Final Exam - New Jersey Life and Health
How soon can the benefit payments begin with a deferred annuity?
A minimum of 12 months after date of purchase
All of these are valid options for an Adjustable Life Policy EXCEPT
A nonforfeiture option can be used to increase the death benefit
A single premium cash value policy can be described as
A policy that is paid up after only one payment
Health insurance advertisements that mention statistical information are required by New Jersey law to
Accurately convey all pertinent facts
A long-term care policy typically provides all of the following levels of care EXCEPT
Acute care
A life insurance policy which contains cash values that vary according to its investment performance of stocks is called
Adjustable Whole Life
A non-contributory health insurance plan helps the insurer avoid
Adverse selection
What does the Group Life underwriting risk selection process help protect insurance companies from?
Adverse selection
Advertising material for a life insurance policy does NOT need to contain which of the following?
Agent's commission rate
An insurance company that is organized or chartered in a country other than the United States is defined as
Alien
Which of the following does Coordination of Benefits allow?
Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid
What amount will be paid under a policy where the insured misstated his/her age?
An amount the premium would have purchased at the correct age
Loss of income insurance provides
An individual the means to replace wages
Which of these may NOT be used in a health insurance advertisement?
An insurance company's trademark instead of the company's actual name
The coverage, condition, and limitations in the master policy of a group contract can be found in which document?
Certificate of coverage benefits
Which of the following may be used as continuation education credit?
Completing a CLU designation course
Field underwriting performed by the producer involves
Completing the application and collecting initial premium
An effort by an existing insurer to prevent replacement and continue existing Life Insurance in force is known as which of the following?
Conservation
Where would policy proceeds be paid if both the insured and primary beneficiary were killed in the same accident?
Contigent beneficiary
The Commissioner must approve
Continuing education courses
In what part of insurance policy benefits found?
Declarations
In a group health care, what is the purpose of the coordination of benefits provision?
Determines what is paid by the primary and secondary insurers in the event of a claim
A doctor who accepts Medicare Assignment agrees to which of the following?
Doctor cannot charge more than Medicare's scheduled coverage
A pharmacy benefit covers prescription drugs derived from a list called
Drug formulary
Benefits provided by a Medicare Supplement policy must NOT
Duplicate Medicare benefits
The power given to an individual producer that is not specifically addressed in his/her contract is considered what type of authority?
Implied
Which of the following situations would be suitable for a temporary work authority?
When an applicant passes a licensing examination and answers all background questions negatively
An individual can enroll in a Part C Medicare Advantage Plan at what time?
When becoming eligible for Medicare
When does a life insurance policy typically become effective?
When initial premium is collected and policy is issued
When are group disability benefits considered to be tax-free to the insured?
When the recipient pays the premiums
Loans obtained by a policyowner against the cash value of a life insurance policy
Would not be treated as taxable income
Which scenario would most life insurance policies exclude coverage for?
An individual who has a hobby racing cars once a month
A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called
Association or labor group
A Renewable Term Life insurance policy can be renewed
At a predetermined date or age, regardless of the insured's health
When an insured changes to a more hazardous occupation, which disability policy provision allows an insurer to adjust policy benefits and rates?
Change of occupation provision
All of the following are included as part of a contract in the entire contract provision EXCEPT the
Changes made by the producer
Naming a contingent beneficiary as "all surviving children" is describing by which term
Class designation
A Medicare Supplement policy can be cancelled by the insurer for
Nonpayment
A beneficiary change can occur:
Normally at any time during the policy term
A clause that allows an insurer the right to terminate coverage at any anniversary date is called
Optional renewability clause
An example of an unfair method of competition is
Overstating the benefits of an insurance policy
Which of the following MUST contain a "Statement of Policy Cost and Benefit Information"?
Policy Summary
Which of the following does Medicare Part D cover?
