Life and Health part 2.

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An insured decided to surrender his Whole Life insurance policy. The cash value at surrender is higher than the premiums paid into the policy, due to interest. What part of the surrender value would be income taxable?

The difference between the premiums paid and the cash value

All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT

Dollar limits on essential benefits

Which of the following could reduce the amount of the death benefit?

Failure to repay a policy loan

All of the following statements are true regarding an Ordinary (Straight) Life policy EXCEPT

It does not have a guaranteed death benefit

All of the following are true of the Survivorship Life policy EXCEPT

The premium is based on the age of each insured

Who determines if a particular group of employees can be excluded from group health coverage?

The employer

Which of the following statements in INCORRECT?

Medicare and Medigap policies provide coverage for long-term custodial or nursing home care

All of the following are true of credit life EXCEPT

The insured names the beneficiary

To qualify for disability income benefits under Social Security, an individual's disability must be expected to result in death or last for at least

12 months

An agent's first-year commission CANNOT exceed what percentage of the renewal commission for servicing a Medicare Supplement policy in its second year?

200%

All of the following are benefits that must be provided by core policies issued by the New York Partnership for Long-Term Care EXCEPT

Inflation protection option of 10% compounded annually

What does the Guaranty Association guard against?

Insurer insolvency

Which of the following is permissible reason for an insurance company to contest payment of a claim based on statements in the applicantion?

The application contains material misstatements

Which of the following is true regarding pure life annuity settlement option?

It provides the highest monthly benefit

The Omnibus Budget Reconciliation Act of 1990 requires

Larger group health plans must provide primary coverage for disabled individuals under age 65 who are not retired

All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT

An association of 35 people

An elimination (waiting) period may NOT have to be satisfied for a disability in which of the following?

An insured suffers a relapse of a prior disability within 6-months of the initial covered disability

Regarding the consideration clause, which of the following is NOT correct?

Consideration of the insurer and insured must be equal

What is the purpose of the gatekeeper in HMO?

Controlling costs

Darryl is involved in an automobile accident with another motorist. Darryl was at fault. Darryl was injured and hospitalized for 2 months. The other motorist suffered $15,000 of medical expenses as a result of the accident. Darryl's disability income policy will pay

Darryl's loss of income

Which of the following is NOT correct concerning taxation of disability income benefits?

If paid by the individual, the premiums are tax deductible

Which of the following is TRUE of level term insurance?

It is temporary protection

Which of the following best describes pure life annuity?

It provides the highest monthly benefits

Medicare Part B covers all of the following EXCEPT

Long-term care services

An insured falls down a flight of stairs and sustains a neck injury that renders him severely disabled. The insured owns a Whole Life policy. Is it possible for the policy to include a Wavier of Cost of Insurance rider, and if so, what insurance costs would be wavied?

No; it is not possible for this waiver to be included in a whole life policy

Dividends received on participating life insurance policies are

Not taxable because they are a return of unused premiums

When the owner of a participating whole life policy uses the dividend to provide more life insurance coverage, which of the following dividend options is being used?

Paid-up additions

Which of the following is NOT a characteristic of Managed Care Plan?

Risk retention

With respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy

Only the executive officer of the company

What is the cost of coverage based on for group life insurance?

The average age and the ration of men to women

In a life insurance application, all of the following signatures will be required EXCEPT

The home office underwriter

Underwritters use all of these methods to protect the insurer against adverse selection EXCEPT

Only accepting a small number of applicants

A stock insurer is defined as an insurer

Owned be its stockholders

Which of the following would NOT be eligible for coverage under key person?

The owner of a shop

A life settlement broker represents

The policyower

An insured driver is involved in an accident in which he is disabled and his passenger and the other driver are injured. Which of the following will be covered by his disability income policy?

His lost income

When a whole life policy is surrendered for its nonforfeiture value, what is the automatic option?

Extended term

If a person, firm, association or corporation conducts insurance business in New York without a certificate of authority the penalty for the first violation is

$1,000

In the state of New York, how is "Outline of Coverage" referred to?

Disclosure Form

A married couple wants to include the entire family in their whole life policy under one rider. Which of the following riders will help them achieve that goal

Family term

All of the following are features of catastrophic plans EXCEPT

High premiums

In group insurance, the primary purpose of the Coordination of Benefits provision is to

Prevent overinsurance

An individual was denied coverage under Social Security because his disability did not meet the strict definition of total disability used by Social Security. Which of the following would provide disability income coverage?

SIS rider

According to the "Common Disaster" clause, if the insured and primary beneficiary are killed in the same accident and it cannot be determined who died first, which of the following will be assumed?

