Carrillo-7

Under the mandatory uniform provision Legal Actions, an insured is prevented from bringing a suit against the insurer to recover on a health policy prior to 60 days after written proof of loss has been submitted Must wait 60 days but no later than 3 years

60 days after written proof of loss has been submitted Must wait 60 days but no later than 3 years

The conversion privilege under a group life plan allows an employee to convert to a(n)? A. family plan with another insurer B. individual plan with another insurer that has better rates C. individual plan upon employment termination D. individual policy in the spouse's name

C

Under HIPAA portability, which of the following are not pretended under required benefits? A. Pregnant women B. Mental ill C. Group of one or more

C

What does the Group Life underwriting risk selection process help protect insurance companies from? A. Risk aversion B. Natural selection C. Adverse selection D. Risk management

C

Which of the following is NOT correct concerning taxation of disability income benefits? A. If the insured paid the premiums, any disability income benefits are tax-free B. If the benefits are for a permanent loss, they are not subject to income taxation no matter who paid the premium C. If paid by the individual, the premiums are tax deductible D. If the employer paid the premiums, income benefits are taxable to the insured as ordinary income

C

All of the following are considered appropriate uses of life insurance for business purposes EXCEPT A) Attracting quality employees by offering a group life plan B) Funding an entity buy-sell agreement C) Protecting the business by covering key employees with life insurance D) Protecting the business by covering entry level employees with life insurance

D

Which of the following is a correct statement about annuities? Fixed annuities do not provide protection against inflation

Fixed annuities do not provide protection against inflation

A life insurance policy clause that prevents an insurance company from denying payment of a death after a specified period of time is known as the? Incontestability Clause

Incontestability clause

MRMIP stands for Major Risk Medical Insurance Program

Major Risk Medical Insurance Program

Which statement about medicare is not correct? a. Medicare part C covers long-term care b. Medicare part A covers long-term care

Medicare part C covers long-term care

What is required after a life agent sells an insurance policy to an applicant without being appointed by the insurer? Notice of appointment must be submitted to the Commissioner within 14 days

Notice of appointment must be submitted to the Commissioner within 14 days

An example of a third-party administrator is an: Outside organization that processes claims for an employer's self-funded group plan

Outside organization that processes claims for an employer's self-funded group plan

Which of the following describes a contributory group insurance plan? Part of the premium is paid by the employee

Part of the premium is paid by the employee

All of the following must be specified in an insurance policy EXCEPT a. The financial rating of the insurer

The financial rating of the insurer

What is the first step in submitting medicare claims? a. The medical provider submits expenses to medicare b. the patient submits expenses to medicare

The medical provider submits expenses to medicare

What effect did the Pregnancy Discrimination Act have on the health industry? Under the Pregnancy Discrimination Act, employers must treat pregnancy the same as any other medical condition.

Under the Pregnancy Discrimination Act, employers must treat pregnancy the same as any other medical condition.

Which of the following statement concerning the usual coordination of benefits provisions is correct? a.When two plans both have the provision, coverage as an employee is primary to coverage as a dependent

When two plans both have the provision, coverage as an employee is primary to coverage as a dependent

Traditional comprehensive major medial plans include all of the following EXCEPT first dollar amount

first dollar amount

It is considered an unfair method of competition for an agent to advertise that the insurer to which the agent is appointed with A- member of the Insurance Guarantee Association.

member of the Insurance Guarantee Association.

An insured had a heart attack while jogging, but is expected to return to work in approximately 6 weeks. The insured's Disability Income policy will? replace a percentage of his lost income

replace a percentage of his lost income

All of the following are examples of a Business Continuation Plan EXCEPT A) Key person insurance B) Cross-purchase agreement C) Stock Redemption Plan D) Deferred Compensation

D) Deferred Compensation

Which approach predicts a person's earning potential and determines how much of that amount would be devoted to dependents? A) Future value approach B) Earnings approach C) Needs approach D) Human life value approach

D) Human life value approach

Which of the following does the California Insurance Code NOT require an insurance policy to specify? Insurer's financial rating Policy period Premium What or who is being insured

Insurer's financial rating

Which of the following is NOT protected under the California Life and Health Guarantee Association? Policyowners Insureds Primary beneficiaries Insurers

Insurers

All of the following are true regarding the guaranteed insurability rider EXCEPT It is available automatically, for no extra premium.

It is available automatically, for no extra premium.

