Health Insurance Set A

HEALTH INSURANCE
7th Edition, Version 1.4 – 1 October 2022

Set A

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Health Insurance Set A

Set A
C9(II)/8.20
1. Mr. Tan is a 65-year-old Singaporean concerned about paying his medical expenses in the
event of suffering from any severe disability. However, he was not eligible to join the
ElderShield Scheme when it was launched in September 2002 because he had pre-existing
disability. If Mr. Tan suffers a severe disability and assuming that his per capita household
income is S$2,000, he will qualify to receive a payout of ______ under the Interim disability
Assistance Programme for the Elderly.

A. S$150 per month for up to 72 months

B. S$150 per month for up to 60 months
C. S$250 per month for up to 72 months
D. S$250 per month for up to 60 months

C9(I)/ 5.14, C9(II)/6.7

2. Richard, 55 years old, wishes to use his CPF Medisave to finance his Integrated Shield plan
with an annual premium of $2,500; ElderShield with an annual premium of $300; and
ElderShield Supplements with an annual premium of $1,000.

Assuming the applicable withdrawal limits (per person per year) for the following Medisave
Approved Medical Insurance plans are:
MediShield Life: No limit
Integrated Shield Plan: $600 (age 41 to 70 years old)
ElderShield: No limit
ElderShield Supplements: $600

Calculate the total amount Richard will have to pay in cash after withdrawing the maximum
amount from his Medisave?

A. $0
B. $1,200
C. $2,300
D. $2,900

C1/4.3
3. Public healthcare is the same as private healthcare in its _____________ healthcare services.

A. primary
B. secondary
C. intermediate
D. standard

C12/3.21
4. The detection of any early cognitive impairment is essential when underwriting which product?

A. Dread Disease Insurance.

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

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Health Insurance Set A

C6/4.1(d) (ii)
5. In a Critical Illness Insurance Product (CI Plan), major cancer is covered. Which of the
following term(s) is/are considered “meeting the definition”?

A. Sarcoma
B. Leukemia
C. Lymphoma
D. All of the above

C1/4.5
6. Under the Community Health Assist Scheme (CHAS), eligible Singapore citizens can receive
________ treatments at participating General Practitioners (GPs) and dental clinics without
the need to travel to the polyclinics.

A. free
B. subsidised
C. basic
D. limited

C2/2.9(a)
7. Daily Room and Board Charges are covered under Inpatient Expenses of a Medical
Expense Insurance Policy. Which of the following is NOT covered under Daily Room and
Board Charges?

A. Accommodation
B. Meals
C. General Nursing Services
D. Medicines and drugs

C2/3.48
8. Which one of the following exclusions and limitations under Medical Expense Insurance is
FALSE?

A. To avoid the insurer selecting against the policyowner (i.e anti-selection)

B. To make premium more affordable.
C. To avoid policyowner receiving reimbursement twice and making a profit.
D. To define more clearly the necessary medical care and treatment.

C3/2.2(c)
9. Which one of the following characteristics of group insurance is important to the underwriter in
determining the “feel” of future claim experience?

A. Minimal Underwriting Requirements

B. Experience-rating
C. Cost effectiveness
D. Plan continuation

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Health Insurance Set A

C14/2.1(b) (table)
10. As a Financial Adviser Representative (FA Rep), which one of the following situations will be
considered as needs selling?

A. The FA Rep’s relationship with the prospective client depends on how well the client
likes his product.
B. The FA Rep helps the prospective client to uncover his needs and recommend suitable
solutions for him.
C. The FA Rep creates the pressure to buy, as the prospective client’s needs are already
present.
D. The FA Rep assumes that the prospective client needs his product, and as such, he
makes a detailed recommendation to the prospective client.

C3/4.14
11. How does the “Continuation Benefits” under the Transferable Medical Insurance Scheme
(TMIS) benefits the employee?

A. To continue enjoying hospitalization coverage from the employment termination date up

to a period of 12 months.
B. To enjoy automatic coverage under the New Employer Group Medical Expense Plan.
C. Waiver of exclusion on pre-existing medical conditions when joining his new employer.
D. Enjoy a lower entitlement of either the new employer TMIS plan or prior employer TMIS
plan.

C5/4.2(c)
12. When a person requires an assistive rehabilitation device (eg wheelchair), which one of the
following benefits under a Long Term Care plan could provide for it?

