ExamFX

Producer'slicense has been non-renewed how long does a producer have to request a hearing

10 days

What is the minimum required free look. For Medicare supplement policies in the state

30

BRONZE

60%

It is considered an unfair claim settlement practice to pay a claim in full within how many days from the claimants filing of the proof of loss

90

A guranteed renewal disability insurance policy A) Is renewable at the insured's option to a specified age B) Is renewable at the option of the insurer to a specified age of insured C) Is guranteed to have a level premium for the life of the policy D) Cannot be canceled by the insured before the age of 65

A

A new law requires a policy to increase benefits AND increase premiums. Which is tru about the policy changes? A) The policyholder is not required to agree to the changes B) The policy is not subject to the new law because of "grandfathering" C) The policy is null and void D) The policyholder must agree to the change in writing

A

A noncontributory grop disability income plan has a 30-day waiting period and offers benefits of $2,000 a month. If an employee is unable to work for 7 months due to a covered disability, the employee will receive A) $12,000, all of which is taxable B) $14,000, none of which is taxable C) $14,000, all of which is taxable D) $12,000, none of which is taxable

A

A producer's license has been nonrenewed. How long does the producer have to request a hearing? A) 10 days B) 15 days C) 30 days D) 45 days

A

A waiver of premium provision may be included with which kind of health insurance policy? A) disability income B) Basic medical C) hospital indemnity D) dread disease

A

All of the following are unfair claims settlement practices EXCEPT A) Suggesting negotiations in settling the claim B) Refusing to pay claims without conuding resaonable investigation C) Failing to adopt and implent reasonable standards for settling claims D) Failing to acknowledge pertinent communication regarding a claim

A

All of the following events will terminate a producer's crtificate of appointment EXCEPT A) A new commissioner is put into office B) A producer's license expires and is not renewed C) A termination issued by the appointing insurer D) A producer's license is suspended or revoked by the Department of Insurance

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, whihc of the following would be true? A) Benefits that are attributable to employer contributions are full taxable to the employee as income B) The insured has to wait 2 more months to start receiving 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 insured is covered by a disability income policy that contains an accidental means clause. The insured exits a bus by jumping down the steps and breaks an ankle. What coverage will apply? A) No coverage will apply since the injury could have been forseen B) No coverage will apply, since disability income policies cover sickness only C) Coverage will apply since the break was accidental D) Coverage will apply, but will be reduced by 50%

A

An insured purchased a noncancellable health plan 1 year ago. Which of the following circumstances would NOT be a reason for the insruance company to cancel the policy? A) The insured is in an accident and incurs a large claim B) The insured does not pay the premium C) The insured reaches the maximum age limit specified in the policy D) Within 2 yers of the application, the insurer discovers a misrepresentation

A

An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principles has the insurer violated? A) Consideration B) Good Faith C) Represenation D) Adhesion

A

Assuming that all of the following perople are covered by High Deductible Health Plan and are not claimed as dependents on anyone's tax returns, which would NOT be elegible for a Health Service Account? A) Amanda is 67 and is covered by a basic medical expense policy B) Andy is 55 and is covered under a dental care policy C) Jenny is 60 and also has a long-term insurance plan D) Joe is 40 and is not covered by any other health insurace

A

Because an insurance is a policy is legal contract, it must conform to the state laws governing contracts which require all of the following elements EXCEPT A) Conditions B) Consideration C) Legal purpose D) Offer and acceptance

A

Concerning Group and Dental insurance, which of the following statements is INCORRECT? A) Employee benefits are tax deductible the year in which they were received B) Benefits received by the employee are free from federal income tax C) Premiums paid by the employer are deductible as a business expense D) Employee paid premiums may be deducted if certain conditions are met

A

How long is an open enrollment period for Medicare supplement policies A) 6 months B) 1 year C) 30 days D) 90 days

A

If an insurance company wishes to order a consumer report in an applicant to assist in the underwriting process, and if a notice of insurance information practices has been provided, the report may contain all of the following information EXCEPT the applicants A) Ancestry B) Credit History C) Habits D) Prior insurance

A

In a basic expense policy, after the limits of the basic policy are exhausted, the insured must pay what kind of deductible? A) Corridor B) Full C) HAlf D) None

A

In an individual long-term care insurance plan, the insured is able to deduct the premiums from taxes. What incoem taxation will be imposed on the benefits received? A) No tax B) Tax deductible C) State income tax D) Federal income tax

A

In long-term care (LTC) policies, as the benefit period lengthens, the premium A) Increases B) Remains unchanged C) LTC premiums are not bases on benefit periods D) Decreases

A

Long-term care coverage may be available as any of the following options except A) Endorsement to a health policy B) Group long-term care C) Individual long-term care D) Endorsement to a life policy

A

Regarding a PPO, which of the following is correct when selecting a primary care physician? a) The insured may choose medical providers not found on the preferred list and still retain coverage b) The insured is allowed to receive care from any provider, but if the insured select a PPO provider, the insured will realize lower out of pocket costs c) If a non-network provider is used, the insured's out-of-pocket costs will be higher d) All of the above are true

A

Social Security supplement (SIS) or social security riders would provide for the payment of income benefits in each of the situation is below except A) When the amount payable under Social Security is more than the amount payable under the rider B) When used to replace or supplement benefits payable under other social insurance programs C) When the insured is eligible for Social Security benefits but before the benefits begin D) If the insured has been denied coverage under Social Security

A

The primary purpose of disability income insurance is two A) Replace income loss due to a Isabella B) Reimbursed medical expenses and or loss income due to accidents at work C) Reimburse lost income while in the hospital D) Reimbursed loss of income to a family due to the death of the insured

A

To comply the Fair Credit Reporting Act, when must a producer notify an applicant that a credit report may be requested? A) At the time of application B) When the applicants credit is checked C) When the policy is delivered D) At the initial interview

A

Under what condition are group disability income benefits received an employee not taxable as income A) When the benefits received are equal or less than the employees percentage of the contribution B) When the employer makes all the premium pay C) When the employee is 59 1/2 years old D) When the amount of the benefit is equal or less than the amount of contributed by the employer

A

Under workers compensation, which of the following benefits are NOT included A) Legal benefits B) Medical and rehabilitation benefits C) Income benefits D) Death benefits

A

What is NOT a benefit of a POS plan? A) IT allows guranteed acceptance of all applicant's B) It allows employees to use an HMO provider doctor C) It allows the employee to use a doctor not covered by the HMO D) With the POS plan the emplyees do not have to make a decision between the HMO or PPO plans that lock them in

