examfx life and health
10%
individuals who itemize deductions can claim deductions for medical expenses not covered by health insurance that exceed what percent of their adjusted gross income?
Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class
A guaranteed renewable health insurance policy allows the
The benefits will be coordinated
A husband and wife are insured under group health insurance plans at their own places of employment, and as dependent under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid?
Pay dividends to the policyowner
A participating insurance policy may do which of the following?
Convert to an individual health policy
A small company offers group health insurance to its employees, but recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?
disability income
A waiver of premium provision may be included with which kind of health insurance policy?
Pregnancy will be covered immediately
A woman obtains health coverage through the Marketplace on October 1. Two weeks later she finds out that she is 3 months pregnancy. Which of the following is true about coverage for pregnancy?
10 days
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?
pay the claim
An insured pays her Major Medical Insurance premium annually on March 1st. Last March she forgot to mail her premium to the company. On March 19th, she had an accident and broke her leg. The insurance company would
cash option
An insured receives an annual life insurance dividend check. What term best describes this arrangement?
Employee benefits are tax deductible the year in which they were received
Concerning group medical and dental insurance, which of the following statements in INCORRECT?
seek higher returns
Equity Indexed Annuities
Speculative Risk
Events in which a person has both the chance of winning or losing are classified as
reduction
Following a career change, an insured is no longer required to perform many physical activities, so he has implemented a program where he walks and jogs for 45 minutes each morning. The insured has also eliminated most fatty foods from his diet. Which method of dealing with risk does this scenario describe?
20% of covered charges above the deductible
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?
Nonpayment of premium
For which of the following reasons may an insurer terminate a small employer health insurance policy?
2
How many names (real or fictitious) may insurers have?
Within 90 days or as soon as reasonably possible, but not to exceed 1 year
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insuring company?
30
If a licensee changes his or her residence address, within how many days must the department be notified?
Guaranteed Insurability Rider
If a life policy allows the policyowner to make periodic additions to the face amount at standard rates, without proving insurability, the policy includes a
Cold Lead Advertising
Making use directly or indirectly of any methods of marketing which fail to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contract will be made by an insurance agent or insurance company is known as
6 credits
Minimum number of credits required for partially insured status for Social Security disability benefits is
attending physician
Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?
Promptly forwarding premiums to the insurance company
Pertaining to insurance, what is the definition of a fiduciary responsibility?
100%
S is a sole business proprietor who owns a medical expense plan. what percentage of the cost of the plan may he deduct?
By state and local governments
Services provided by the Health Insurance Counseling and Advocacy Program are paid for
Notice Regarding Replacement
Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the
Annually Renewable Term
The death protection component of Universal Life Insurance is always..
Part A
The part of Medicare that helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care, is known as
Reduction of premium
The policyowner pays for her life insurance annually. Until now, she has collected a nontaxable dividend check each year. She has decided that she would rather use the dividends to help pay for her next premium. What option would allow her to do this?
Fiduciary Responsibility
The requirement that an agent not co-mingle insurance monies with their own funds is known as
Probationary period - Waiting Period - Benefit Period
Three time periods are common in medical expense policies. Which of the following is the normal chronological order of their occurrence?
The name of the writing agent
Under a group plan, Certificates of Insurance all of the following EXCEPT
PPO (Preferred Provider Organization)
Under which of the following organizations are the practicing providers compensated on a fee-for-service basis?
Premiums always stay the same
Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT
The beneficiary will only receive payments of the interest earned on the death benefit.
Upon the death of the insured, the primary beneficiary discovers that the insured chose the interest only settlement option. what does this mean?
Attending Physician's Statement
What document describes an insured's medical history, including diagnoses and treatments?
Early detection through regular checkups
What is the goal of the HMO?
ownership
What is the major difference between a stock company and a mutual company?
To cover the expenses of retraining the insured to return to work
What is the purpose of the rehabilitation benefit in disability insurance?
money borrowed from the cash value is taxable
Which of the following is NOT true regarding policy loans?
The insurance contract
Which of the following is an agreement between an insured and an insurer, where the insurer agrees to indemnify the insured for specific losses in exchange for a premium?
loss of two limbs
Which of the following is considered a presumptive disability under a disability income policy?
Agent in charge must be licensed
Which of the following is true regarding branch agency licensing?
Dividends are not taxable
Which of the following is true regarding taxation of dividends in participating policies?
Monthly
Which of the following premium modes would result in the highest annual cost for an insurance policy?
Elderly insureds
Who does the secondary notice provision protect?