Prescription drugs
Claims payable to a Disability Income insured, even when the insured can continue to work, are the result of a
Presumptive disability
Premium mode is a term used to describe the
Frequency of the premium payment
A health insurance policy that allows an insurer to change the policyowner's premiums, but NOT cancel the policy is called
Guaranteed renewable policy
Tara the producer is delivering a specified disease insurance policy to a new policyowner. Upon delivery, she may be expected to collect all of the following EXCEPT a(n)
Modified application with a new signature
How long must an individual be unable to engage in any gainful activity due physical or mental disability in order to qualify for Social Security Total Disability?
12 months
Frank is shopping for a disability income policy. Which of the following would have the HIGHEST premium?
14 day waiting period / 10 year benefit period
An insurer must furnish to a claimant forms for filing proof of loss within ___ days upon receiving a notice of claim.
15
EXCEPT for fraud, the time after issuance of a policy during which an insurance company may contest a health insurance claim due to the statements on an application is
2 years
How long is the Contestable Period for health insurance policies sold in New Jersey
2 years
How long is the Contestable Period for health insurance policies sold in New Jersey?
2 years
Joanne has a $100,000 whole life policy with an accumulated $25,000 of cash value. She would like to borrow $15,000 against the cash value. Which of the following statements is TRUE?
Net death benefit will be reduced if the loan is not repaid
The solicitation of a non-authorized contact in New Jersey violates
New Jersey Code
Which entity is responsible for processing insurance advertising in New Jersey?
New Jersey Department of Banking Insurance
When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid?
No deductible payment is required
A beneficiary has just received a claim payment for a life insurance policy. Which of the following is TRUE regarding the federal income tax?
No federal income tax is owed on life insurance proceeds
Disability Income plans which require that the insurer can NEVER change or alter premium rates are usually considered
Noncancellable
A provision in a whole life policy that allows a policy owner to terminate the policy in return for a reduced paid-up policy of the same type is called
Nonforfeiture provision
Which of these is NOT considered to be a risk factor in life insurance underwriting?
Number of children
All of the following are considered appropriate uses of life insurance for business purposes EXCEPT
Protecting the business by covering entry level employees with life insurance
Who is the individual paid on a fee-for-service basis?
Provider
An indemnity plan
Provides the insured a specific dollar amount for services
Which of the following statements is CORRECT regarding an individual applying for life or health insurance?
The applicant's medical history may be analyzed and reported
If an insurer receives a notice of claim under an individual health policy, and fails to provide proof of loss forms within 15 days, the insured must
File a written proof of loss, detailing the occurrence, character and extent of loss
After an insured gives notice of loss, what must he/she do if the insurer does not furnish forms?
File written proof of loss
A medicare supplement plan can be canceled by the insurer
For nonpayment of premiums
An applicant intentionally lying to an insurance company on an application in order to obtain a cheaper premium is an example of
Fraud
The New Jersey Life and Health Insurance Guaranty Association is
Funded by assessments on member companies
Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a(n)
Guaranteed insurability rider
Maria the agent would like to advertise an annuity product on a highway billboard. Which of the following must be included in the advertisement?
Her name
Which type of long-term care benefit would be most appropriate for a stroke victim who requires speech therapy administered at her home?
Home health care
Which type of coverage pays an amount per day for hospitalization directly to the insured regardless of the insured's other health insurance?
Hospital Identity
Over the course of a year, which premium payment mode is most expensive?
Monthyl
A producer's secretary who solicits prospects on the telephone
Must be licensed as a producer
All of the following are typically included in a life insurance policy illustration EXCEPT
Names of the beneficiary
Which of the following is NOT part of an insurance contact?
Certificate of Authority
What is the contract called that is issued to an employer for a Group Medical Insurance plan?
Master Policy
A branch office registration form is required to be filed at least _____ days before selling insurance out of that branch
30
A licensed producer is required to file notice of any change of address within how many days?
30
A newborn is required to be covered for _____ days from the moment of birth
30
A producer must notify the Commissioner within _____ days of a felony conviction
30
Within how many days must a producer notify the Department of Banking and Insurance of a change in address?