A

What is the initial period of time specified in a disability income policy that must pass after the policy is in force before a loss can be covered A) Probationary period B) Contestable period C) Elimination period D) Grace period

A

What phase begins after a new policy is delivered? A) Free-look period B) Insurability period C) Elimination period D) Grace period

A

Which is the typical deducible for basic surgical expense insurance A) $0 B) $100 C) $200 D) $500

A

Which of the following determines whether disability insurance benefits are taxed? A) Whether the premiums were tax deductibl B) State satutes C) Contract provisions D) If the total of benefits paid meets the minimum state taxation standard

A

Which of the following in a NONPROFIT organization with physicians, dentist for medical or surgical services. A) Medical Service Corporation B) Health Maintenance Organization C) Health Service Corporation D) Hospital Service Corporation

A

Which of the following is INCORRECT conering Medicaid? A) It is solely a federally administered program B) It provides medical assistance to low-income people who cannot otherwise provide for themselves C) It pays for hospital care, outpatient care, and laboratory and X-Ray services D) The federal government provides about 56 cents for every MEdicaid dollar spent

A

Which of the following is NOT considered misrespresentation as it pertains to unfair trade practices? A) Making comparisons between different policies B) Stating that the insurance policy is a share of stock C) Exaggerating the benefits provided in the policy D) Stating that the competitors will arbitrarily increase their premiums each year

A

Which of the following is NOT true regarding Worker's Compensation A) Benefits are offered by the insurer B) Benefits are not regulated by the federal government C) Benefits vary from state to state D) Benefits are regulated by the state government

A

Which of the following is an individual accident and sickness insurance policy that is marketed primarily as a supplement to reimbursments under Medicare for the hospital, medical, or surgical expenses are insureds after the age of 65 A) Medicare Supplement Policy B) Medicare SELECT C) Medicaid D) Social Security disability

A

Which of the following statements concerning group health insurance is CORRECT? A) The employer is the policyholder B) Only the employer receives a policy C) Each employee receives a policy D) Under group insurance, the insurer may reject certain individuals from coverage

A

Which of the following statements concerning group health insurance is correct A) The employer is the policyholder B) Only the employer receives a certificate of insurance C) Under group insurance the insurer may reject certain dividual's from coverage D) each employee receives a policy

A

Which of the following statements regarding the Change of Beneficiaries Provision is false? A) The policyowner has the right to change beneficiaries in any case B) A policyowner can change beneficiaries without the consent of the former revocable beneficiary C) The policy ownwer cannot change the beneficiaries if he/she has chosen to have an ireevocable beneficiary, unless the policyowner has the permission of the irrevocable beneficiary D) All policies that allow death benefit must at least provide the option of change of beneficiary provision

A

Which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses? A) Stop-loss Limit B) out-of-pocket limit C) First dollar coverage D) Corridor deductible

A

Which of the following would basic medical expense coverage NOT cover? A) Surgeon's services B) Mental illness C) Maternity D) Hospice

A

Which one of the follwing is an elgibility for Social Security disability income benefits A) Fully insured status B) Experiencing at least 1 year of disability C) Being at least 50 years og age D) Currently employed status

A

Which provision states how much time must pass between tw like illnesses in order for the second one to be covered under a new set of benefits? A) Recurrent Disability Provision B) Disability Relapse Clause C) Relapse Provision D) Corridor Clause

A

Which provision states that the insurance company must pay Medical Expense claims immediately? A) Time of Payment of Claims B) Payment of claims C) Legal Actions D) Relation of Earnings to Insurance

A

Which type of care is NOT covered my Medicare A) Long-term Care B) Hospice Care C) Respite D) Hospital

A

Whitin how many days of requestin an ivestigative consumer report must an insurer notify the consumer in writing taht the report will be obtained? A) 3 days B) 5 days C) 10 days D) 14 days

A

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained? A) 3 days B) 5 days C) 10 days D) 14 days

A

How long is an open enrollment period of Medicare supplement policies? A) 6 months B) 1 year C) 30 days D) 90 days

A)

A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks her leg and if off work for 45 days. How many days of disability benefits will the policy pay? A) 10 days B) 15 days C) 25 days D) 45 days

B

A deductible is A) A nominal fee for the use of an insurer's service B) A specified dollar amount the the insured must pay before the insurance company will pay the policy benefits C) A percentage of the medical bill the insured must pay before services will be rendered D) An insurer's obligation to the service provider

B

Acme Insurance Co. submits a policy form to the Commissioner for approval. More than 3 months later, Acme still has not heard back from the Commissioner's office. What can Acme Insurance assume? A) That they failed to submit the form in the correct manner B) THat their policy form was approved C) That their policy form was disapproved D) That their submission is still being examined and therefore pending

B

After a hearing, the Commissioner establishes that a producer was aware that he was asserting false information about the company he represents. What can the producer expect as a penalty? A) A flat penalty of $500 B) Up to $5,000 for each violation, up to an aggregate penalty of $100,000 for acts committed within any 6 month period C) Loss of all commissions during the period of negligence D) A penalty of up to $1,000 for each violation, up to an aggregate penalty of $10,000 for all related acts

B

All of the following are defined as transacting insurance under the Insurance Code EXCEOT: A) Soliciting B) Coercing C) Negotiating D) Selling

B

All of the following are true regarding Kay Employee Disability Income insurance EXCEPT A) Premiums are not tax deductible for the employer B) Benefots are taxible to the employer C) The employer owns the policy D) Benefits are paid to the employer to retrain a new person

B

An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen? A) The PPO will pay the same benefits as if he insured had seen a PPO physician B) The PPO will pay reduce bebefits C) THe PPO will not pay benefits at all D) The insured will be required to py a higher deductible

B

An insurance contract requires that both the insured and the insurer meet certain conditions in order for the contract to be enforceable. What contract characteristic does this describe? A) Conditional B) Contingent C) Aleatory D) Unilateral

B

An insured notified the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss? A) Legal Actions B) Time of Payment of Claims C) Incontestability D) PhysicL ExM and Autopsy

B

An insured notified the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss? A) Legal Actions B) Time of Payment of Claims C) Incontestability D) Physical Exam and Autopsy

B

An insured pays a monthly premium of $100 for her health insurance what would be the duration of the grace period under her policy A) 7 days B) 10 days C) 32 days D) 60 days

B

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy? A) 7 days B) 10 days C) 31 days D) 60 days

B

An insured stated on her application for life insurance that she had never had a heart attack, when in fact she had a series of minor heart attacks last year for which she sought medical attention for. Which of the following will explain the reason a death benefit claim is denied A) Estopple B) Material Misrepresentation C) Waiver D) Utmost good faith