The primary beneficiary died before the insured

If any authorized entity fails to file an annual financial solvency statement, or does not reply to a written inquiry within 30 days, they are subject to a penalty of up to

$250 per day of delay, not to exceed an aggregate of $25,000 for each failure

A whole life policy is surrendered for a reduced-paid up policy. The cash value in the new policy will

Continue to increase

Which of the following is NOT true regarding a deferred annuity?

Income payments begin within 1 year from the date of purchase

Regarding the PPACA health care tax credit, which of the following is true?

Persons receiving Medicaid are not eligible

As required by the Affordable Care Act, employers must provide minimum value plan that covers what minimum percentage of the participant's expected health care costs?

60%

How much of a business must an employee own at any time in the year to be considered a "highly-compensated employee"?

5%

If a person qualifies for Social Security disability benefits after the 5 month elimination period, when will benefits begin?

Benefits begin at the beginning of the 6th month and are not retroactive to the beginning of the disability

In a deferred annuity, the difference between the accumulation value and the surrender value is the

Surrender charge

What is the exclusion ration used to determine?

The annuity benefit to be excluded from taxes

In group health insurance, what is experience rating?

When an insurer uses the experience of the group as a whole to determine the premiums

Which of the following is NOT a crucial factor in health insurance underwritting?

Income

If an agent follows the rules and terms of his agent contract, he is exercising his

Express authority

What is another term for health insurance policy subscriber?

Participant

A life producer applying for a life settlement broker license may be exempt from the prelicensing education and examination requirement if the producer has held an active life license for at least how many years?

1 year

Which of the following is NOT a format for marketing Long-Term Care insurance?

Associations formed for the purpose of purchasing LTC insurance

Which of the following would NOT trigger the payment of Accelerated Death Benefits?

Being permanently disabled

Regarding major medical plans

Higher stop-loss means lower premium

Under the New York State Partnership for Long-term Care, there are restrictions for applying for New York State Medicaid benefits. Which of the following statements is correct?

If you buy a long-term care insurance policy under the Partnership program, and you use 3 years of nursing home care, or 6 years of home care.

Which of the following is NOT a Medicaid qualifier?

Insurability

Which statement is required to be printed on the first page of a health insurance policy, which signals to the insured that the policy's benefits are limited?

Limited Policy Notice

A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT

Part A deductible

An Equity Indexed Annuity will grow based upon

Performance of a recognized index

What is the difference between a straight life policy and a 20-pay whole life policy?

Premium payment period

What must states do after the death of a person who received Medicaid benefits, according to the Medicaid Estate Recovery Act?

Seek repayment of funds that were paid

In Credit Life Insurance, who is responsible for paying the policy premiums?

Borrower only

The needs approach to calculating the amount of life insurance needed is based on

Predicted needs of a family after the premature death of the insured

An insurer must notify the consumer in writing that an investigative consumer report has been requested, within how many days of the initial request?

3 days

Which of the following is required in order for a plan to be qualified

The plan must be formally written and communicated to the employees

Under the Affordable Care Act, when would pregnancy be considered a pre-existing condition?

Never

If an individual willfully violates provisions of the Fair Credit Reporting Act, what is the maximum civil penalty?

$2,500

An employee dies having 6 quarters of coverage during the previous 13-quarter period. What status of coverage does the employee have under Social Security?

Currently insured

An insurer wants to create a brochure to advertise its company, so a professional advertiser is hired to create and print the material. Several months after the publication of the brochure, a client threatens to sue the insurer for false advertising because of misleading information included in the brochure. Who is legally responsible for the false material?

The insurer

Whenever the Superintendent has reason to believe that a person has violated or is about to violate any unfair method of competition or an unfair claim practice, he or she may serve a statement of the charges and a notice​ of a hearing. What is the timeframe for the hearing after the notice is served?

10 days

According to the Time Limit on Certain Defense provision, statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been in force for a minimum of how many years?

2 years

The Omnibus Budget Reconciliation Act of 1990 requires that large group health plans (100 employees or more) must provide primary coverage for nonretired, disabled individuals under age

65

A subscriber has been treated for a medical condition by his primary care physician for 3 months with experimental remedies without a significant health improvement before being referred to a specialist. Which of the following types of plans does the subscriber have?

A gatekeeper HMO plan to control the costs

Which of the following is provided by skilled medical personnel to those who need occasional medical assistance or rehabilitative care?

Intermediate care

An insured recently received his major medical insurance policy. Only 20 days after the policy issue, while recreational rock climbing, the insured suffered a fall that required hospitalization, surgery and physical therapy to repair his broken leg. Which of the following is true?

Both a deductible and coinsurance payments will be required

Which of the following is NOT true regarding insurance consultants?

They may own shares in the insurers they represent

What is the purpose of a benefit schedule?

To state what and how much is covered in the plan


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