30
An agent is required to keep replacement forms on file for at LEAST _____ years
5
The legal action provision in a health contract is limited to no more than ___ years.
5
Carmen's individual life insurance policy has recently lapsed. She may reinstate her policy within _____ years
3
Ron has a life insurance policy with a face value of $100,000 and a cost of living rider. If the consumer price index has gone up 4%, how much may Ron increase the face value of the policy?
$4,000
What is the maximum fine for a producer violating a New Jersey Insurance law for the first time?
$5,000
Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
10 days
Medicare Part A does not pay for medical benefits provided for treatment in a skilled nursing facility beyond
100 days
After passing the state Producer licensing exam, application for the license must be made within
12 months
How many months can a life insurance policy normally be backdated from the date of application?
6
An example of rebating would be
A producer who shares commissions with a client
If an insured's age on a life insurance policy has been misstated, what is the insurer's liability if the insured dies?
A prorated death benefit based on the amount of insurance the insured's premiums would have been if purchased at the correct age
A plan in which an employer pays insurance benefits from a fund derived from the employer's current revenues is called
A self-funded plan
The double indemnity provisions in a life insurance policy pertains to an insured's death caused by a
Accident
Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental?
Accidental bodily injury provision
Which of these if NOT considered to be a purpose of an annuity?
Annuities are intended to create an estate
The entire contract includes the actual policy and the
Applicant
The entire contract includes the actual policy and the
Application
Who would make the final determination on whether or not an insurance advertisement is misleading?
Banking and Insurance Commissioner
Why are dividends from a mutual insurer not subject to taxation?
Because dividends are considered to be a return of premium
A disability income policy can prevent an insured from earning a higher income than if he/she were working by utilizing
Benefit limits
XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?
Benefits are fully taxable
Which of these premium payment frequencies is not typically available to a policy owner?
Bi-weekly
In which of the following relationship would there NOT be an insurable interest?
Business owner to business customer
The type of policy where the insurer can send a notice to the insured that the policy has been cancelled in the middle of the term is called
Cancelable
Maria is a Preferred Provider Organization (PPO) subscriber and received care from an out-of-network provider. Which of the following is the likely result?
Care is covered
Which of these is NOT subject to income taxation under a Modified Endowment Contract (MEC)?
Death benefit
Key Person Disability Insurance pays benefits to the
Employer
The policyholder for a group health benefit plan is considered to be the
Employer
When a qualified plan starts making payments to its recipient, which portion of the distributions is taxable?
Gains
Which of these will typically authorize treatment from a specialist?
Gatekeeper
How is Medicare Part B funded?
General tax revenue and user premiums
A master contract and certificate of coverage can be found in which type of policy?
Group
A debtor may receive Credit Life insurance in which of the following forms?
Group Term Life
A Buyer's Guide MUST
Have it's content approved by the Insurance Commissioner
What does the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 allow an employee to do ?
In the event of the employment termination, group health insurance can be kept if the EMPLOYEE pays the premiums
Mike has inherited his father's traditional IRA. As beneficiary, he will pay ____ taxes on any money withdrawn.
Income
What happens to interest earned if the annuitant dies before the payout start date?
It is taxable
Which of the following would disqualify a company's retirement plan from receiving favorable tax treatment?
It is temporary
Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
May 30
Jay the producer is giving insurance advice regarding a prospect's existing coverage. If Jay were to receive a fee for this advice (in addition to his commission), he MUST
Obtain a signed memorandum from the prospect acknowledging the amount of compensation
Which of the following is a reinstatement condition?
Proof of insurability
Before conducting an HIV related test, an insurer is REQUIRED to obtain written authorization from the
Proposed insured
Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called
Skilled nursing care
What does a life insurance policy guarantee to the stated beneficiary upon the death of the insured?
Specified amount of money
Which of the following actions is REQUIRED by an agent who is replacing an existing life insurance policy?
Submit to the replacing insurer a list of the policies to be replaced
This MANDATORY health policy provision states that the policy, including endorsements and attached papers, constitutes
The entire insurance contract between the parties
What does the word "level" in Level Term describe?