An individual who transacts life, disability, or life and accident and health insurance on behalf of an insurer is called a(n) adjuster analyst life agent insurance solicitor

Life agent

What is required after a life agent sells an insurance policy to an applicant without being appointed by the insurer? Notice of appointment must be submitted to the Commissioner

Notice of appointment must be submitted to the Commissioner

Which of the following is NOT a primary objective of insurance regulation? Insurance Code enforcement Licensing agents Protect policyowners Interpret policy provisions

Policy provisions

A terminated employee that has exercised the conversion privilege is able to convert: term group life coverage into permanent insurance

term group life coverage into permanent insurance

14) Because of an injury, an insured has been unable to work for 7 months. He wasn't able to pay his life insurance policy premium, yet the policy remained in force. The policy includes A- Waiver of Premium Rider B- guaranteed insurability

A

Which of the following would NOT be considered a form of direct response marketing? A sign in an insurer's office

A sign in an insurer's office

Which of the following is NOT considered to be an unfair claims settlement practice? Advising a claimant to hire an attorney Failing to provide a reasonable basis for the denial of a claim upon request Failing to adopt and implement reasonable standards for prompt investigation and processing of insured's claims Misrepresenting to insureds pertinent facts or policy provisions relating to coverage at issue

Advising a claimant to hire an attorney

Which of the following statement is true of both the fixed period and fixed amount settlement options? Both Guarantee that the Principal and Interest will be fully paid out.

Both Guarantee that the Principal and Interest will be fully paid out.

All of these are common personal uses of life insurance EXCEPT A) Pay final expenses B) Fund a child's education C) Replace an insured's income D) Fund a Buy-Sell agreement

D

Key person insurance is intended to A) allow a key person to purchase the business B) help retain key employees by offering added benefits C) give premium-grade benefits to key employees D) cover business losses due to the death of a key employee

D

Unintentional concealment entitles the injured party to which course of action? A) Possible imprisonment to the party who concealed the information B) $250 fine to be paid to the injured party C) None, given the fact that the concealment was unintentional D) Rescission of the contract

D

The California Life and Health Insurance Guarantee Association covers all of these types of policies EXCEPT Whole life Immediate annuities Disability Self-funded plans

Self-funded plans

Which of the following does NOT have to be included on life insurance policy illustrations? Age of the insured Name of the agent Statement that all values and benefits are guaranteed Name of the insurer

Statement that all values and benefits are guaranteed

Who does a life settlement broker represent?

A life settlement broker represents the individual wanting to sell their life policy to a third party.

All of the following actions are examples of risk avoidance except a. Bill won't fly in an airplane. b. Wendy keeps her money out of the stock market. c. Pat pays his insurance premium. d. John never drives a car

C

The Human Life Value concept is based on A) education level B) age C) income D) occupation

C

In health insurance the coinsurance is; A percentage paid for covered expenses by the insured and insurer after the deductible is satisfied

A percentage paid for covered expenses by the insured and insurer after the deductible is satisfied

"Life insurance creates an immediate estate". This phrase means: A) cash value has accumulated in the policy B) the insured's estate receives the death benefit C) when the insured dies, a death benefit is paid D) premiums are payable by the insured's estate

C

A tornado is an example of A. a physical hazard B. a speculative risk C. a peril D. a moral hazard

C

All of the following are characteristics of a Group Life Insurance Plan EXCEPT? A. Group underwriting B. Master contract C. Individual underwriting D. Probationary period

C

In the insurance business, risk can best be described as a. sharing the possiblity of a loss b. uncertainty regarding the future c. uncertainty regarding financial loss d. uncertainty regarding when death will occur

C

Which of the following meets the insured's personal needs, and is provided by nonmedical personnel? A. Skilled care B. Assisting living C. Custodial care

C

Which of the following will NOT be included in the buyer's guide? A. Explanation on how to choose the amount and type of insurance B. Basic information about life insurance policies C. Specific information about the policy D. Comparison of policy costs

C

Which of the following acts is NOT a Federal offense committed by an insurance agent? Embezzlement Insurance fraud Misrepresentation on an insurance application Falsify records

Misrepresentation on an insurance application

Which of the following is NOT considered to be an act of insurance solicitation? An agency sending out direct mail for a promotion An agent giving a rate quotation Airing a television commercial recommending an insurance product Publishing a magazine where one of the advertisers is an insurer

Publishing a magazine where one of the advertisers is an insurer

Which of the following individuals would be a likely candidate to purchase a deferred annuity? Someone who wants to grow retirement funds tax deferred

Someone who wants to grow retirement funds tax deferred

The family and medical leave act (FMLA) covers all of the following EXCEPT Traveling with a spouse who has been transferred overseas

