Wyoming Health Insurance Practice Exam Free - 2026

• A. Within 15 days
• B. Within 30 days
• C. Within 45 days after receipt of the proofs of loss and supporting evidence
• D. Within 60 days

Correct answer: C. Within 45 days after receipt of the proofs of loss and supporting evidence

Explanation: Wyo. Stat. § 26-15-124(a) requires claims under life, accident or health policies to be rejected or accepted and paid within forty-five days after receipt of the proofs of loss and supporting evidence, with an exception for health claims whose validity or amount is referred to the Wyoming state medical peer review committee. A's 15 days is the appointment filing period. B's 30 days is the guaranty-association claim window and address-change period. D's 60 days is the nonforfeiture election period for life policies. See Wyo. Stat. § 26-15-124.

• A. Newborn after 31 days; adopted child on the final decree of adoption
• B. Newborn from the moment of birth; adopted child on the final decree of adoption
• C. Both children only after the insurer receives notice and any added premium
• D. Newborn from the moment of birth; adopted child from the earlier of the petition filing date or entry into the adoptive home

Correct answer: D. Newborn from the moment of birth; adopted child from the earlier of the petition filing date or entry into the adoptive home

Explanation: Wyo. Stat. § 26-20-101 requires individual and group health policies covering family members to pay children's benefits automatically for a newly born child from the moment of birth and for an adopted child from the earlier of the date the adoption petition is filed or the child's entry into the adoptive home (final decree governs only for children in state custody); § 26-20-102 includes congenital defects and pre-placement conditions. A wrongly delays newborn coverage. B misstates the adoption trigger for a child not in state custody. C makes coverage contingent on notice, which the statute does not do. See Wyo. Stat. § 26-20-101.

• A. Twisting: making a misrepresentation or incomplete comparison to induce a policyholder to lapse, forfeit, surrender or exchange a policy
• B. Rebating: giving valuable consideration not specified in the contract
• C. Defamation: making statements derogatory to an insurer's financial condition
• D. Controlled business: writing insurance principally on his own interests

Correct answer: A. Twisting: making a misrepresentation or incomplete comparison to induce a policyholder to lapse, forfeit, surrender or exchange a policy

Explanation: Wyo. Stat. § 26-13-105 defines twisting as making any written or oral statement misrepresenting or making incomplete comparisons of policy terms, conditions or benefits to induce a policyholder to lapse, forfeit, surrender, retain, exchange or convert a policy, which is exactly Cole's incomplete comparison. B (rebating, § 26-13-110) involves inducements of value, not comparisons. C (defamation, § 26-13-107) concerns false statements about an insurer's financial condition. D (controlled business, § 26-9-226) concerns a license used mainly to insure the producer's own interests. See Wyo. Stat. § 26-13-105.

• A. None; only the one-time evaluation and training is mandated
• B. Additional medically necessary training limited to 3 hours per year
• C. Unlimited training as long as it is prescribed
• D. Up to 10 hours per year

Correct answer: B. Additional medically necessary training limited to 3 hours per year

Explanation: Wyo. Stat. § 26-20-201(a) requires coverage of diabetes equipment, supplies and outpatient self-management training, limited to a one-time evaluation and training program when medically necessary within one year of diagnosis, plus additional medically necessary training on a significant change in symptoms, condition or treatment, limited to three hours per year. A ignores paragraph (a)(ii). C ignores the express three-hour cap. D states a figure that does not appear in the statute. See Wyo. Stat. § 26-20-201.

• A. Charging different rates based on legitimate risk factors
• B. Charging lower premiums than competing insurers
• C. Offering different policy types
• D. Treating similarly situated individuals differently based on prohibited factors

Correct answer: D. Treating similarly situated individuals differently based on prohibited factors

Explanation: Unfair discrimination occurs when an insurer treats similarly situated individuals differently based on factors not related to risk, such as race, religion, or national origin, rather than legitimate underwriting factors.

• A. An ethical obligation to recommend coverage that suits the client's needs
• B. A fiduciary duty to hold the client's premium payments in a separate trust account
• C. A legal obligation to recommend the policy that produces the highest commission
• D. An obligation to recommend the plan with the broadest benefits regardless of cost

Correct answer: A. An ethical obligation to recommend coverage that suits the client's needs

Explanation: A producer is expected to act honestly and recommend coverage that fits the client's needs, rather than steering the sale toward the highest commission or the most expensive product. In agency law the producer legally represents the insurer, and a binding legal best-interest standard applies only in specific contexts such as annuity suitability rules. The separate term fiduciary responsibility usually refers to holding premium funds in trust without commingling them.

• A. A schedule of usual and customary charges for covered services
• B. A list of network providers a member may use for care
• C. A list of prescription drugs covered by a health plan
• D. A list of pre-existing conditions excluded from a health plan

Correct answer: C. A list of prescription drugs covered by a health plan

Explanation: A formulary is a list of prescription drugs covered by a health insurance plan. Drugs are often organized into tiers, with different cost-sharing amounts for each tier.

• A. Requiring plan approval before a specialty drug is dispensed
• B. Limiting the quantity of a drug a member may fill in a given period
• C. Charging progressively higher copayments as drugs move up formulary tiers
• D. Requiring trial of lower-cost drugs before more expensive options

Correct answer: D. Requiring trial of lower-cost drugs before more expensive options

Explanation: Step therapy requires patients to try one or more lower-cost medications (typically generics) before the plan will cover a more expensive brand-name drug for a condition.

• A. Coverage for assistance with daily living activities when unable to care for oneself
• B. Coverage that replaces lost income when a disability keeps the insured from working
• C. Coverage for extended inpatient hospital stays beyond major medical benefit limits
• D. Coverage that pays the gaps left by Medicare for physician and hospital deductibles

Correct answer: A. Coverage for assistance with daily living activities when unable to care for oneself

Explanation: Long-term care insurance covers services needed when a person cannot perform activities of daily living (like bathing, dressing, eating) due to chronic illness, disability, or cognitive impairment.

• A. Household tasks such as shopping and managing money and medications
• B. Basic self-care tasks used to measure need for long-term care
• C. Skilled nursing services ordered by a physician for a chronic condition
• D. Cognitive tests used to diagnose dementia before benefits are paid

Correct answer: B. Basic self-care tasks used to measure need for long-term care

Explanation: Activities of daily living (ADLs) are basic self-care tasks including bathing, dressing, eating, toileting, transferring (moving), and continence. Inability to perform ADLs often triggers long-term care benefits.

• A. The waiting period that must pass before benefits begin
• B. The event that causes premiums to be waived during a claim
• C. The criteria that must be met before benefits are paid
• D. The maximum number of days for which benefits will be paid

Correct answer: C. The criteria that must be met before benefits are paid

Explanation: A benefit trigger is the condition that must be met before long-term care insurance benefits begin. Common triggers include inability to perform a certain number of ADLs or cognitive impairment.

• A. Requiring every health plan to offer mental health benefits as a covered service
• B. Requiring equal premium rates for members with and without a mental health diagnosis
• C. Requiring mental health screening before a policy is issued to an applicant
• D. Requiring equal coverage for mental health as for medical/surgical conditions

Correct answer: D. Requiring equal coverage for mental health as for medical/surgical conditions

Explanation: Mental health parity means that when a plan does cover mental health and substance use disorder benefits, the financial requirements and treatment limitations applied to them may be no more restrictive than those applied to medical and surgical benefits. Parity does not by itself require a plan to offer mental health coverage; that obligation comes from the essential health benefits rules for individual and small group plans.