The face amount
Krissa purchases a 10-year level term life insurance policy that has a death benefit of $200,000. Which of these statements is true?
The face amount and the premium will remain constant over the 10-year period
When calculating the amount of life insurance needed for an income earner, what has to be determined when using he Needs Approach?
The family's financial objectives if the income earner were to die or become disabled
Which of the following is true concerning the proceeds of a life insurance policy?
There is protection of proceeds against the insured's and the beneficiary's creditors
In the advertising of Individual Life Insurance policies, an "introductory" or "special enrollment" may not be made available until any previous enrollment period for the same policy has been closed for at least how long?
Three months
All of the following are elements of an insurance policy EXCEPT
claims forms
Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)
deductible
Level premium permanent insurance accumulates a reserve that will eventually
equal the face amount of the policy
A life insurance policy normally contains a provision that restricts coverage in the event of death under all of the following situations EXCEPT
fare-paying passenger
A _____ insurance company is one that was formed under the laws of a state other than New Jersey
foreign
An insurance consultant is BEST defines as a
producer who charges fees for advice
A limited payment whole life policy provides
Lifetime protection
How many employees must an employer have for a terminated employee to be eligible for COBRA?
20
Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss.
20
New Jersey insurance law requires eligible individuals to make an election to continue health insurance benefits within a MAXIMUM of _____ days after coverage termination
60
Pierre the producer receives a premium for an individual health insurance policy. Pierre MUST remit the premium to his insurer within ___ business days of receipt.
7
In accordance with New Jersey law, a Producer must remit health insurance premiums to the insurer within what period?
7 business days
A 10% excise tax is normally applied to an early withdrawal from an IRA. According to HIPPA, this tax will not be applied if the withdrawal is used for medical expenses that exceed _____ of the individual's adjusted gross income
7.5%
How much does Medicare Part B pay for physician fees?
80%
A health insurer must be provided with written proof of loss _____ days after the date of loss
90
Continued coverage under COBRA would be provided to a(n)
A covered employee is terminated for gross misconduct
A fee for service health insurance plan will normally cover
A disease
HIPPA considers which of the following as "individually identifiable health information"?
A person's health claim information
All of these are valid policy dividend options for a life insurance policyowner EXCEPT
Accumulate without interest
Which dividend option would an insurer invest the policyowner's money and add any interest earnings as the dividends accrue?
Accumulation at Interest Option
In advertisements of life insurance and annuities, all of the following are true EXCEPT
Advertisements must include training materials provided to the producer
How long must an insurance company keep record on life insurance replacement activity
At least five years
An attending physician's statement would be appropriate for which life insurance purpose?
At the request of the insurer to assist in the underwriting decision
The purpose of a coordination-of-benefits provision in group health accident and health plans is to
Avoid overpayment of claims
Which of these if NOT considered a form of life insurance advertisement?
Buyer's Guide
Which of these riders will pay a death benefit if the insured's spouse dies?
Family term insurance rider
Which of the following is a requirement for ANY change in an insurance application?
Change must be initialed by the applicant
Which of the following is NOT a required provision in an accident and health insurance policy?
Change of occupation
Ownership of a life insurance policy may be temporarily transferred with a(n)
Collateral assignment
In New Jersey, group health insurance may be offered to all of these groups EXCEPT
College seminar participants
The Commissioner issues a subpoena to a producer. The producer decides not to respond. Which course of action must be taken by the Commissioner?
Commissioner may impose an administrative penalty
Advertisements of insurance in a local newspaper, must be approved by
Commissioner of Insurance
Pat is insured with a life insurance policy and Karen is his primary beneficiary. They are both involved in an automobile accident where Pat dies instantly and Karen dies 5 days later...
Common disaster clause
When the word "insurance" appears in a producer's business name, which of the following words cannot be approved?
Company
Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)
Conversion
Which of these is affected by the frequency of an insurance policy's premium payments?