B

For how many days of skilled nursing facility care will Medicare pay benefits? A) 90 B) 100 C) 30 D) 60

B

If an insured and inusrer have a dispute, which of the following is true? A) The Guaranty Association will settle the dispute B) The producer represents the insurer C) The producer represents the insured D) The producer will settle the dispute

B

In a replacement situation all of the following must be considered except A) Exclusions B) Assets C) Benefits D) Limitations

B

Insurance policies are not drawn up through negotiations, and an insured has little to say about its provisions. What contract characteristic does this describe? A) Personal B) Adhesion C) Conditional D) Unilateral

B

Insurance policies are not drawn up through negotiations, and an insured has little to say about its provisions. What contract characteristic does this describe? A) Personal B) Adhesion C) Unilateral D) Conditional

B

Regarding Medicare SELECT policies, what are restricted network provisions? A) They help avoid adverse selection B) They condition the payment of benefits C) They determine who can be insured D) They determine premium rates

B

Regarding the taxation of Business Overhead policies, A) Premiums are not deductible, but expenses paid are deductibles B) Premiums are deductible, and benefits are taxed C) Premiums are not deductible, and benefits are taxed D) Premiums are not deductible, but benefits are deductibles

B

Social Security Supplement (SIS) or SOcial Security Riders would provide for the payment of income benefits in each of the situations below EXCEPT A) If the insured has been denied coverage under Social Security B) When the amount payable under Social Security is more than the amount payable under the rider C) When used to replace or supplement benefits payable under the other social insurance programs D) When the insured is eligible for Social Security benefits but before the benefits begin

B

The Commissioner has just determined that an applicant is ineligible for an appointment with the insurer. How many days does the Commissioner have to notify the insurer of this determination? A) 1 B) 5 C) 10 D) 15

B

The Commissioner has just determined that an applicant is ineligible for appointment with the insurer. How many days does the Commissioner have to notify the insurer of this determination? A) 1 B) 5 C) 10 D) 15

B

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the A) Probationary Period B) Insuring Clause C) Incontestability Clause D) Consideration Clause

B

The selection of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the A) Probationary period B) Insuring Clause C) Incontestability Clause D) consideration Clause

B

The selection of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the A) Probationary period B) Insuring clause C) Incontestability clause D) Consideration clause

B

The type of dental plan hbu have is incorporated into a major medical expense plan is a/an A) Blanket dental plan B) Integrated dental plan C) Supplemental dental plan D) Stand-alone dental plan

B

Under a health insruane policy, benefits, other than death benefits, that have not otherwised been assigned, will be paid to A) The spouse of the insured B) The insured C) Creditors D) Beneficiary of the death benefit

B

Under which conditioin would an employee's group medical benefits be exempt from income taxes? A) When the premiums and other unreimbursed medical expenses exceed 10% of the employee's adjusted gross income B) An employee's group medical beenfits are generally exempt from taxation as income C) An employee's group medical benefits are never exempt from taxation as income D) When the premiums and other unreimbursed expenses exceed 5% of the employee's adjusted gross income

B

What are two types of Flexible Spending Accounts A) Medical Savings Accounts and Health Reimbursment Accounts B) Health Care Accounts and Dependent Care Accounts C) Health Care Accounts and Health Reimbursement Accounts D) Medical Savings Accounts and Dependent Care Accounts

B

What happens if non-member physician is utilized under the POS plan A) The member patient will have to pay out of pocket B) The attend physician will be paid a fee for service, but the member patient will have to pay a higher coinsurance amount C) The non-member physician will be paid a fee for service D) The non-member physician will be paid a fee of service, but the member patient will be penalized per visit on his/her monthly premium

B

What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered? A) Grace Period B) Probationary Period C) Contestable Period D) Elimination Period

B

What is the main difference between coinsurance and copayments? A) With coinsurance, the insurer pays all of the cost B) Copayment is a set dollar amount C) Coinsurance is a set dollar amount D) With copayments, the insured pays all of the cost

B

What is the maximum age for qualifying for a catastrophic plan? A) 26 B) 30 C) 45 D) 62

B

What is the maximum age for qualifying for a catastrophic plan? A) 26 B) 30 C) 45 D) 62

B

Which if tru regarding HMO coverage? A) HMOs provide nationwide coverage B) It is divided into geographic territories C) It is divided based on the average tax bracket of a family D) It is divided by state

B

Which is NOT a characteristic of group health insurance? A) The actual policy is called the "Master Contract" B) A policy is issued to each insured individual C) Dependents of insureds can be covered under group health plans D) Group coverage may be converted to individual coverage if the group contract is ended

B

Which of the following activities would NOT be intterupted as legally acting as an insruance producer? A) Negotiating directly with a purchaser concering terms adn conditions of a contract B) Knowingly placing coverage in a insolvent insurer C) Offering advice to a prospective producer on a specific insurance contracts D) Attempting to sell insurance from a particular company

B

Which of the following does the ensuring clause not specify A) The name of the insured B) A list of available doctors C) Covered perils D) The insurance company

B

Which of the following entiities has the authority to make changes to an insurance policy? A) Producer B) Insurer's executive offer C) Department of Insurance D) Broker

B

Which of the following is NOT a factor is determining qualifications for Social Security disability benefits? A) Number of work credits earned B) Worker's occupation C) Worker's PIA D) Worker's age

B

Which of the following is NOT a feature of noncancellable policy? A) The insured has the right to renew the policy for the life of the contract B) The insurer may terminate the contract only at renewal for certain conditions C) The premiums cannot be increased beyond the amount stated in the policy D) The gurantee to renew coverage usually applies until the insured reaches certain age

B

Which of the following parties is required to retain a copy of a Notice Regarding Replacement? A) The former Insurer B) The applicant and new insurer C) The former insurer and new insurer D) The applicant

B

Which of the following protects consumers agents against the circulation of inaccurate or obsolete personal or financial information? A0 Consumer Privacy Act B) The Fair Credit Reporting Act C) Unfair Trade Practices Law D) The Guaranty Assosiaction

B

Which provision states that the insurance company must pay Medical Expense claims immediately? A) Relation of Earnings to Insurance B) Time of Payment of Claims C) Payment of Claims D) Legal Actions

B

Which statement accurately described group disability income insurance? A) Short-term plans provides benefits for up to 1 year B) The extent of benefits is determined tby the insured's income C) In long-term plans, monthly benefits are limited to 75% of the insured's income D) There are no participation requirements for employees

B

Which statement is NOT true regarding underwriting group health insurance? A) Everyone in the group is covered, regardless of their medical histroy B) The group is assessed individually for insurability C) The premium can be made retroactive for the year D) The cost of the policy is partially determined by the ratio of males to females in the group