A. Rehabilitation Expense Benefit

B. Extended Care Benefit
C. Surgical and Prosthesis Device
D. Financial Assistance with Adaptation

C4/6.6 & 6.9

13. What is true of the difference between “Rehabilitation Benefit” and “Rehabilitation Expense
Benefit”?

A. Rehabilitation Benefit is for payment if the insured is unable to go to work.

B. Rehabilitation Benefit is for reimbursement of medical aids eg. Wheelchair.
C. Rehabilitation Expense Benefit is also known as “Partial Disability Benefit” and it
provides for a reduced benefit to the insured if he is able to return to work.
D. Rehabilitation Expense Benefit is reimbursements that includes workplace
modifications.

C2/6.1
14. The coverage for an insured person will terminate under Medical Expense Insurance
when ____________.

A. the total amount of claims has reached the annual limit.

B. when the insured attains the maximum age of entry.
C. when the insured enters full time military service.
D. when the insured enters National Service Reservist Training.

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Health Insurance Set A

C4/8.10 new
15. Underwriters may use which one of the following factors to determine the terms of acceptance
for Disability Income Insurance Policy?

A. Occupation
B. Benefit Amount
C. Benefit Period
D. Deferred Period

C5/3.1(a)
16. Under Long Term Care Insurance Policy, “Service Based” policy pays the covered amount,
regardless of the actual cost of services received. Which type is it describing?

A. Indemnity Method
B. Expense Incurred Method
C. Monthly Benefit Method
D. None of the above

C6/3.1
17. Which one of the following regarding the LIA Critical Illness Framework 2019 (“The CI
Framework’) is /are true?

A. Seeks to improve the interests of the consumers in the claim of critical illnesses.
B. Seeks for easier product comparison by insurers.
C. Seeks for consistent outcomes for underwriters in accepting proposals.
D. Seeks to reduce ambiguity of the same CI claim being paid by one insurer but rejected
by another.

C2/2.11(a)
18. Catastrophic Outpatient Expenses in Medical Expense Insurance Policy covers _________.

A. Outpatient liver treatment charges

B. Outpatient kidney treatment charges
C. Living organ transplant
D. Intensive care unit charges

C1/2.8 (d)
19. To ensure healthcare remains affordable, how does the government enhance support for
Singaporeans?

A. Expand Medisave to cover all types of outpatient treatments.

B. Enhancing collective responsibility for healthcare through MediShield Life.
C. Reduce Government healthcare expenditure through MediShield Life.
D. Increase Government share of national healthcare expenditure by providing more
choices of hospitals and polyclinics.

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C6/4.13
20. Amy bought an Additional Benefit Critical Illness Rider of $150,000 on a Whole Life Insurance
Policy of $200,000. Which of the following statements is TRUE?

A. Upon accidental death, insurer will pay $350,000.

B. In the event of an accident that caused her to be total permanently disabled, insurer
will pay $350,000.
C. She was diagnosed with skin cancer and subsequently died 4 months later. Insurer will
pay a total sum of $350,000.
D. In the event she was diagnosed with one of Critical Illness, insurer with pay a sum
assured of $350,000.

C7/3.3
21. Which one of the following circumstances will allow the policy owner of a Travel Insurance
policy, to claim for medical expense benefits while she is overseas?

A. Aesthetic surgery performed in Seoul.

B. Routine health check-up performed in New York.
C. Miscarriage expenses in America.
D. Death resulting from civil commotion in Bangkok.

C10/5.26
22. John bought a Conditionally Renewable Health Insurance Policy. Shortly after that, he was
diagnosed with cancer. The insurer __________________.

A. can refuse to renew his policy as his health conditions change

B. can refuse to renew his policy as it is considered pre-exisiting conditions.
C. should renew his policy.
D. should renew his policy and charge a higher premium.

C8/3.8(a)
23. Which one of the following methods, does Managed Healthcare Organization pre-pays the
providers a fixed amount for each member’s medical care usually on a monthly basis?

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

C8/3.2
24. Which component of managed healthcare is not used to contain and control healthcare
expenditure?