Cost
Which disability policy provision would address any concerns of the value of the benefits decreasing over time?
Cost of living benefit
_____ is NOT an element of valid contract
Countersignature
What happens to the coverage under a children's term rider when that child reaches a certain specified age?
Coverage is eliminated
A producer who intentionally makes an untrue or incomplete statement in the course of an insurance transaction may be guilty of
Misrepresentation
Julie has a $100,000 30-year mortgage on her new home. What type of life insurance could she purchase that is designed to pay off the loan balance if she dies within the 30-year period?
Decreasing term insurance
All of the following are core benefits of Medicare Supplement Plan A EXCEPT
Deductible payments for the first 60 days of hospitalization under Medicare hospitalization under Medicare hospitalization insurance
All of these are standard exclusions found in a life insurance policy EXCEPT
Disability
Which of the following is NOT a federal requirement of a qualified plan?
Employee must be able to make unlimited contributions
A professional liability for which producers can be sued for mistakes of putting a policy into effect is called
Errors and Omissions
Which of the following is NOT a duty of the Commissioner?
Establish insurer rates
The Commissioner may
Establish new insurance laws
How often must an insurance producer's license in New Jersey be renewed?
Every two years
As of January 1, 2007, producer's license expires
Every two years on the last day of the producer's birth month
The taxable portion of each annuity payment is calculated using which method?
Exclusion Ratio
An insurance company needs to obtain personal information from a third party concerning an applicant. Which law do all insurers and their producers need to comply with?
Fair Credit Reporting Act
Which of the following actions may an insurance company NOT do in a health policy that contains a guaranteed renewable premium benefit
Increase the premiums on an individual basis
What happens to the total amount of premium paid for an insurance policy when the payment frequency increases?
Increases
An insurance company may ONLY pay a sales commission to
Individuals licensed by the state
Which of the following is present when an applicant stands to lose value if the insured dies?
Insurable interest
In regards to a life insurance contract, which of the following statements is NOT true regarding the concept of insurable interest?
Insurable interest can be established sufficiently by sentimental attachment alone
In New Jersey, health insurance advertisements are required to contain the
Insurance company's trademark
Ambiguities in an insurance policy are always resolved in favor of the
Insured
All advertisements for health insurance shall make clear the identity of the
Insurer
Which of these is NOT considered to be a nonforfeiture option in a whole life insurance policy?
Interest only
An example of a primary care physician would be an
Internist
An applicant's character and personal habits can be obtained for underwriting purposes from which source?
Investigate consumer report
The names of the insurance companies represented by the producer
Is available to the public
What is the purpose of having an accelerated death benefit on a life insurance policy?
It allows for cash advances to be paid against the death benefit if the insured becomes terminally ill
Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?
It would be considered taxable income to the employee
A life insurance policy written on one contract for two people in which it is payable upon the first death is called
Joint
The time limit for filing claim disputes is addressed in which provision of an accident and health policy?
Legal actions
An insurance producer is issued a _____ as evidence of authority
License
Which settlement options pays a stated amount to an annuitant but no residual value to a beneficiary?
Life income
A life insurance policy that has premiums fully paid up within a stated time period is called
Limited payment insurance
The premium for a Modified whole life policy is
Lower than the typical...
Small employers who are sponsored by an insurer to provide group benefits to its employees are called
MEWA
The treasurer of XYZ Insurance Company discovers that the treasurer's company is being investigated by the Banking and Insurance Commissioner...
Making false financial statements
The reinstatement provision in a health insurance policy is
Mandatory
In contrast to a guaranteed renewable policy, a noncancellable policy
May never raise premiums
The law that established insurance transactions regulated by the states is called
McCarran-Ferguson Act
Which of these is likely to occur when life or health insurance is being applied for?
Medical history from the insured may be reviewed and reported
Which of the following is Medicare Part B also known as?
Medical insurance
A guaranteed issue insurance policy has no
Medical underwriting
Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance?
Medicare in-hospitable deductible
Mark continues working after the age of 65 and is covered through his employer's group health plan. Which of the following statements is TRUE?