B

Which type of insurance is affected through contact between the insurer an individual insured without employing the intermediary services of a producer, broker, or solicitater A) Cold Calling B) Direct Response C) Direct Marketing D) Cold lead advertising

B

A Medicare Supplement Plan must have at least which of the following renewal provisions? A) Nonrenewable B) Noncancellable C) Guranteed renewal D) Conditionally renewal

C

A brain surgeon has an accident and develops tremors in her right arm. Which disability income policy definition of total disability will cover for her for all losses? A) "Any occupation" - less restrictive than other definitions B) "Any occupation" - more restrictive than other definitions C) "Own occupation" - less restrictive than other definitions D) " Own occupation" - more restrictive than other definition

C

A deductible is A) An insurer'a obligation to the service provider B) A nominal fee for the use of an insurer's services C) A specified dollar amount that the insured must pay before the insurance will pay the policy benefits me D) A percentage of the medical bill the insured must pay before services will be rendered

C

A licensed procuer in VA wants to start selling policies in WV. The department will waive certain examination requirements, provided that VA would waive these ruirements if a WV producer sought licensure in VA. What term is used to describe this agreement? A) Fair change B) Controlled business C) Reciprocity D) Continuing education

C

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, A) The insurance plans will split the coverage evenly B) Both plans will pay the full amount of the claim C) The insurance though his company is primary D) The insurance through his wife's company primary

C

According to the rights of renewability riderr for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy EXCEPT A) Claims incurred before cancellation must be honored B) An insurance company may cancel the policy at any time C) Unearned premiums are retained by the insurance company D) The insurer must provide the insured a written notice of the cancellation

C

All of the following would be qualified as a dependent under a dependent care flexible spending account except A) Matt must be constantly watch due to his violent muscle spasms which often lead to Matt injuring himself B) He is severely autistic and refuses to take care of his own personal needs which are taken care of by his father C) Jeremy had to have both legs amputated but has learned how to take care of himself and to get around in a wheelchair D) Joe was paralyzed from the neck down in a car accident and his cared for by his wife

C

An angent is in the proccess of replacing the insured's current healht policy with a new one. Which of teh following would be a proper action? A) Policies must overlap to cover pre-existing conditions B) The old policy must be cancelled before the new one can be issued C) The old policy should stay in force until the new policy is issued D) There should be at least a 10-day gap between the policies

C

An insuerd is hospitalized with a back injury. Upon chcking his disability income policy, he learns that he will not be eligble for benefits for atleast 30 days. This indicates that his policy is written with a 30-day A) Probationary period B) Waiver of benefits period C) Elimination period D) Blackout period

C

An insurance company is domiciled in Montana and transacts insurance in Wyoming. Which term best describes the insurer's classification in Wyoming? A) domestic B) unauthorized C) foreign D) alien

C

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 ecess plan pay? A) $10,000 B) $7,500 C) $5,00 D) $0

C

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> A) Contingent B) Irrevocable C) Revocable D) Primary

C

Any and all chargers made by a producer in the taking of an application, the issuance of a policy, and any related services rendered are defined as A) Considerations B) Fees C) Premiums D) Dues

C

Any inducement offered to the insured in the sale of an insurance policy that is not specified in the is an unlawful practice known as A) Controlled business B) Coercion C) Rebating D) Twisting

C

Because an insurance policy is a legal contract it must conform to the state laws governing contracts which require all of the following elements except A) Legal purpose B) Offer in Acceptance C) Conditions D) Consideration

C

For an individual who is eligible for Medicare at 65, and who is still employed and covered under the employer's plan, which of the folloing is true? A) The employers plan is discontinued, and MEdicare is primary coverage B) The employer plan continues, and Medicare is not available until the employee retires C) The employer plan is primary covergae, and Medicare is secondary coverage D) The employer plan is secondary coverage, and MEdicare is primary coverage

C

If one party to an insurane contract has made a legally enforceable promise, what kind of contract is it? A) Conditional B) A legal (but unethical) contract C) Unilateral D) Adhesion

C

In a disability policy, the elimination (or waiting) period refers to the period between? A) Coverage under a disability policy and coverage under Social Security B) During which any specific illness or accident is excluded from coverage C) The first day of disability and the day the insured starts receving benefits

C

In the event of a loss, Business overhead insurance will pay for A) Salary of the business owner B) Medical bills of the business owner C) Rent D) Loss if profita

C

Medicaid provides all of the following EXCEPT A) Eyeglasses B) Family Planning Services C) Income Assistance for work-related injury D) Home Health Care Services

C

Medicare A services do NOT include which of the following? A) Hospitalization B) Hospice Care C) Outpatient Hospital Treatment D) Post Hospital Skilled Nursing Faciliy Care

C

Medicare Part A services do NOT include which of the following? A) Hospitalization B) Hospice Care C) Outpatient Hospital Treatment D) Post hospital Skilled Nursing Facility Care

C

Most TLC plans have which of the following features? A) Variable premiums B) Open renrollment C) Guranteed renewability D) No elimination period

C

Most policies will pay the accidental death benefits as long as the death is caused by the accident and occurs within A) 30 days B) 60 days C) 90 days D) 120 days

C

Premiums paid by self-employed sole proprietors for medical expense insurance are A) Not tax deductible B) Partially tax deductible C) Totally tax deductible D) Taxable

C

Shelia has embolism in her brain. After a week-long hospitalization and subsequent bed rest, she is allowed to work again. Three months later, she develops a second brain embolism. Which provision would determine whether a new set of benefits would cover the second embolism? A) Relapse Clause B) Corridor Clause C) Recurrent Disability Provision D) Elimination Period Provision

C

The insurance policy, together with the policy application and any added riders form what is known as A) Contract of adhesion B) Whole life policy C) Entire Contract D) Certificate of coverage

C

The proposed insured makes the premium payment on a new insurance policy. If the insured should die, the insurer will pay the death benefit to the beneficiary if the policy is approved. This is an example of what kind of contract? A) Personal B) Unilateral C) Conditional D) Adhesion

C

The proposed insured makes the premium payment on a new insurance policy. If the insured should die, the insurere will pay the death benefit to the beneficiary if the policy is approved. This is an example of what kind of contract? A) Personal B) Unilateral C) Conditional D) Adhesion

C

Todd has been informed that he has a hernia which requires repair. When Todd researches the cost, he learns that his insurance plan will cover 200 points worth of surgical expenses. Each point represents $10, which means that $2000 of his surgery will be covered by his insurance plan. What system is Todd's insurance company using? A) Point-based medical B) Conversion factor C) Relative value D) Basic surgical

