final exam - Georgia Life and Health 2

K failed to pay a renewal premium within the time granted by the insurer. K then sends in a payment which the insurer subsequently accepts. Which policy provision specifies that coverage may be restored in this situation?

Reinstatement

which of the following is not considered rebating

Sharing commission with an agent licensed in the same line of business

the percentage of an individual's primary Insurance amount determines the benefits paid in which of the following programs

Social Security Disability Income

When can a policyowner change a revocable beneficiary?

anytime

which of the following medical expenses does cancer insurance not cover

arthritis

the guarantee of insurability option provides a long-term care policy owner the ability to

buy additional coverage at a later date

what type of group insurance plan involves employees sharing the cost

contributory plan

K has a life insurance policy where her husband is beneficiary and her daughter is contingent beneficiary. Under the Common Disaster clause, if K and her husband are both killed in an automobile accident, where would the death proceeds be directed?

daughter

The Combination of Whole Life and _____ Term insurance is referred to as a Family Income Policy

decreasing

which of the following Provisions specifies how long a policyowners health coverage will remain in effect if a policyowner does not pay the premium when it is due

grace period

which of these types of coverage is best described as a short-term medical policy

interim coverage

J was reviewing her Health Insurance policy and noticed the phrase "This policy will only pay for a semi-private room". This phrase is considered to be a(n)

internal limit

k is an insured under a life insurance policy owned by a third party which of these statements is true

k has no ownership rights

Pre-hospitalization authorization is considered an example of

managed care

whole life insurance policies are contractually guaranteed to provide each of the following except

partial withdrawal features beyond a surrender charge period

what is the minimum number of activities of daily living (adl) an insured must be unable to perform to qualify for long-term care benefits

2 A qualified Long Term Care policy must stipulate that the insured be incapable of performing at least two of the ADL's without assistance for at least 90 days to qualify for benefit

An insured must notify an insurer of a medical claim within how many days after an accident?

20 days

Insurers may request a hearing within ___ if their policy is rejected

20 days

An individual participant personally received eligible rollover funds from a profit-sharing plan. What is the income tax withholding requirements for this transaction?

20% is withheld for income taxes

According to the Mandatory Uniform Policy Provisions, what is the maximum amount of time after the premium due date during which the policy remains in force even though the premium has not been paid?

31 days

Which of these options can an individual use their medical flexible spending account to pay for?

prescription drugs

Which health policy clause stipulates that an insurance company must attach a copy of the application to the policy to ensure that it is part of the contract?

Entire Contract

long-term care policies will usually pay for eligible benefits using which of the following methods

Expense incurred

which of the following nonforfeiture options offers the highest death benefit

Extended term

which of the following types of organizations are prepaid group health plans, where members pay in advance for the services of participating Physicians and hospitals that have agreements

HMO

W is a 39-year old female who just purchased an annuity to provide income for life starting at age 60. All of these would be acceptable annuity choices EXCEPT a(n)

Immediate annuity

T, age 70, withdraws cash from a profit-sharing plan and purchases a Straight Life Annuity. What will this transaction provide?

Income that cannot be outlived by the owner

what is the initial requirement for an insured to become eligible for benefits under the waiver of premium provision

Insured must be under a physician's care

How are policyowner dividends treated in regards to income tax?

Interest on accumulations is taxed

K's whole life insurance policy lapsed two months ago due to nonpayment. She would now like to reinstate the policy. All of these statements are correct about the policy's reinstatement EXCEPT

K will forfeit the right to use the automatic loan provision upon reinstatement

an insurance company would most likely pay benefits under an accidental death and dismemberment policy for which of the following losses

Loss of eyesight due to an accidental injury

under a guaranteed renewable health insurance policy the insurer

May cancel the policy for nonpayment only

J has a Disability Income policy that does NOT provide benefits for losses occurring as the result of his employment. What kind of coverage is this?

Nonoccupational coverage

which statement is true regarding a minor beneficiary

Normally, a guardian is required to be appointed in the Beneficiary clause of the contract

Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured?

PPO

on a life insurance policy who is qualified to change the beneficiary designation

Policyowner

ABC Insurance Company has accepted a life insurance application which contains unanswered questions. The company then makes the application part of the life contract. In this situation, the insurer has

waived one of its legal rights

P is blinded in an industrial accident. Which provision of his life insurance policy will pay a stated benefit amount?

Accidental Death and Dismemberment clause

common exclusions to continuation of group coverage include

Dental care, other prescription drugs

A CEO's personal assistant suffered injuries at home and as a result, was unable to work for four months. Which type of policy will pay a monthly benefit to the personal assistant?

Disability Income

E and F are business partners. Each takes out a $500,000 life insurance policy on the other, naming himself as primary beneficiary. E and F eventually terminate their business, and four months later E dies. Although E was married with three children at the time of death, the primary beneficiary is still F. However, an insurable interest no longer exists. Where will the proceeds from E's life insurance policy be directed to?

F (insurable interest only needs to exist at the time of application)

P has recently signed an application for insurance. The insurer MUST advise her in writing that an investigative consumer report may be conducted according to the

Fair Credit Reporting Act

which requirement must be met for an association to be eligible for a group Life Plan

Group was formed for a purpose other than acquiring insurance

Which type of renewability best describes a Disability Income policy that covers an individual until the age of 65, but the insurer has the right to change the premium rate for the overall risk class?

Guaranteed renewable

which of the following is the reimbursement of benefits for the treatment of a beneficiary's injuries caused by a third party

Subrogation

which of the following statements is correct about an agent who is taking an insurance application

The agent should have the applicant initial any changes made on the application

J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take?

The insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age

T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called

Time Limit on Certain Defenses

Which type of life policy contains a monthly mortality charge as well as self-directed investment choices?

Variable Universal Life

under which circumstance May the Commissioner of Insurance suspend revoke or refuse to renew a license of an agent

agent is found guilty of misrepresentation in obtaining the license