A. Accessibility
B. Cost
C. Quality of Care
D. None of the above

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Health Insurance Set A

C1/3.1
25. What is the main aim of the “Healthcare 2020” Masterplan? It aims to:

A. shape the future of healthcare in Singapore by identifying, developing and

experimenting with game-changing systems-level concepts and innovations in the key
areas of health promotion, illness prevention and delivery.
B. expand its services and building new facilities to make it easier for Singaporeans to seek
healthcare.
C. develop and seek a higher quality of Singapore’s healthcare professional workforce
through initiatives in building further skills and knowledge and salary increase for public
healthcare staff.
D. make medical fees more affordable through subsidies that have been rolled out for lower
to middle income patients.

C8/6.2
26. For a fixed annual premium, insurer offer Managed Healthcare Plans which provides their
policyowners with some benefits. Which of the following is Not a benefit under this Plan?

A. Primary Care
B. Preventive Care
C. Emergency Care
D. Inpatient Care

C9(II)/7.23
27. To make a claim under a CareShield Life Policy, the insured needs to submit a claim
application to the ________________.

A. Ministry of Health Holdings

B. Agency of Integrated Care (AIC)
C. Pioneer Generation Department
D. Monetary Authority of Singapore

C2/2.9(d)
28. Under the Medical Expense Insurance, Hospital Miscellaneous Expenses refers to the
services and supplies (other than room and board and general nursing care) furnished during
a hospital stay, and will usually include:

A. Short-stay ward
B. Operating room expenses
C. Intensive care unit
D. Surgical implant and prosthesis charges

C9(I)/3.12(c)
29. Jenny is a CPF member. She can use her Medisave for mammogram screenings at approved
medical centres if her age is over ____________.

A. 40
B. 45
C. 50
D. 55

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C9(II)8.20
30. A Singaporean will qualify and receive from Interim Disability Programme for the Elderly if he
has no household income and is living in a residence with Annual Value of ______ for _____.

A. $13,000 for $250 per month

B. $14,000 for $150 per month
C. $15,000 for $150 per month
D. Nothing, as it is based on household monthly income of S$2,800 or lower.

C5/7.8
31. Danny is severely disabled; how does he qualify under Interim Disability Assistance
Programme for the Elderly (IDAPE)?

A. He must be born on 30 Sept 1932 or earlier.

B. Had pre-existing disability as of Sept 2002.
C. Unable to join ElderShield.
D. All of the above

C10/3.3
32. Which of the following section in a Health Insurance Contract must the adviser goes through
with the client to ensure no typographical error?

A. Policy Schedule
B. Insuring Clause
C. Entire Contract Clause
D. Benefit Provision

C12/2.1
33. Underwriters help the insurer assess the risk and determine whether or not to accept an
application, and if so, on what terms it will offer. Hence the role of underwriters is to
______________.

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

C10/5.19
34. The Renewal Provision in a Health Insurance Contract describes:

A. Insurer’s right to increase premium on policy.

B. Insurer’s right to change the terms of the contract.
C. Insured’s right to renew his policy under certain conditions.
D. Insured’s right to refuse renewals and for a refund of premiums.

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Health Insurance Set A

C13/2.1
35. Which one of the following is Most TRUE?
MAS Notice No: MAS 120 comprises both mandatory requirements and best practice
standards on the disclosure of information and provision of advice to policy owners for:

A. Life Policies
B. Accident and Health (A&H) Policies
C. A&H Policies and Life Policies that provides A&H benefits
D. A&H Policies, Investment- Linked policies and Universal Life policies

C11/2.2
36. Which one of the following key factors is NOT used in computing premium for Health
Insurance Products?

A. Investment Income
B. Mode of Premium
C. Extent of underwriting
D. Occupation

C11/3.13
37. Which one of the following statements about 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.

C9(II)/6.3
38. Jane bought an ElderShield 400 policy from one of the approved insurers. She subsequently
needed long-term care, but recovered after 75 months. How much can Jane received from
her ElderShield 400 policy?

A. $3,200
B. $4,800
C. $28,800
D. $30,000

C2/3.7
39. Mr. Lim is buying a policy for himself and his wife and 2 children of the same premium each.
What is the premium payable given the following?

Mr. Ang’s premium $182.31

Mrs. Ang’s premium $227.89
1 child’s premium $102.50

A. $512.70
B. $584.44
C. $615.20
D. $487

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Health Insurance Set A

C5/3.2(b)
40. Which one of the following type(s) is/are by far the most common type of Long Term Care
Insurance Plans found in Singapore?