C

Under the Affordable Care Act, which classification applies to health plans based on amount of covered costs? A) Grandfathered and nongrandfathered B) Rick classification C) Metal Level classification D) Guranteed and nonguranteed

C

Under what condition are group disability income benefits received by an employee NOT taxable as income? A) When the employee is 59 1/2 B) When the amount of the benefit is equal or less than the amount of contributed by the employer C) When the benefits received are equal or less than the employee's percentage of the contribution D) When the employer makes all the premium payments

C

Under which of the folllowing organizations are the practicing providers comepnsated on a fee-for service basis? A) Blue Cross/Blue Shield B) Open Panel C) PPO D) HMO

C

Under worker's compensation, which of the following benefits is NOT included A) Income Benefits B) Death benefits C) Legal Benefits D) Medical and Rehabilitaion benefits

C

Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons except A) Pre-existing conditions that were previously covered may not be covered under the replacing policy B) benefits may change C) Premiums always stay the same D) due to age or health policy may change dramatically

C

What is NOT a benefit of the POS plan A) It allows the employee to use a doctor not covered under the HMO B) With the POS plan the employees do not have to make a decision between the HMO or PPO plans C) It allows guranteed acceptance of all applicants D) It allows the employee to use an HMO provided doctor

C

What type of health insurance policy provides an employer with funds to train a replacement is a valued employee becomes disabled? A) Disability buy-sell B) Business overhead C) Key person disability D) Group disability

C

When an insured makes truthful statements on the application for insurance and pays the required premiums, it is known as which of the following? A) Contract of Adhesion B) Acceptence C) Consideration D) Legal Purpose

C

When both parties go a contract must perform certain duties and follow rules of conduct to make the contract enforceable, the contract is A) personal B) Unilateral C) Conditional D) Aleatory

C

When would a misrepresentation on the insurance application be considered fraud? A) When the application is incomplete B) Any misrepresentation is considered fraud C) If it is intentional and material D) Never; statements by the applicant are only representations

C

Which benefit is based on the peron's Primary Insurance Amount (PIA) A) Accidental Death Benefits B) Long-term Care Benefit C) Social Security Disability Benefit D) Death benefit in a universial Life Policy

C

Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company? A) Subrogation B) Warranty C) Aleatory D) Adhesion

C

Which of the following is NOT covered under Part A Medigap insruance? A) The first three pints of blood each year B) The Medicare Part A deductible C) Approved hospital cost for 365 additional days after Medicare benefits ended D) The 20% Part B coinsurance amounts for Medicare approved services

C

Which of the following is a nonoprofit organization created to contract with the public and physicians, dentist, podiatrists for medical or surgical services and with duly licensed chiropractor and other health agencies for other health services to be furnished to subscribers under their contracts with the corporation? A) Hospital Service Corporation B) Health Service Administration C) Medical Service Corporation D) Health Maintenance Organization

C

Which of the following is a nonprofit corporation organized to contract with public and health agencies for hospital and other health services to be furnished to subscribers under terms of their contracts with the corporation? A) Health Maintenance Organization B) Hospital Service Corporation C) Health Service Corporation D) Medical Service Corporation

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 required C) Its goal is to channel patients to providers that discount services D) The most common type of PPO is the staff model

C

Which of the following is true regarding optional benefits with long-term care policies A) They are offered at no additional cost to the insured B) they are included in all policies C) they are available for an additional premium D) only standard benefits or available with LTC policies

C

Which of the following riders would NOT increase the premium for a policyowner? A) Waiver of Premium Rider B) Multiple Indemnity Rider C) Impairment Rider D) Payor Benefit Rider

C

Which of the following would basic medical expense coverage NOT cover? A) Maternity B) Hospice C) Surgeon's service D) Mental Illness

C

Which type of insruance is affected through contact between the insurer and individual insured without employing the internediary services of a producer, broker or silicitor A) Cold Lead Advertising B) Cold Calling C) Direct Response D) Direct Marketing

C

With repsect of the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance? A) Providing warranties on application B) Notice of policy cancellation C) Payment of premium D) Promise to renew the policy at the end of the policy period

C

With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance? A) Providing warranties on the application B) Notice of policy cancellation C) Payment of premium D) Promise to renew the policy at the end of the policy period

C

A Medicare SELECT policy does all of the following EXCEPT A) Make full and fair disclosure in writing of the provisions, restrictions, and limitations of the Medicare SELECT policy to each applicant B) Provide payment for full coverage under the policy for covered services not available through network providers C) Provide for continuation of coverage in the event that Medicare SELECT policies are discontinued fue to the failure of Medicare SELECT program D) Prohibited payment for regulary covered services if provided by non-network providers

D

A deductible is A) A percentage of the medical bill the insured must pay before services will be rendered B) An insurer's obligation to the service provider C) A nominal fee for the use of an insurer's services D) A specified dollar amount that the insured must pay first before the insurance company will pay the policy benefits

D

A guranteed renewable disability insruance policy A) Is renewable at the option of the insurer to a specified age of the insured B) Is guranteed to have a level premium for the life of the policy C) Cannnot be canceled by the insured before the age of 65 D) Is renewable at the insured's option to a specific age

D

A guranteed renewable disability insurance policy A) IS renewable at the option of the insurer to a specified age of the insured B) Is guranteed to have a level premium for the life of the policy C) Cannot be cancelled by the insured before the age of 65 D) Is renewable at the isured's option to a specified age

D

A health maintanence organization is named "Acme Causualty" This is considered to be A) Acceptable B) Incomplete C) Insolvent in nature D) A deceptive Practive

D

A life insurance policy has a legal purpose if both of whihc of the following elements exist? A) Underwriting and reciprocity B) Ofer and counteroffer C) Policy owners and named beneficiaries D) Insurable interest and consent

D

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, A) Both plans will pay the full amount of the claim B) The insurance through this company is primary C) The insurance through his wife's company is primary D) The insurance plans will spilt the coverage evenly

D

A participating insurance policy may do which of the following? A) Provide Group Coverage B) Pay dividends to the stockholder C) Require 80% perticipation D) Pay dividens to policyowner

D

A provision found in insurance policies which prevents the insured from collecting twice for the same loss is called A) Consent to settle loss B) Right of Salvage C) Appraisle D) Subrogation

D

All of the following are true regarding ley person disability income insurance EXCEPT A) The employer receives benefits if the key person is disabled B) The employer pys the premiums C) The employee is the insured D) Premiums are tax deductible as a business expense

