Tennessee Health Insurance Practice Exam Free - 2026

• A. 20 days
• B. 90 days
• C. 45 days
• D. 180 days

Correct answer: B. 90 days

Explanation: Tennessee's required proofs-of-loss provision requires written proof of loss to be furnished within ninety (90) days after the date of the loss (or, for periodic loss-of-time benefits, after termination of the period for which the insurer is liable). Twenty days is the notice-of-claim period, forty-five days relates to reinstatement, and 180 days is not in the statute. See Tenn. Code Ann. § 56-26-108.

• A. Immediately after denial, but no later than one year after proof of loss
• B. Not before 30 days after proof, and no later than two years after proof was required
• C. Not before 60 days after written proof was furnished, and no later than three years after the time proof was required
• D. Not before 90 days after proof, with no outside limit

Correct answer: C. Not before 60 days after written proof was furnished, and no later than three years after the time proof was required

Explanation: Tennessee's required legal-actions provision bars suit on an accident and sickness policy earlier than sixty (60) days after written proof of loss has been furnished, and bars suit brought more than three (3) years after the time written proof was required to be furnished. The one-year, two-year and no-limit alternatives, and the 30- or 90-day waiting periods, do not match the statute. See Tenn. Code Ann. § 56-26-108.

• A. There is no statutory free look for health policies in Tennessee
• B. 30 days
• C. 20 days
• D. 10 days

Correct answer: D. 10 days

Explanation: Every individual accident and health policy in Tennessee must carry a notice that the purchaser may return it within ten (10) days of its delivery and have the premium refunded if not satisfied for any reason; if returned, the policy is void from the beginning. Twenty and thirty days are not the statutory period, and a free look is statutorily required, so the 'no free look' option is wrong. See Tenn. Code Ann. § 56-26-129.

• A. Within 31 days after the date of birth
• B. Within 60 days after the date of birth
• C. Within 90 days after the date of birth
• D. Before the next policy anniversary

Correct answer: A. Within 31 days after the date of birth

Explanation: Tennessee requires health policies covering children to cover a newborn from the moment of birth, including congenital defects; if a specific premium is required for the child, the policy may require notice of birth and payment of the premium within thirty-one (31) days after birth for coverage to continue beyond that 31-day period. Sixty and ninety days and 'the next anniversary' are not the statutory deadline. See Tenn. Code Ann. § 56-7-2301(c).

• A. Only health records stored in electronic databases
• B. Only information about a patient's payment history
• C. Individually identifiable health information transmitted or maintained in any form or medium
• D. Any health statistic, even if it cannot be linked to a specific person

Correct answer: C. Individually identifiable health information transmitted or maintained in any form or medium

Explanation: PHI is individually identifiable health information that is transmitted by or maintained in electronic media or in any other form or medium, so paper and oral information qualify along with electronic records. Information that cannot identify an individual is not PHI. See 45 CFR 160.103.

• A. A disclosure to a health care provider for treatment purposes
• B. A routine internal report shared among the insurer's departments
• C. A disclosure to a business associate performing claims analysis
• D. A response to another insurer's request for underwriting records

Correct answer: A. A disclosure to a health care provider for treatment purposes

Explanation: The minimum necessary rule applies to most uses, disclosures, and requests of PHI, but it does not apply to disclosures to or requests by a health care provider for treatment, to disclosures made to the individual, or to uses and disclosures made under a valid authorization. Treatment communications need full information to be safe. See 45 CFR 164.502(b).

• A. Disclosing records to another provider for the patient's treatment
• B. Using records internally to process a claim for payment
• C. Routine health care operations such as quality review
• D. Using the individual's information for marketing communications

Correct answer: D. Using the individual's information for marketing communications

Explanation: Treatment, payment, and health care operations generally do not require authorization. Marketing, most uses of psychotherapy notes, and any sale of PHI do require a valid written authorization from the individual. See 45 CFR 164.508.

• A. All business records of any kind
• B. Electronic protected health information they create, receive, maintain, or transmit
• C. Only paper medical charts kept on site
• D. Only information posted on the entity's public website

Correct answer: B. Electronic protected health information they create, receive, maintain, or transmit

Explanation: The Security Rule applies specifically to electronic PHI: covered entities must ensure its confidentiality, integrity, and availability and protect against reasonably anticipated threats. Paper and oral PHI are protected by the Privacy Rule rather than the Security Rule. See 45 CFR 164.306.

• A. 60 days, measured from the later of the date coverage ends or the date the election notice is provided
• B. 31 days from the date of the qualifying event
• C. 90 days from the date the plan administrator is notified
• D. 45 days from the date coverage ends

Correct answer: A. 60 days, measured from the later of the date coverage ends or the date the election notice is provided

Explanation: COBRA gives qualified beneficiaries at least 60 days to elect continuation coverage, running from the later of the date coverage would end or the date the election notice is provided. The 45-day figure is a distractor: that is the deadline for making the first premium payment after electing. See 29 U.S.C. 1161-1168 (COBRA).

• A. Coverage may extend from 18 to a maximum of 29 months, and the plan may charge up to 150% of the premium during the 11-month extension
• B. Coverage may extend to 36 months at the standard 102% premium
• C. Coverage becomes free of charge for the duration of the disability
• D. Coverage may extend indefinitely as long as the disability continues

Correct answer: A. Coverage may extend from 18 to a maximum of 29 months, and the plan may charge up to 150% of the premium during the 11-month extension

Explanation: When a qualified beneficiary is disabled under Social Security rules during the first 60 days of COBRA coverage, the standard 18-month period can be extended by 11 months, to 29 months total. During the 11-month extension the plan may charge the disabled beneficiary up to 150% of the plan's cost, versus the usual 102%. See 29 U.S.C. 1161-1168 (COBRA).

• A. The employee's voluntary resignation
• B. The employee's reduction in work hours
• C. Divorce or legal separation from the covered employee
• D. The employer switching insurance carriers

Correct answer: C. Divorce or legal separation from the covered employee

Explanation: Divorce or legal separation, the covered employee's death, the employee's entitlement to Medicare, and a child's loss of dependent status each give the spouse or dependent up to 36 months of COBRA coverage. Termination of employment and reduction in hours are 18-month events, and a carrier change is not a qualifying event at all. See 29 U.S.C. 1161-1168 (COBRA).

• A. He may elect COBRA but only for 12 months
• B. Termination for gross misconduct is not a qualifying event, so no COBRA continuation coverage is required
• C. He may elect COBRA at 150% of the premium
• D. He automatically receives 18 months of employer-paid coverage

Correct answer: B. Termination for gross misconduct is not a qualifying event, so no COBRA continuation coverage is required

Explanation: COBRA's qualifying event for employees is termination of employment for reasons other than gross misconduct, or a reduction in hours. When the termination is for gross misconduct, the employer is not required to offer continuation coverage to the employee or the family. See 29 U.S.C. 1161-1168 (COBRA).