ch 15
How can an insurer encourage participation in a wellness program?
A policy amendment Offering the employer premium credits Raising premiums for those employees who do not participate Reducing certain coverages until the employee complies
Inflation protection is not required in an LTC Partnership policy if the insured is, at the time the policy is purchased:
62 67 72 77
A license that has lapsed may be reinstated by meeting renewal requirements and paying the reinstatement fee within:
90 days 6 months 1 year 5 years
Before a contract can be entered into, all of the following must be obtained by the settlement provider, except:
A written statement from an attending physician that the insured is of sound mind A signed consent to release medical records to the settlement provider or broker and the insurance company A financial statement from the investor(s) A written statement attesting to the fact that the insured has not been coerced into entering into a viatical settlement contract
All of the following statements about an LTC policy's Outline of Coverage are true, except:
Advertisements must be true and accurate Prominently display on the first page that the policy may not cover all costs associated with long-term care incurred by the insured Include any policy limitations, restrictions or exclusions Refer applicants to the Senior Health Insurance Program for information on the Asset Preservation Program
Under a group health insurance policy:
An eligible employee is defined as an employee normally working at least 40 hours per week The employer, regardless of size, must cover all eligible employees and their dependents A small employer is defined as having up to 75 eligible employees on at least half the previous year's work days The carrier may not condition individual eligibility on medical condition, claims experience, or other evidence of insurability
Which of the following group health insurance requirements applies to small employers?
An eligible employee or dependent may be excluded if the person is a risk that would cause the carrier to increase the premium or decrease the coverage of the small employer The insurer may not offer a small employer premium credits or discounts to pressure it to participate in a wellness or disease management program The carrier must provide the same coverage for each eligible employee and his/her dependents In order for a carrier to treat any person as a late enrollee, the initial enrollment period must be at least 60 days
Benefits under a long-term care insurance policy are triggered by:
Attainment of an age specified in the policy Loss of activities of daily living or cognitive impairment Taxation of accelerated death benefits when long-term care is provided under a policy of life insurance Illness or medical condition requiring hospitalization of at least 14 days
In covering a newborn child, which of the following statements is true?
Birth defects or abnormalities may not be covered in all cases The insured may be required to notify the insurer and pay more premium There is no cost for the first 60 days for newborn coverage A newborn is no longer considered a child upon reaching age 18
Any statement regarding cost indexes must disclose they are only useful for:
Comparisons of term and whole life insurance policies Comparisons of group life policies Comparisons of costs of similar policies Comparisons of cash values
Life licensed producers are deemed to meet the licensing requirement to operate as viatical settlement brokers if they:
Have errors and omissions insurance for a minimum amount of $250,000 Pay the Commissioner a fee of $150 within 30 days from the first day of operating as a viatical settlement broker Separately apply for a license as a viatical settlement broker Have been licensed for at least 1 year prior to operating as viatical settlement brokers
In advertising for health insurance, the phrase 'this policy will help to fill some of the gaps that Medicare and your present insurance leave out' can be used only:
If there is documented evidence to support it It can never be used If the advertisement does not mention a specific carrier If the advertisement is preapproved by the Commissioner
All of the following are loss ratio requirements, except:
Ratios must be a percentage of the premium paid A copy of the insurer's financial statement Frequent rate filings are encouraged Special circumstances must exist to allow any deviation from loss ratio requirements
To operate as a viatical settlement provider or broker, which of the following statements is TRUE?
Producer must hold errors and omission coverage for at least $1 million Prior licensing as a resident or nonresident producer does not meet viatical licensing regulations A producer must first obtain a license from the Commissioner A producer is not required to notify the Commissioner, but can act as a provider or broker based on his current license to sell insurance
The purpose of the Iowa Long-Term Care Partnership Program is to:
Provide group long-term care for members of professional partnerships Allow individuals with assets to access Medicaid benefits to pay for their long-term care Assure quality long-term care by establishing standards of care Reduce Medicaid expenditures by encouraging middle-income people to buy policies to pay for their long-term care
Which of the following statements regarding skilled nursing care is TRUE?
Skilled nursing care may be used if there is no facility available within 30 miles The insurer must reimburse the insured based on the acute care rate Costs must be covered during hospitalization only for acute care Policies only need cover the facility costs
Advertisements for viatical settlement must:
State that the settlement contract is backed by state guaranty funds State the name of the life insurance company Be sufficiently complete and clear so as to avoid deception Imply that interest charged on an accelerated death benefit is unfair, inequitable, incorrect, or improper practice
At renewal, a carrier may:
Terminate spousal coverage Change the coverage provided Discontinue a plan and write a new one Prohibit a covered dependent from continuing coverage under a terminated basic health benefit plan
An individual health policy is prohibited from:
Terminating a spouse's coverage for adverse claims history Continuing coverage for a spouse if the insured dies Refunding premiums for time spent in the military Renewing a policy if material facts are misrepresented
Every insurer must develop a set of suitability standards for the sale or replacement of LTC insurance, and make them available, if requested, to which of the following?
The Insurance Commissioner The NAIC State director of Medicaid FINRA
Which of the following factors is not considered in determining whether an LTC policy is suitable for a client?
The ability to pay the premiums The amount of the commission the producer will earn The client's goals and advantages and disadvantages of insurance to meet the goals The values and benefits of the client's existing insurance
Standards for Supplemental Illustrations include all of the following, except:
The correct premium No reference to the Basic Illustration State that non-guaranteed elements are not guaranteed Show non-guaranteed elements no more favorably than the Basic Illustration
A carrier may choose to not renew a policy in which of the following instances?
The insured exceeds the number of office visits allowed by the contract Premium payments are consistently late The policy is discontinued in Iowa The insured unintentionally misstates his date of birth
Using a designation such as 'financial planner' or 'investment adviser' is prohibited unless:
The producer sells only life insurance and annuities The producer's primary insurer allows its use The producer specializes in retirement planning The producer holds a certification for the specialty
Iowa's regulation of Medicare Supplements is for all of the following purposes, except:
To standardize coverage To make policies more easily understood by the public Eliminate confusing provisions Regulate group coverage through labor organizations
