Life ans Health SC

Elaine's Basic Hospital Expense policy has a $500 per day limit for room and board in a hospital for a maximum of 5 days. Elaine got sick and had to spend 3 days in the hospital at $650 a day. How much will Elaine have to pay to cover the rest of her room and board charges?

$450

if an insured is injured while committing an illegal act and the insured's health policy contains the illegal occupation provision, what precentage of the claim will be paid?

0%

insurance policies are incontestable if they have been in wffect for atleast

2 years

An agent first year commission cannot exceed what percentage of the renewal commission for servicing a medicare supplement policy in its second year?

200%

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

3 days

a producer must report to the director any conviction of the producer taken in any jurisdiction within how many days

30 days

how long is the free look peeiod of a medicare supplement policy

30 days

Joe, age 63, was disabled and can no longer work. He meets the Social Security definition of total disability. How many work credits must Joe have accumulated to have the status of fully insured?

40

a lapsed license may be reinstated within what maximum period of time as long as the continuing education requirement has been met and the required fees have been paid

6 months

which of the following statements is INCORRECT concerning modified endownment contracts (mecs)

An MEC must always pass the 7-pay test

In life insurance, producers are permitted to share or split commissions, provding that

Both are properly licensed for the line of insurance

a dentist is off work for 4 months due to a disability. his dental assistant's salary would be covered by

Business overhead insurance (BOE)

In addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health?

By requiring that the insurance be incidental to the group

what type of an interest rate is guaranteed in universial life policies

Contract interest rate

which of the following statement is true regarding SIMPLE plans?

Contributions and earnings are tax deferred until funds are withdrawn

a producer license may be cancelled for noncompliance with continuing education requirements. Which of the following would constitue noncompliance?

Failing to complete at least 8 credit hours in each line of authority

In order for an alumni association to be eligible to purchase group health insurance for its members, all of these statements must be true EXCEPT when the association

Has been active for five years minimum

who would be allowed to catch-up contributions into an IRA plan

Individuals age 50 or older

Agents may be found guilty of defamation if they make false statements that are intended to

Maliciously criticize another insurance company

what effect will the long-term care (LTC) rider have on the death benefit of a life insurance policy if LTC benefits were paid to the insured?

Reduce the death benefit

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

what is the purpose of a disability buy-sell agreement

To allow the business buyout in case of the owner's disability

which of the following describes the relationship between the principal sum and a capital sum

a captial sum is a percentage of the principal sum

the policy owner has an option to pledge the life insurance as collateral for bank loan. this is called

a collateral assignment

A major medical expense policy would exclude coverage for all of the following treatements except

drug addiction

whose responsibililty is it to ensure that the application for health insurance is complete and accurate?

the agents

once the initial benefit limit in medicare part d is reached, how is the beneficary affected

the beneficiary is then responsible for a portion of prescription drug costs

what is the purpose of a buy-sell agreement

to allow the busniess buyout in case of the owners death

what is the purpose of a key person insurance

to cover decreased busniess revenues as a result of the death of a key employee

what is the purpose of a benefit schedule

to state what and how much is covered in the plan

considering the principles of liquidity, how would the policyowner use todays cash value in a life insurance policy?

use it for emergency expenses

under the mandatory uniform provision "notice of claim", written notice of a cliam must be submitted to the insurer within what time parameters?

within 20 days

the renewable provision allows the policyowner to renew the coverage at the expiration date

without evidence of insurability

what is the purpose of the gatekeeper HMO

controlling costs

which of the following does Not need to be included on the first page of a medicare supplement policy?

premium rates

when an agent delivered an insurance policy to the insured, he collect the inital premium, as well as a document verifying that the insured had not had any injuries or illness since the application date. what is this document called

statement of good health

an insured does pay their monthly premium. They submit a claim for an outpatient procedure 22 days later. Which of the following describes the benefit that will be paid on this claim?

the amount of the premium will be deducted fromt the claims payment

according to the metal level classification of health plans, what percentage of health care costs will be covered under a gold plan?

80%

Under the mandatory uniform provision Proof of Loss, the claimant must submit proof of loss within what time period after the loss?

90 days

According to the life insurance replacement regulations, which of the following would be an example of policy replacement?

A policy is reissued with a reduction in cash value

which of the following best describes a rebate

A producer returning part of her commission to her client, as an inducement to buy

which of the following is true of level term insurance

It is temporary protection

Guaranteeing future dividends is considered to be an unfair or deceptive act known as

Misrepresentation

which if the following best defines the unfair trade practice of rebating?

