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A restorative dental procedure refers to treatments that restore the function and integrity of a tooth, typically after damage or decay. A filling is a common restorative procedure, where the dentist repairs a cavity. An extraction removes a tooth, while a root canal treats infection within the tooth, and fitting dentures replaces missing teeth, all of which are not categorized as restorative procedures but are considered reparative or replacement treatments.

Virginia Code § 38.2-4306 mandates HMO benefits, focusing on comprehensive care. Option A (wellness programs) is common, promoting prevention (e.g., smoking cessation). Option C (24-hour emergency care) is required, ensuring access via PCP coordination or direct ER services. Option D (outpatient services) is standard, covering clinic visits. Option B (discounts on local health spa memberships) isn’t a typical HMO feature; while some plans offer wellness incentives, spa discounts are ancillary, not a core benefit under Virginia law or NAIC HMO models. The study guide likely lists HMO staples (A, C, D) with examples—e.g., annual checkups (D)—contrasting them with optional perks like B, making it the exception.

An unfair claims settlement practice occurs when insurers do not properly or promptly investigate and settle legitimate claims. This is a key element of unfair practices, as insurers are required by law to act in good faith when handling claims. Failing to promptly investigate or settle legitimate claims is considered unethical and unfair, as it delays rightful compensation and causes unnecessary hardship for policyholders.

The other options may describe improper actions, but failing to promptly investigate and settle claims is more directly tied to unfair practices under the insurance regulations.

Medicare Part B covers physician services, outpatient hospital treatment, preventive services, and certain medical supplies. Inpatient hospital services fall under Part A.

Exact Extract (Virginia Medicare Study Guide): “Part B—covers outpatient hospital services, physician services, and preventive care. Part A covers inpatient hospitalization.”

References (Virginia Documents / Study Guide):

— Virginia Health Insurance Examination Outline, Medicare Part A and B Benefits