"own occupation" - less restrictive than other definitions
a brain surgeon has an accident and develops tremors in her right arm. which of the disability
limited-pay life
an insured has a life insurance policy that requires him to only pay premiums for a specific number of years until the policy is paid up
occupational
an insured has health insurance that covers them at work and at home. this policy has written on what basis?
the insured was in compliance with the policy requirements regarding claims.
an insured submitted a notice of claim to the insurer, but never received claims forms. he later submits proof of loss, and explains the nature and extent of loss in a hand-written letter. which of the following is true?
100%
for group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?
policyowner
if the policyowner, the insured, and the beneficiary under a life insurance policy are three different people, who has the ownership right?
control health insurance claims expenses
the purpose of managed care health insurance is to
30
what is the maximum age for qualifying for a catastrophic plan?
the policyowner has the right to change beneficiaries in any case
which of the following statements regarding the Change of beneficiaries provision is false?
pregnancy will be covered immidiately
A woman obtains health coverage through the Marketplace on October 1. Two weeks later she finds out that she is 3 months pregnant. Which of the following is true about coverage for pregnancy?
change of beneficiary
Alexander has a policy with his ex-wife as its beneficiary. What provision allows him to change the beneficiary to his new wife?
Speaking
All of the following are activities of daily living EXCEPT
Diagnosis must indicate that death is expected within 3 years
All of the following are features and requirements of the Living Needs Rider EXCEPT
Beneficiary's age
All of the following information about a customer must be used in determining annuity suitability EXCEPT
Guaranteed issue
All small employer group health plans, in order to comply with the requirements of the Florida Employee Health Care Access Act, must be issued on what basis?
Prepaid Basis
An HMO is regarded as an organized system of health care that provides a comprehensive array of medical services on a
The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off
An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true?
It will increase because the insured will be 5 years older than when the policy was originally purchased.
An insured buys a 5-year level premium term policy with a face amount of $10,000. The policy also contains renewability and convertibility options. When the insured renews the policy in 5 years, what will happen to the premium?
$50,000
An insured owns a $50,000 whole life policy. At age 47, the insured decides to cancel his policy and exercise the extended term option for the policy's cash value, which is currently $20,000. What would be the face amount of the new term policy?
Revocable
An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?
12 credits
If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?
Medicare pars its share of the bill directly to the provider
In a situation when a Medicare insured uses the services of a non-participating provider, which of the following is NOT true?
Is not covered
In health insurance, if a doctor charges $50 more than what the insurance company considers usual, customary, and reasonable, the extra cost
Occasional nursing or rehabilitative care
In long-term care insurance, what type of care is provided with intermediate care?
100
In order for a debtor group to qualify for group life insurance, what should the minimum number of participants joining the plan every year?
Rates by class
Insurers may change which of the following on a guaranteed renewable health insurance policy?
Protecting the insurer against adverse selection
Profitable distribution of exposures serves the purpose of
Needs substantial hands on or standby assistance with ADLs.
Qualified long-term care policies covering home care must provide benefits if the insured is impaired in at least two of the six activities of daily living (ADL). The term "impaired" means
21 days
The Department of Insurance contacts an agent about a claim that was settled two months ago. Within what timeframe must the agent issue a complete response?
Expenses
The factor added to the net premium to cover the costs of the insurer in obtaining and maintaining the business is called
Americans with Disabilities Act
The federal act which mandates that "all personnel actions must be unrelated to either the existence or consequence of disability to include recruitment and selection of employees, compensation of employees, training, and all terms, conditions and privileges of employment" is known as
if the representation is false in a material point
The key factor of representation that allows the injured party to rescind the contract is
The policyowner can specify the way proceeds are split in the policy
The owner of a life insurance policy wishes to name two beneficiaries for the policy proceeds. What will the soliciting insurance producer say?
24 months
The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to their average income over the last
Increasing Term
What type of insurance would be used for a Return of Premium rider?
For 31 days.
When an employee terminates coverage under a group insurance policy, coverage continues in force
for 31 days
When an employee terminates coverage under a group insurance policy, coverage continues in force
November 1 through January 31
When is the annual open enrollment for state insurance exchanges?
Investigative Consumer Report
Which document is used to assess risk associated with an applicant's lifestyle and character?
$5,000
an insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay?
revocable
an insured wants to name her husband as the beneficiary of her health policy. she also wishes to retain all of the rights of ownership. the insured should have her husband named as what type of beneficiary?
Conversion
if an employee terminates her employment, which of the following provisions would allow her to continue health coverage under and individual policy, if requested within 31 days?