A. Monthly Benefit Policy

B. Daily Benefit Policy
C. Annually Benefit Policy
D. Both Daily and Monthly Benefit Policies

C9(II)/6.11
41. ElderShield has a deferment period of _______ days starting from the claim date, i.e. the
date that the claim form is certified by one of the insurer’s appointed assessors.

A. 30
B. 60
C. 75
D. 90

C12/3.4
42. If Mr. Tan states in his Critical Illness Insurance proposal form that he is receiving treatment
for high blood pressure, the underwriter will most likely require a/an:

A. Financial report
B. Blood profile analysis
C. Attending physician’s statement
D. Supplementary lifestyle questionnaire

C9(I)/7.8
43. Jennie has purchased an ElderShield Supplement plan from an approved insurer. The annual
premium for this Plan is $1,300. Calculate the amount Jennie has to pay in cash.

A. 0
B. $600
C. $700
D. $1,300

C4/4.1, Eg 4.1
44. Andrew, an engineer became disabled and unable to go to work. Compute his total Disability
Income Benefit. Given the following details:
Escalation Benefit: 3%
Monthly Income: $5,000
Monthly Expense: $3,000
No of year: 30 years

A. $1,141,809
B. $1,712,714
C. $2,140,893
D. $2,854,524

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Health Insurance Set A

C12/3.41
45. Which one of the following types of underwriting is often used where the products are sold via
direct or online channel for product such as Hospital Income Plans and the applicants are
covered regardless of their health?

A. Moratorium underwriting
B. Simplified Issuance offer
C. Guaranteed Issuance offer
D. Full Medical underwriting

C13/57 (Appendix 13A)

46. An A&H insurance intermediary should institute controls, process and procedures to
effectively monitor and track switching of long-term accident and health plans. Which is true
of such process?

A. Track the volume of switches so as to identify any A&H insurance reps with an unusually
high volume of switching transactions.
B. Ensure supervisor reviewed each switch recommended.
C. Identify any unusual trends in switching transactions.
D. All of the above.

C14/3.3(b)
47. Mrs. Tan is keen to purchase Medical Insurance Product. She knows the product well and
the coverage needed. In this case, she comes under _________of the Fact-Find Document.

A. Application Type 1
B. Application Type 2
C. Application Type 3
D. Application Type 4

C7/4.11(d)
48. Cover for each individual insured employee under a Group Dental Care Insurance Policy will
automatically terminate under which event?

A. Insured enters full time military service.

B. Insured exercises one of the non-forfeiture options.
C. Insured could claim from other sources like Workmen Compensation.
D. Insured reaches age 60.

C14/4.13, Eg 14.3
49. Miss X’s monthly income and expenses are $4,000 and $3,000 respectively. She is 32 years
old, single and would like to provide for herself till retirement (55 years old) in the event of
disability. She has an existing $100,000 Whole Life Insurance. Given an inflation rate of 2%
and interest rate of 4%, calculate the maintenance cost needed.

A. $795,586
B. $571,688
C. $671,688
D. $445,530

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Health Insurance Set A

C15/2.5
50. The most suitable product for meeting Maintenance Cost is _____________.

A. Disability Income Insurance

B. Dread Disease Insurance
C. Hospital Cash Insurance
D. Managed Healthcare Insurance

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Health Insurance Set A

Answers – Set A

Question Answer Question Answer

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

Answers – Working
Ans: Qn 2
IP premium to be paid in cash = $2,500 - $600 = $1,900
ElderShield Supplement to paid in cash = $1,000 - $600 = $400
Hence total = $1,900 + $400 = $2,300 (Ans: C)

Ans: Qn 38
ElderShield400 = $400 for maximum of 72 months
Total Payout = $400 x 72 =$28,800 (Ans: C)

Ans : Qn 39
($182.31 + $227.89 + $102.5 + $102.5) X 95% (enjoy family discount of 5%) = $584.44 (Ans: B)

Ans: Qn 43
Medisave withdrawal limit = $600
Cash payment = $1,300 - $600 =$700 (ans: C)

Ans : Qn 44
$5,000 x 75% = $3,750
$3,750 X 12 x *47.5754 = $2,140,893
* 47.5754 (factor from Table A1 – 3%; 30 years) (Ans: C)

Ans: Qn 49
$3,000 x 12 = $36,000 x 18.6580 (table A2– 2%; 23 yrs)
$671,688 - $100,000 = $571,688 (Ans: B)

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