Examfx 2
A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT a) Income. b) Eyesight. c) Limb. d) Life.
a
An individual is insured under his employer's group Disability Income policy. The insured suffered an accident while on vacation that left him unable to work for 4 months. If the disability income policy pays the benefit, which of the following would be true? a) Benefits that are attributable to employer contributions are fully taxable to the employee as income. b) The insured has to wait 2 more months to start receiving the benefits. c) For the business, payments are not considered tax deductible as an ordinary business expense. d) The insured can deduct his medical expense benefits from his income tax.
a
An insurance company wants to obtain the insurance history of an applicant. Which source releases coded information to insurers regarding information included on previous insurance applications? a) Medical Information Bureau b) Insurer's Protection Guild c) Integrated Insurer's Support d) Federal Bureau of Investigation
a
Circulating deceptive sales material to the public is what type of Unfair Trade Practice? a) False advertising b) Defamation c) Coercion d) Misrepresentation
a
For how many days of skilled nursing facility care will Medicare pay benefits? a) 100 b) 30 c) 60 d) 90
a
In disability income insurance, the own occupation definition of disability applies a) For the first 2 years of a disability. b) During the waiting period. c) During the elimination period. d) As long as an individual is unable to work.
a
In which of the following health plans are benefit payments attributed to employer contributions taxable to the employee? a) Group Disability Income b) AD&D c) Disability Buy Out d) Medical Expense
a
The benefits received by the business in a Disability Buy-Sell policy are a) Income tax free. b) Tax deductible. c) Partially taxable. d) Fully taxable.
a
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan? a) Diagnostic and preventive care b) A broad coverage area c) A low monthly premium d) Low cost deductibles
a
. If an employee terminates her employment, which of the following provisions would allow her to continue health coverage under an individual policy, if requested within 31 days? a) Renewability b) Conversion c) Replacement d) Grace period
b
A small business owner is the insured under a disability policy that funds a buy-sell agreement. If the owner dies or becomes disabled, the policy would provide which of the following? a) Disability insurance for the owner b) Cash to the owner's business partner to accomplish a buyout c) The rent money for the building d) The business manager's salary
b
All of the following actions can be described as twisting EXCEPT a) Making an incomplete comparison between the existing and proposed policies b) Explaining to client the advantages of permanent insurance over term and suggesting changing policies c) Misrepresenting the terms and conditions of the existing policy to make the new one more attractive d) Embellishing the terms of the proposed policy in order to convince the insured to switch
b
All of the following are true of the Key Person disability income policy EXCEPT a) The income may be used to find a replacement for the key employee. b) Benefits are considered taxable income to the business. c) Premiums are not deductible to the business. d) It is typically written to cover key employees in the event they become disabled and are unable to work.
b
Federal law makes it illegal for any individual convicted of a crime involving dishonesty or breach of trust to work in the business of insurance affecting interstate commerce a) Without receiving written consent from a Federal Judge. b) Without receiving written consent from an insurance regulatory authority. c) Under any circumstances. d) Unless they have served an appropriate prison sentence.
b
The expense for an autopsy covered under the physical exam and autopsy provision is paid by a) The estate of the insured. b) The insurer. c) The state's autopsy fund. d) The limits of coverage under the health insurance policy.
b
What is the contract provision that allows the insurer to nonrenew health coverage if certain events occur? a) Guaranteed renewable b) Conditionally renewable c) Optionally renewable d) Noncancellable
b
What type of information is NOT included in a certificate of insurance? a) The length of coverage b) The cost the company is paying for monthly premiums c) The policy benefits and exclusions d) The procedures for filing a claim
b
Which of the following is NOT a cost-saving service in a medical plan? a) Risk sharing b) Denial of coverage c) Preventive care d) Second surgical opinions
b
Which of the following is NOT covered under Plan A in Medigap insurance? a) The first three pints of blood each year b) The Medicare Part A deductible c) Approved hospital costs for 365 additional days after Medicare benefits end d) The 20% Part B coinsurance amounts for Medicare approved services
b
Which of the following is the basis for a claim against an insurance policy? a) Misrepresentation b) Loss c) Material change d) Hazard
b
Which statement regarding insurable risks is NOT correct? a) An insurable risk must involve a loss that is definite as to cause, time, place and amount. b) Insureds cannot be randomly selected. c) Insurance cannot be mandatory. d) The insurable risk needs to be statistically predictable.