Medicare is the secondary payer
A policyowner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this injury would make him eligible for benefits under which provision?
Partial disability
The automatic premium loan provision authorizes an insurer to withdraw from a policy's cash value at the amount of
Past due premiums that have not been paid by the end of the grace period
States that have "no loss no gain" laws require a replacing policy to
Pay for ongoing claims under the policy it replaces
Which type of rider will waive the premium on a child's life insurance policy if the parent paying the premium dies?
Payor benefit
In what form do disability income policies typically pay benefits?
Periodic income
Which type of disability would be less than total impairment and equal to permanent impairment?
Permanent partial disability
A written statement describing the elements of a policy is called
Policy Summary
Which of the following MUST contain a "Statement of Policy Cost and Benefit Information"
Policy Summary
A producer who sells an individual life insurance policy in New Jersey MUST deliver to the policyowner
Policy Summary and Buyer's Guide
Which situation accurately describes a reduced paid-up nonforfeiture option?
Policy has a decreased face amount
Replacement regulation is designed to protect the interests of
Policyowners
All Medicare Supplement policies MUST contain which provision?
Pre-existing conditions may only be excludes from coverage for a maximum of 6 months
A person who is a nonsmoker, of average weight, and in excellent health would most likely be in which risk classification?
Preferred
A policy owner may exercise which of these dividend options that uses the dividend to pay all or part of the next premium due?
Reduction of premium dividend option
If credit life insurance is terminated before the scheduled maturity date of the debt, any unearned premium held by the insurer will be?
Refunded to the creditor
Statements made by an insurance applicant on an application are considered to be
Representations
Which market index is associated with an indexed annuity's rate of return?
S&P 500
Which of the following enables a life policy to be replaced with another life policy and results in the postponement of the tax consequence?
Section 1035 exchange
Health insurance involves two perils, accident and _____
Sickness
An insurer has the right to recover payment made to the insured from the negligent party. These rights are called
Subrogation
Johan the producer charged a fee to a sales prospect for analyzing insurance coverages...
Substance of the services performed
Which of the following describes a person who is NOT acceptable by an insurer at standard rates because of health history, occupation, or hobbies?
Substandard risk
The type of policy which pays on the death of the last person is called
Survivorship life
Which of the following is typically NOT eligible for coverage in a group health policy?
Temporary employee
A producer has recently died and leaves behind a spouse. In order for the producer's insurance business to continue, the Department of Banking and Insurance may issue to the producer's spouse a
Temporary insurance license
Which of these is NOT a characteristic of the Accelerated Death Benefit option?
The benefit can be offered as a rider at a specific extra cost or may be at no cost
Converting a group plan to permanent life insurance requires
The conversion being applied for within 31 days of termination
A Medicare Supplement basic benefit is
The first 3 pints of blood per year
What will the beneficiary receive if an annuitant dies during the accumulation period?
The greater of the accumulated cash value or the total premium paid
An insured individual and the policy's beneficiary die from the same accident. The common disaster provision states the insurer will continue as if
The insured outlived the beneficiary
Who assumes the investment risk in a variable insurance contract?
The insurer
Under a life insurance policy, what does the insuring clause state?
The insurer's obligation to pay a death benefit upon an approved death claim
When a Medicare supplement policy is purchased during the open enrollment period
The policy must be issued regardless of health status
If an insured dies during the grace period with no premiums paid
The policy would be payable, minus the premium amount
What happens when an insurance policy is backdated?
The policy's effective date is earlier than the present
What is the purpose of the Medical Information Bureau (MIB)?
To help underwriters evaluate risk
Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?
Unpaid premium
Funding for Medicare Part B is partially provided by
User premiums
Which of the following is an example of defamation?
Using derogatory statements about an insurance company's financial condition
Twisting is best defined as
Using misrepresentation to induce an insured person to terminate an existing policy and purchase a new policy
A securities license is required for a life insurance producer to sell
Variable life insurance