Traveling with a spouse who has been transferred overseas

According to the California insurance code, all of the following long-term care (LTC) insurance sales are considered unnecessary EXCEPT a. A replacement LTC policy with equal benefits for a lower premium b. A replacement LTC policy with lower benefits for a higher premium

A

All of the following are characteristics of group health insurance plans EXCEPT: A. The parties that hold a group health insurance contract are the employees and the employer B. The cost of insuring an individual is less than what would be charged for comparable benefits under an individual plan C. Employers may require the employees to contribute to the premium payments D. The benefits under a group plan are more extensive than those under individual plans

A

All of the following are true of credit life EXCEPT: A. the insured names the beneficiary B. the death benefit cannot exceed the amount of the loan C. the premium payment is included in the loan payment D. The creditor is the policy owner

A

Factual statements about the insured or the risk in an insurance policy are considered a. express warranty b. implied warranty

A

Statistical probabilities of loss for a particular class of insured is best predicted when the insured group is? A. Older B. Large C. Diverse

B

Key person insurance can provide protection for all of the following economic losses to a business EXCEPT: A. Pay the death benefit to the estate of the insured B. Provide deferred compensation retirement benefit if the insured key person survives to retirement C. Fund the expense of finding a suitable replacement following the death of an employee D. Fund the cost of training a current employee to perform the duties of a deceased employee

A

Which of the following does NOT have to be included in the first page of a Medicare supplement policy? A. Premium rates B. Renewal provision C. Continuation provision D. The company's rights to change premium

A

Which of the following statements does not describe an element of an insurable risk? a. The loss must not be due to change. b. The loss must be definite and measurable. c. The loss cannot be catastrophic. d. The loss exposures to be insured must be large.

A

Which of the following types of insurance policies perform the cash value accumulation? A. Whole life B. Convertible C. Term life

A

Which of the following would NOT be eligible for coverage under key person? A. The owner of a shop B. The executive officer of a company C. The pharmacist in a drug store D. The manager of a small store

Answer: A The owner is the principal not the key person

All of the following are excluded from coverage in an individual health insurance policy EXCEPT: A. Treatment received in a government hospital B. Mental illness C. Experimental procedures D. Purely cosmetic surgery

Answer: B; mental illness is covered with some limitations

Which of the following is true of the taxation of cash values in a business life insurance policy? A. Cash values are tax deductible B. Cash values are not taxable C. Cash values are taxed immediately D. Cash values grow tax deferred

Answer: D taxed in the same manner as an individually owned policy

All the following are nonforfeiture options in life insurance policies EXCEPT Automatic Premium Loans

Automatic premium loans

All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT: A. Single employer with 14 employees B. An association of 35 people C. Labor union D. Multiple employer trust

B

Which of the following statements is correct? a. Only speculative risks are insurable. b. Only pure risks are insurable. c. Both pure risks and speculative risks are insurable. d. Neither pure risks nor speculative risks are insurable.

B

With a conditional renewable policy, the premiums are more likely to be? A. Flexible B. Increased C. Decreased

B

Buy-sell agreements are typically funded by which two insurance products? A) Decreasing term insurance and Workers' Compensation B) Life insurance and disability insurance C) Endowments and MedicareD) AD&D and Social Security

B) Life insurance and disability insurance

During the accumulation phase of a fixed annuity, the annuitants interest rates is based on a minimum rate as specified in the contract or the current interest rate, which ever is A. Lower B. Specified in the annuity contract C. Higher

C

As defined by the California Code of Regulations, a person who asserts a right of recovery under an insurance policy is called the A- claimant B-Agent

Claimant

Which statement regarding insurable risks is NOT correct? A. Insurance cannot be mandatory B. The insurable risk needs to be statistically predictable C. An insurable risk must involve a loss that is definite as to cause, time, place and amount. D. Insureds cannot be randomly selected.

D

Vision insurance usually limits coverage in all of the following ways EXCEPT a. A specific dollar amount for examination b. A specific dollar for glasses

a. A specific dollar amount for examination

The employee retirement income security act of 1974 (ERISA) regulates group insurance in the area of a. Disclosure and reporting

a. Disclosure and reporting

Under group disability insurance an employee is eligible for a partial disability benefit when they can? a. Perform some of their job activities on a part time basis injury

a. Perform some of their job activities on a part time basis injury

Medicare part A provides coverage for all of the following EXCEPT a. Physicians services b. hospital care

a. Physicians services

A health insurance issuer offering coverage in the individual market must provide premium rebates if its medical loss ratio (MLR) is less than what percentage? a. 70% b. 80%

b. 80%

An agent's attempt to stop the replacement of an existing life insurance policy is known as

conservation