b
. Which provision states that the insurance company must pay Medical Expense claims immediately? a) Legal Actions b) Relation of Earnings to Insurance c) Time of Payment of Claims d) Payment of Claims
c
A disability income policy is written with a 10-month benefit period, a 30-day elimination period, and a 30-day probationary period. If the insured becomes disabled due to illness 9 days after the effective date, the policy will pay benefits for a maximum of a) 21 days. b) 6 months. c) 10 months. d) 270 days.
c
Health insurance underwriting is best defined as a) Issuance of policies. b) Reporting and rejection of risks. c) Selection, classification, and rating of risks. d) Transacting of insurance.
c
Items stipulated in the contract that the insurer will not provide coverage for are found in the a) Benefit Payment clause. b) Consideration clause. c) Exclusions. d) Insuring clause.
c
What is the maximum penalty for habitual willful noncompliance with the Fair Credit Reporting Act? a) $100 per violation b) Revocation of license c) $2,500 d) $1,000
c
Which of the following acts is NOT considered to constitute an act of transacting insurance? a) Execution of an insurance contract b) Contract negotiations c) Filing forms with the Department d) Solicitation of an insurance contract
c
Which of the following factors about the insured determines the amount of disability benefit that the insured will receive? a) Marital status b) Age c) Income d) Gender
c
Which of the following is true of a PPO? a) Claim forms are completed by members on each claim. b) No copayment fees are involved. c) Its goal is to channel patients to providers that discount services. d) A most common type of PPO is the staff model.
c
Which statement accurately describes group disability income insurance? a) There are no participation requirements for employees. b) Short-term plans provide benefits for up to 1 year. c) The extent of benefits is determined by the insured's income. d) In long-term plans, monthly benefits are limited to 75% of the insured's income.
c
Which statement best defines a Multiple Employer Welfare Arrangement (MEWA)? a) A government health plan that provides health care for the unemployed b) A group health plan that covers medical expenses arising from work related injuries c) A joining together by employers to provide health benefits for employee d) A plan that provides hospice care for terminally ill employees
c
new employee who meets HIPAA eligibility requirements must be issued health coverage on what basis? a) Nondiscriminatory b) Indemnity c) Guaranteed d) Noncancellable
c
At what point must an Outline of Coverage be delivered? a) At any point up to 30 days after policy delivery b) At the time of application only c) Upon delivery of the policy only d) At the time of application or upon delivery of the policy
d
Every order by the Commissioner suspending any insurance license must specify the period during which the suspension will be effective and may not last longer than a) 18 months. b) 2 years. c) 6 months. d) 12 months.
d
Most insurers issue health insurance policies for delivery in many states. Because each state regulates and mandates the requirement for policies delivered to their residents, instead of having a policy form for each state, the insurer attaches a) Miscellaneous optional provision. b) A waiver of other state requirements. c) Nothing. An insurer's policy only needs to conform to the regulations of the state where the insurer is domiciled. d) Conformity with State Statutes provision.
d
The provision that states that both the printed contract and a copy of the application form the contract between the policyowner and the insurer is called the a) Certificate of insurance. b) Aleatory contract. c) Master policy. d) Entire contract.
d
What is the elimination period for Social Security disability benefits? a) 6 months b) 12 months c) 3 months d) 5 months
d
Which of the following is INCORRECT concerning Medicaid? a) It provides medical assistance to low-income people who cannot otherwise provide for themselves. b) It pays for hospital care, outpatient care, and laboratory and X-ray services. c) The federal government provides about 56 cents for every Medicaid dollar spent. d) It is solely a federally administered program.
d
Which of the following is true regarding METs? a) They make deals with local hospitals to provide low cost coverage to the needy. b) They provide insurance for larger corporations. c) They provide insurance companies with medical information on applicants. d) They allow several small employers purchase less expensive insurance together.
d