The death benefit will be smaller
if an insured withdraws a portion of the face amount
unilateral
if only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it?
insurable interest
stranger-oriented life insurance policies are in direct opposition to the principle of
owner's income
traditional IRA contributions are tax deductible based on which of the following?
premiums are tax deductible and benefits are not taxed
which of the following is correct regarding the taxation of group medical expense premiums and benefits?
Work-related disability
workers compensation insurance covers a worker's medical expenses resulting from work related sickness or injuries and covers loss of income from
Funds exceeding the premium paid are taxable as ordinary income.
Which is TRUE about the cash surrender nonforfeiture option?
Extended Term
Which nonforfeiture option has the highest amount of insurance protection?
reduced paid-up
Which nonforfeiture option provides coverage for the longest period of time?
Presuming the applicant is eligible for Medicaid, based on the nature of the policy
Which of the following is NOT among the goals of a Medicare supplement application?
Automatic Premium Loan
Which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium?
The larger the percentage that is paid by the insured, the lower the required premium will be
Which of the following statements is true regarding coinsurance?
Withdrawals are not taxable
Which of the following statements regarding the taxation of Modified Endowment Contracts is FALSE
Termination of employment due to downsizing
Which of the following would be a qualifying event as it relates to COBRA?
Option B
Which option for Universal life allows the beneficiary to collect both the death benefit and cash value upon the death of the insured?
face amount
Which policy component decreases in decreasing term insurance?
Family Term Rider
Which rider, when attached to a permanent life insurance policy, provides an amount of insurance on every family member?
An individual not covered by an employer-sponsored plan who has earned income
Who can make a fully deductible to a traditional IRA?
Insurer
Who must pay for the cost of a medical examination required in the process of underwriting?
Payment of premium
With respect to the consideration clause, which of the following would be considered consideration on the part of the applicant for insurance?
join the group after the effective date
in a group health policy, a probationary period is intended for people who
No tax
in an individual long-term care insurance plan, the insured is able to deduct the premiums from taxes. What income taxation will be imposed on the benefits received?
Both a life insurance license and a securities license
what license or licenses are required to sell variable annuities?
when the expenses exceed a certain percentage of the insured's adjusted gross income
when may an insured deduct unreimbursed medical expenses paid under a long term care policy
Payment is limited to a certain period of time
which of the following applies to partial disability benefits
present earnings and earnings prior to disability
which of the following are the main factors taken into account when calculating residual disability benefits
policyowner
which of the following individuals must have insurable interest in the insured?
Premiums are tax-deductible
Which of the following is CORRECT regarding Business Overhead Insurance?
Coverage for dependents
Which of the following is NOT an exclusion in medical expense insurance policies?
it does not have limits on contributions
Which of the following is NOT true regarding a flexible spending account?
premiums are not tax deductible, and benefits are not taxable
which of the following describes taxation of individual disability income insurance premiums and benefits?
special risk policy
Which of the following special policies covers unusual risks that are NOT normally included under Accidental Death and Dismemberment coverage?
10%
An annuity contract is issued to a senior consumer over age 65. What is the maximum surrender charge for a withdrawal of money allowed on this annuity?
Consideration Clause
An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she had not met the conditions specified in the
Students at a public school
Which of the following groups would most likely be covered under a blanket accident policy?
this is a form of insurance that covers part time workers
Which of the following is NOT true regarding partial disability?
Money borrowed from the cash value is taxable
Which of the following is NOT true regarding policy loans?
a permanent resident lawfully present in the U.S.
which of the following individuals will be eligible for coverage on the Health Insurance Marketplace?
to allow the consumer to compare the costs of different policies
what is the purpose of the buyer's guide?
The capital amount in a lump sum
An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?
Offer the supplement policy on a guaranteed issue basis
An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare part A and B. what is the insurance company obligated to do?
Florida Healthy Kids
Which of the following government health programs provides health insurance coverage to children who do not have access to adequate health care services?
the insurance through his company is primary
a man works for company A and his wife works for company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim
To purchase a smaller amount of the same type of insurance as the original policy.
the paid-up option uses the dividend
The insured's estate
the sole beneficiary of a life insurance policy dies before the insured. if the policyowner fails to change the beneficiary before the insured's death. the proceeds of the policy will go to
a presentation of nonguaranteed elements of a policy
the term "illustration" in a life insurance policy refers to
Subrogation
the transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses?
flexible
what type of premium do both Universal Life and Variable Life policies have?
