatient hospital benefits. It also sets a $2,000 yearly cap on adult acupuncture, which is not an essential health benefit under the plan. Which cap violates the Affordable Care Act?
- A Both caps, because the ACA bars dollar limits on any covered service
- B Neither cap, as long as the plan has no lifetime dollar limit
- C The hospital cap, since essential benefits may not carry yearly dollar limits
- D The acupuncture cap, because limits must apply equally to every benefit
Example answer, marked sure: A · Correct answer: C
C is correct. Hospitalization is one of the essential health benefits. HealthCare.gov explains that insurers cannot set yearly or lifetime dollar limits on what they spend on essential health benefits, but they may still set dollar limits on services that are not essential health benefits. The CDI outline makes the same point in its description of health coverage. A is wrong because non-essential benefits may carry dollar caps. B is wrong because yearly limits on essential benefits are barred on their own. D is wrong because there is no rule that limits must be uniform. Remember: no dollar caps on essential health benefits, yearly or lifetime.
Readiness by domain uses the weights of the real exam: General Insurance: Basic Insurance Concepts and Principles 9.3%, General Insurance: Contract Law 5.3%, General Insurance: The Insurance Marketplace 9.3%, General Concepts of Medical and Disability Insurance 5.3%, Medical Expense Insurance: Individual Insurance 18.7%, Medical Expense Insurance: Group Medical Expense Insurance 10.7%, Medical Expense Insurance: Patient Protection and Affordable Care Act 10.7%, Medical Expense Insurance: Senior Health Products 20%, Disability Income Insurance 5.3%, Long-Term Care Insurance 5.3%.
What the full analysis adds
- The right answer to every question, the explanation, and the primary source it comes from.
- Readiness by domain, weighted like the real exam, so you know which domain would sink you.
- Where you were sure and wrong: the answers that would cost you on exam day.
- Time per question by domain, against the exam clock.
- Every question you missed, in one list, with its explanation.
- A study plan that starts with your weakest domain: what it covers, the key concepts, and the official sources to read.