D

All of the following would be exempt from the licensing requirement EXCEPT? A) An employee of an insurance company handling incoming calls B) An employee in charge of enrolling individuals into a group plan C) Human Resources benefit personnel D) An employee of an insurance company involved in the effectuation of the insurance contract

D

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 Part B. what is the insurance company obligated to do? A) seclude pre-existing conditions from coverage under the supplement policies B) Look at the applicant's medical history to decide what premium to charge C) Send the applicant to a doctor for a physical. nothing can happen until they get the results D) Offer the supplement policy on. Guaranteed issue basis

D

An insurance contract must contain all of the following to be considering legal binding EXCEPT A) Offer and acceptance B) Consideration C) Competent parties D) Beneficiary's consent

D

An insured has Medicare Part D coverage. Upon reaching the initial benefit limit, what percentage of the prescribition drug cost is the insured responsible of paying? A) 15% B) 16% C) 23% D) 25%

D

An insured is hospitalized with a back injury. Upon checking his disability income policy, he learns that he will not be eligible for benefits for at least 30 days. This indicates that his policy is written with a 30-day A) Blackout period B) Probationary period C) Waiver benefits period D) Elimination period

D

An insured notifies the insurance company that he has become diabled. What provision states that claims must be paid immediately upon written proof of loss? A) Incontestability B) Physical Exam and Autopsy C) Legal Actions D) Time of Payment of claims

D

An insured submitted a notice of claim to insurer, but never received claims forms. He later submits proof of loss, and explains the nature and extend of loss in a hand-written letter to the insurer. Which of the following would be true? A) The claim will most likely not be paid since the official claims form was not submitted B) The insurer will be fined for not providing claims forms C) The insured must submit proof of loss to the Department of Insurance D) The insured was incompliance with the policy requirements regarding claims

D

Circulating deceptive sales material to the public is what type of Unfair Trade Practice? A) Defamation B) Coercion C) Misrepresentaion D) Falso Advertisement

D

Concerning group Medical and Dental insurance, which of the following statements is INCORRECT? A) Benefits received by the employee are free from federal income tax B) Premiums paid by the employer are deductible as business expense C) Employee paid premiums may be deducted if certain conditions are met D) Employee benefits are tax deductible the year in which they were received

D

Disability income policies can provide coverage for a loss of income when returning to work only pert-time after recovering ffrom total disability. What is the benefit that is on the insured's loss of earnings after recovering from a disability? A) Recurrent Disability B) Partial Disability C) Income Placement D) Residual Disability

D

Hospice care is intended for A) People in need of acute care B) Home health visits from a participating health agency C) The caregiver D) The terminally ill

D

How long before their intended use must all policy forms be filed for approval? A) 10 days B) 15 days C) 30 days D) 60 days

D

How soon following the occurrence of a covered loss must an insured written period proof of such loss to the insurance company? A) As soon as possible B) Within 20 days C) Within 60 days D) Within 90 days or as soon as reasonably possible, but not exceed 1 year

D

I guaranteed renewable health insurance policy allows A) Policyholder to renew the policy to a stated agent guarantees the premium for the second. B) policy to be renewed at time of expiration but the policy can be canceled for causing during the policy time C) Insured's to renew the policy to a specific age D) Policyholder to renew the policy to a state at age with the company having the right to increase premiums on the entire class

D

If a business owner becomes totally disabled, a Business Overhead Expense policy will pay all of the following EXCEPT A) Rent B) Utilities C) Employee Roll D) Loss of owner's income

D

If a business wants to buy a disability income policy on a key employee which of the following is considered the beneficiary A) The insurer B) The employee C) The producer D) The employer

D

In forming an insurance contract, when does acceptance usually occur? A) When insurer delivers the policy B) When an insurer receives an application C) When an insured submits an application D) When an insurer's underwriter approves coverage

D

It is considered an unfair claims settlement practice to pay a claim in full whiting how many days from the claimant's filling of the proof of loss? A) 10 day B) 15 working days C) 30 calender days D) 90 calender days

D

It is considered unfair settlement practice to pay a claim in full within how many days from the claimants filing of the proof of loss A) 10 days B) 15 working days C) 30 calender days D) 90 calender days

D

Medicare advantage is also known as A) medicare part D B) Medicare part A C) Medicare part B D) medicare part C

D

Once the person meets the stringent requirements for disability benefits, how long is the waiting period under Social Security before any benefits will be paid? A) 12 months B) Benefits will be paid immediately C) 90 days D) 5 months

D

The annual contribution limit of a Dependent Care Flexible Spending Account is set by A) The emplyer B) The insurer C) The insured D) The irs

D

The period of time immediately follwing a disability during which benefits are not payable is A) Probationary Period B) The Grace Period C) The Blackout Period D) The Elimination Period

D

The primary purpose of disability income insurance is to A) Reimbure medical expenses and/or loss income due to accidents at work B) Reimnurse loss of income to a family due to the death of insured D) Replace income lost due to a disability

D

The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over the last A) 6 months B) 12 months C) 18 months D) 24 months

D

Under a key person disability income policy, premium payments A) Are made by the employee and are not tax-deductible B) Are made by the employee and are tax-free C) Are made by the business and are tax-deductible D) Are made by the business and are not tax-deductible

D

Under the Physical Exam and Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending? A) None at all B) 1 examination per week of the claim processing period C) 2 examinations per week of the claim processing period D) Unlimited

D

What is a penalty tax for nonqualified distributions from a health savings account A) 8% B) 10% C) 12% D) 20%

D

What is the maximum period of time during which an insurer may contest fraud misstatements made in health insruance application? A) 90 days after the effective policy date B) 6 months after the effective policy day C) 1 year after the effective policy date D) As long as the policy is in force

D

When an insurer issues an individual health insurance policy that is guaranteed renewable the insurer agree A) To charge a lower premium every year the policy B) not to change the premium rate for any reason C) To renew the policy indefinitely D) To renew the policy until the insured has reached age 65

D

Which health insurance provision describes the insured's right to cancel coverage? A) Policy Duration Provision B) Insuring Clause C) Cancellation Provision D) Renewal Provision

D

Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company? A) Adhesion B) Subrogation C) Warranty D) Aleatory

D

Which of the following is INCORRECT concerning taxation of disability insurance benefits A) If the employer paid the premiums, income benefits are taxable to the insured as ordinary income B) If the insured paid the premiums, any disability benefits are tax-free C) If the benefits are for a permanent loss, the benefits paid to the emploee are not taxible D) If paid by the individual, the premiums are tax deductible

D

Which of the following is NOT an essential element of an insurance ontract? A) Consideration B) Agreement C) Legal Purpose D) COunteroffer