Offering an inducement of something of value not specified in the policy

a married couple purchased a life insurance policy in their newborn baby. They are concerned about what happened to the policy if either one of them were unable to continue making the premium payments due to death or disability. Which policy ride should their agent recommend?

Payor benefit

what is the difference between a straight life policy and a 20 pay whole life policy

Premium payment period

which of the following actions does not constitue false advertising?

Stating that dividends are not guaranteed

If a licensee wants to transact insurance under a different name than that listed on his or her producer's license, which of the following must occur?

The change must be reported to the director

which of the following services will NOT be provided by an HMO

Unlimited coverage for treatement for drug rehabilitation

what guarnteed that the information explained in the insurance contract is true

a warranty

what term is used for insurance companies that have a certificate of authority to transact insurance

admitted

An insurer who transacts insurance in this state but whose articles of incorporation are registered in Canada is considered what type of insurer?

alien

which of the following is NOT normally an excluded cause of disability income policy?

complications of pregnancy

HMO members pay a small fee when they see their primary care physician. this fee is called

copay

to be valid, an insurance policy must have all of the following except

countersignature

when filling out an application for insurance, the applicant makes a mistake. if a fresh application were not available, what could the applicant do to properly correct the mistake?

cross the incorrecr answer out, write the correct one beside it and initial the answer

which of the following losses would likely be covered unde rthe accidental death rider

death caused by a head on collusions

all of the following health insurance disability benefits are income tax free expect

employer-paid group disability

the "stop-loss" feature on a major medicial policy is inteded to

establish a max. amount of out of pocket expense that an insured will have to pay for medical expense in a calendar year

the guarnteed purchases option is also referred to as the

future increase option

life insurance and annuity replacement regulation applies to all of the following types of life products except

group life

right after an insured reinstated his majoe medical policy, he was involved in an accident that requried hospitalization. when would this accident be covered upon reinstatement policy?

immediately

if the director of insurance determines that producer has engaged in an unfair or deceptive act, the Director may do all of the following EXCEPT

imprison the producer

all of the following statments are true regarding an ordinary life policy except

it does not have a guranteed death benefit

an agreement that is enforceable by law as what kind of contract?

legal

all of the following are true of annually renewable term insurance except

proof of insurability must be provided at each renewal

The purpose of the Fair Credit Reporting Act is to

protect consumers against the circulation of inaccurate or obsolete personal or financial information

an insured was diagnosed two years ago with kidney cancer. she was treated with surgies and chemotherapy and now is in remission. she also has a 30 year smoking history. the insured is now healthy enough to work and has started a full time job. which describes the health insurance that she will most likely receive?

she would be covered under her employer's group health insurance plan, without her hugher premiums

An insured, who is 44 years old, falss while mountain climbing vacation. He is left paralyzed. After a year, doctors feel he will never recover from his injuries. From which of the following programs will he be able to collect disablitly income?

social security

the governor has asked the director to examine an insurance company after serveeal complaints from the insured against the company. Who will pay for this examination?

the insurance company

when a settlement option is chosen at death, how are the monthly income payments taxed

the principal portion is generally income tax free while the interest portion is taxes as ordinary income

If a life insurer holds the proceeds of any policy it issues, which of the following is true?

the proceeds may be exempt from any creditor's claim against the beneficiary

a core medicare supplement policy(plan a) will cover all of the following except

part A deductible

which of the following medicare parts procides prescription drugs benefit

part d

How do premiums in variable universal life policies vary from those in varaible whole life policies

premiums are flexible

all of the following are true regarding key person disability income insurance except

premiums are tax deductible as a busniess expense

which of the following used to be called medicare + choice plans?

medicare advantage plans

all of the following are excluded from coverage in an individual health insurance policy EXCEPT

mental illness

an example of an alien insurer doing busniess in this state is one formed under the laws of

mexico

which of the following best describes a major medical expense policy?

it provides catastrophic medical coverage beyond basic benefits on a usual, customary and reasonable basis

the reduction of premium option uses the diveded to reduce

next years premium

What does Basic Medical expense cover?

nonsurgical services a physician provides

with respect to the entire conteaxt clause in health policies, who has the authority to make changes to an exisiting policy?

only an executive officer of the company

which of the followng statements is TRUE regarding an Agents Report during the policy application process?

it provides the agents personal observations concerning the propesed insured

when HIV related test results be provided to the MIB

only if the individuals is not identified

Misstatement of age, change of occupation, and illegal occupation are all examples of

optional provisions

which of the following is NOT mandatory under the uniform provisions law as applied to accident and health policies?

probationary period

an insurer is attempting to determine the insuranability of an applicant and decides to obtain medical information from several different sources. Which of the following must be notified of the investigation?

the applicant