D

Which of the following is a nonprofit corporation organized to contract with the public and health agencies for hospital and other health services to be furnsihed to subscribers under terms of their contracts with the corporation? A) Health Service Corporation B) Medical Service Corporation C) Health Maintanence Organization D) Hospital organization Corporation

D

Which of the following is not true of Disability Buy-Sell coverage? A) It is typically written to cover partners or corporate officers of a closely held business B) Premium payments are not deductible to the business C) The policies provide funds for the business organization to purchase the business interest of a disabled partner D) Benefits are considered taxable income to the business

D

Which of the following protects consumers against the circulation of inaccurate or obsolete personal or finanical information? A) Unfair Trade Practices Law B) The Guaranty Association C) Consumer Privacy Act D) The Fair Credit Reporting Act

D

Which of the following provides coverage ona first- dollar basis A) Accident expense B) Supplementory major medical C) Limited major medical D) Baic expense

D

Which type of insurance provides funds for a business organization to pruchase the business interest of a disabled partner A) Disability interest buy-out B) Corporate Transfer C) Corporate disability D) Disability buy-sell

D

Warranty means:

Guaranteed to be true

A nonprofit corporation to the Public and Health agencies for hospital and other health services to be furnsiehd to subcribers

Hospital corporation

Health Service Corporations

Nonprofit organizaton

The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over the last A) 6 months B) 12 months C) 18 months D) 24 months

d

What is the goal of the HMO? A) Providing free health care B) limiting the deductibles C) provide health services close to home D) early detection through regular checkups

D

The insurance policy, together with the policy application and any added riders form is known as A) Entire contract B) Certificate of coverage C) Contract if adhesion D) Whole life policy

A

Which of the following best describes the MIB? A) It is a nonprofit organization that maintains underwriting information on applicants for life and health insurance B) It is a government agency that collects medical information in the insured from the insurance companies C) It is a member organization that protects insured again insolvent insurers D) It is a rating organization for health insurance

A

Which of the following entities can legally bind coverage? A) Insurer B) The insured C) Federal Insurance Board D) Agent

A

An insured pays a monthly premium of $100 for her health insurance. what would be the duration of the grace period under her policy? A) 7 day B) 10 days C) 31 days D) 60 days

B

An insurer neglects to pay a legitimate claim that is covered under the terms of policy. Which of the following insurance principles has the insurer violated? A) Adhesion B) Consideration C) Good faith D) Representation

B

Candidates for individual insurance producer licenses are required to submit fingerprints for criminal history and federal background checks. how long are the fingerprint results valid? A) 15 days B) 30 days C) 90 days D) 6 months

B

If an insured and insurer have a dispute, which of the following is true? A) The Guaranty Association will settle the dispute B) The producer represents the insurer C) The producer represents the insured D) The producer will settle the dispute

B

If only one party go an insurance contract has made a legally enforceable promise, what kind of contract is it? A) A legal (but unethical) contract B) Unilateral C) Adhesion D) Conditional

B

Items stipulated in the contract that the insured will not provide coverage for are found in the A) Consideration clause B) Exclusions C) Insuring clause D) Benefit Payment clause

B

The provision that states that both the printed contract and a copy of the application form the contract between the policy owner and the insurer is called the A) Master Policy B) Entire Contract C) Certificate of insurance D) Aleatory contract

B

What is a material misrepresentation? A) Concealment B) A statement by the applicant that, upon delivery, would affect the underwriting decision of the insurance company C) Any misstatement made by an applicant for insurance D) Any misstatement made my the producer

B

Which of the following is NOT an essential element of an insurance contract? A) Legal purpose B) Counteroffer C) Consideration D) Agreement

B

Which of the following is NOT covered under a long/term care policy? A) Home health care B) Acute care in a hospital C) Adult day care D) Hospice care

B

Which of the following long-term care benefits would provide coverage for care for functionally impaired adults in a less than 24-hour basis? A) Home health care B) Adult day care C) Residential care D) Assisted living

B

Which of the following must be present in all Medicare supplement plans? A) Plan C coinsurance B) Plan A C) Foreign Travel provisions D) Outpatient drugs

B

Which of the following provisions woul prevent an insurance company from payment reimbursement claim to someone other than the policy owner? A) Proof of loss B) Payment of Claims C) Entire Contract Clause D) Change of beneficiary

B

Which of the following statement is NOT true concerning Medicaid? A) It is intended to provide medical assistance for certain categories of people who are needy. B) It consists of 3 parts: Part A-hospitalization, Part B- doctors services, and Part C- disability income C) It is a state program D) It is funded by state and federal taxes

B

While a claim is pending, an insurance company may require A) An independent examination only once every 45-days B) An independent examination as often as reasonably required C) The insured to be examined only within the first 30 days D) The insured to be examined only once anuslly

B

A policy available to business owners that provides payment for normal business expenses in the event that the owner is disable is called A) Partial disability B) Recurrent Disability C) Business Overhead Expense D) Credit Accident and Health Coverage

C

A policy with a 31-day grace period implies A) The policy incontestable after 31 days of delivery B) The policy benefits must be paid within 31 days after claim submitted C) The policy will not lapse for 32 days if the premium is not paid when due D) The policyholder may return the policy for a full refund within 32 days

C

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 any copayments or deductibles, how much will the excess plan pay? A) $10,000 B) $7,500 C) $5,000 D) $0

C

In the licensing process, the Commissioner collects an applicant's fingerprints and submits them to A) U.S Court of Federal Claims B) The Federal Bureau of Investigation and the Central Intelligence Agency B) The West Virginia State Police and the Federal Bureau of Investigation D) The police department where the applicant resides and the WV state police

C

Which is NOT a characteristic of group health insurance? A) Group coverage may be converted to individual coverage if the group contract is ended B) The actual policy is called the "master contract" C) A policy is sissies to each insured individual D) Dependents of insureds can be covered under group health olans

C

Which of the Following is true regarding elimination periods and the cost of coverage? A) The longer the elimination period, the higher the cost coverage. B) Elimination periods have no effect on the cost of coverage. C) The longer elimination period, the lower the cost of coverage. D) Th shorter the elimination, the lower the cost of the coverage.

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) It's goal is to channel patients to providers that discount services D) The most common type of PPO is the staff model

C

Which of the following parties is NOT exempt from the requirement of obtaining an insurance producer license? A) A receptionist whose sole occupational purpose is to answer phones B) A director of an insurance producer that receives no commissions C) A producer tho deals primarily with customers in obtaining life insurance D) An officer of an insurance producer, provided he doesn't receive commissions

C

Which of the following provisions would prevent an insurance company from paying a reimbursement claim to someone other than the policy owner? A) Entire Contract Clause B) Proof of Loss C) Payment of Claims D) Change of beneficiary

C

Which of the following would best describe total disability? A) A person's total loss of income B) A person's inability to qualify for insurance coverage C) A person's ability to work is significantly reduced or eliminated for the rest of his/her life D) A person's inability to perform one of the regular duties of his/her occupation

C

Which of the following would qualify as a competent party in an insurance contract? A) The applicant is a 12-year-old student B) The applicant is under the influence of a mind-impairing medication at the time of application C) The applicant has a prior felony conviction D) The applicant is intoxicated at the time of application

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 2 year C) The extent of benefits is determined by the insured's income D) In long/term plans, monthly benefits are limited to 75% if the insured's income

C

A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim? A) 50% of claim will be paid B) If the man is not convicted, he will get 75% of his claim paid C) The claim is paid in full D) Claim is denied if his policy contains the Illegal Occupation provision

D

A small hardware store owner is involved in a car accident that renders him totally disabled for half a year Which type of insurance would help him pay for expenses of the company during the time of his disability? A) Key person insurance B) Disability buy-sell agreement C) Business dis ability policy D) Business overhead expense policy

D

According to the PPACA rules, what percentage of health care costs will be covered under the bronze plan? A) 10% B) 30% C) 40% D) 60%

D

According to the rights of renewability rider for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy EXCEPT A) The insurer must provide the insured written notice of the cancellation B) Claims incurred before cancellation must be honored C) An insurance company may cancel the policy at any time D) Unearned premiums are retained by the insurance company

D

All of the following statements about Medicare Part B are correct EXCEPT: A) It covers services and supplies not covered by Part A B) It is financed by monthly premium C) It is financed by tax revenues D) It is a compulsory program

D

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 to the insurer. Which of the following would be true? A) The claim most likely will not be paid since the official claims form was not submitted B) The insurer will be fined for not providing the claims forms C) The insured must submit proof of loss to the Department of Insurance D) The insured was in compliance with the policy requirements regarding claims

D

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? A) primary B) contingent C) irrevocable D) revocable

D

Any document offered to the insured in the sale of an insurance policy that is not specified in the policy is an unlawful practice known as A) Twisting B) Controlled Business C) Coercion D) Rebating

D

Disability income policies can provide coverage for a loss of income when returning to work only part-time after recovering from total disability. What is the benefit that is based on the insured's loss of earnings after recovery from a disability? A) Recurrent disability B) Partial disability C) Income replacement D) Residual disability

D

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company? A) as soon as possible B) within 20 days C) within 60 days D) within 90 days or as soon as reasonably possible, but not exceed to 1 year

D

If a producer does not complete the continuing education (CE) requirement, which of the following will happen? A) The producers license will be revoked until the CE requirement is met B) Nothing C) The producer will be fined for each month the CE requirement is not met D) The producers license will not be renewed

D

In forming an insurance contract, when does acceptance usually occur? A) When an insurer delivers the policy B) when an insurer receives an application C) When an insured submits an application D) When an insurer's underwriter approves coverage

D

Insurance interest can be best described by which if the following? A) The insured must be genuinely interested in the life of the applicant B) All beneficiaries need to have notification of their status C) It is not necessary for the insured to be aware of the insurable interest or give permission for the insurance that is to be written D) The applicant must experience a financial loss due to an accident or sickness that befalls the insured

D

The Commissioner may exam any company or person engaged in the insurance business as often as it is deemed appropriate, but is required to examine each foreign insurer at least A) Once a year B) Every 2 years C) Every 3 years D) Every 5 years

D

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the A) Time limit on certain defenses clause B) Incontestability clause C) Legal action against us clause D) Entire contract clause

D

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the A) Incontestability Clause B) Consideration clause C) Probationary period D) Insuring clause

D

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the A) Incontestability clause B) Consideration clause C) Probationary period D) Insuring clause

D

To appoint an individual producer as it's agent, from the date agency contract is executed, the appointing insurer must file a notice of appointment within A) 1 month B) 7 days C) 10 days D) 15 days

D

To transact business in the state, an insurer must be A) Captive B) Domestic C) Certified D) Admitted

D

Under the Accidental Death and Dismemberment (AD&D) coverage, what type of benefit will be paid to the beneficiary in the event of the insured's accidental death? A) Capital Sum B) Double the amount of the death benefit C) Refund of premiums D) Principal Sum

D

Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain A) A statement from the insureds employer showing that the insured was unable to work B) An estimate of the total amount of medical and hospital expense for the loss C) A complete physicians statement D) A statement that is sufficiently clean to identify the insured and the nature of the claim

D

What is a foreign insurer? A) An insurer with a home office in another country B) An insurer with licensed agents doing business in other countries C) An insurer with licensed agents who are citizens in more than one country D) An insurer with a home office in another state

D

What is the main difference between coinsurance and copayments? A) With copayments, the insured pays all of the cost B) With coinsurance, the insurer pays all of the cost C) Coinsurance is a set dollar amount D) Copayment is a set dollar amount

D

What is the maximum period of time during which an insurer may contest fraudulent misstatements made in a health insurance application? A) 90 days after the effective policy date B) 6 months after the effective policy fate C) 1 year after the effective policy date D) As long as the policy is in force

D

Which of the following best describes misrepresentation? A) Making a maliciously critical statement that is intended to injure another person B) Discriminating among the individuals of the same insuring class C) Issuing sales material with exaggerated statements about policy benefits D) Making a deceptive or untrue statement about a person engaged in the insurance business

D

Which of the following protects consumers against the circulation of inaccurate or obsolete personal of financial information? A) Unfair Trade Practices Law B) The Guaranty Association C) Consumer Privacy Act D) The Fair Credit Reporting Act

D

Which of the following statements about occupational vs. nonoccupational coverage is TRUE? A) Group medical expense policies and individual medical expense policies always cover both occupational and nonoccupational injuries B) Individual disability policies never cover nonoccupational injuries C) Only group disability income policies can be written in an occupational basis D) Disability insurance can be written as occupational or nonoccupational

D

Which of the following statements is incorrect concerning Medicare part B coverage? A) participates under part B are responsible for an annual deductible B) part B will pay 80% of covered expenses subject to Medicare standards for reasonable charges C) it is a voluntary program designed to provide supplementary medical insurance to cover physician services medical services and supplies not covered under part A D) part B coverage is provided free of charge when an individual turned 65

D

Bethany studied England for a semester. While she is there, she is involved in a train accident that leaves her disable. If Bethany owns a general disability policy, what will be the extent of benefits that she receives? A) Full B) 50% C) 25% D) None

D)