Missed Questions on Exam FX
An insured who has an accidental death and dismemberment policy losses her left arm in an accident., what type of benefit will she most likely receive from this policy
the cattail amount in a lump sum
which of the following statements is correct concerning the relationship between Medicare and HMO
HMO may pay for services not covered by Medicare.
Which of the following authorities issues insurance producer licesnes
commisioner
Which of the following is not an example of insurable intrest
debtor in creditor
Which of the following is NOT a cost saving service in a medical plan
denial of coverage
If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
nothing
The law that protects consumers against the circulation of inaccurate or obsolete information is known as
the fair credit reporting act
For how many days of skilled nursing facility care will Medicare pay benefits?
100
If an insurer believes that inaccurate or misleading information was provided in the policy application, it may contest a claim within how many years?
2 years
When a group disability insurance plan is paid entirely by the employer, benefits paid to disabled employees are
Taxable income to the employer
A policy with a 31 day grace period implies
The policy will not lapse for 31 days if the premium is not paid when due
which of the following best described gross annual premium
annual loading
A long term care shopper guise must be presented at what point
prior to the time of the application
For group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?
100%
under the affordable care act what percentage of preventive care must be covered with cost sharing
100%
the license of forgetful frank has lapsed. how long from the due date of the renewal will frank be reinstated without having to retake a course or exam
12 months
The relation of earnings to insurance provision allows insurance company to limit the insureds benefits to his/her average income over the last
24 months
Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained
3 days
If a consumer request additional information concerning an investigative consumer report how long does the insurer or reporting agency have to comply
5 days
What is the maximum amount that can be contributed to an MSA of the high deductible plan for individuals
75%
When is the earliest a policy may go into effect?
When the application is signed and a check is given to the agent
Under the mandatory uniform provision notice of claim the first notice of injury or sickness covered under and accident and health policy must contain
a statement that is sufficiently clear to identify the insurers and nature of the claim
Which of the following long term care benefits would provide coverage for care for functionally impaired adults on a less than 24 hour basis
adult day care
in reference to the standard Medicare supplement benefits plans what does the term standard mean
all providers will have the same coverage options and conditions for each plan
Under HIPPA which of the following is incorrect regarding eligibility requirements for conversion to an individual policy
an individual who was previously covered by group health insurance for 6 months is eligible
Regarding uniform mandatory provision concerning claims all of the following are true except
an insured must notify the insurer of a claim on forms prescribed by the insurer
Regarding uniform mandatory provisions concerning claims all of the following are true except
an insured must notify the insurer of a claim on forms prescribed by the insurer
Which of the following is the basic source of information used by the company in the risk selection process
application
All of the following are true of the key person disability income policy except
benefits are considered taxable income to the business
HMO that compensate their health care providers based upon a predetermined payment amount per enrollee for a specified period of time, in exchange for providing a defined set of covered health care services regardless of the amount of services actually provided are said to be operating on which method
capitation
A banker is ready to close on a customer loan. the bank is prepared to offer the loan but only if the customer purchases a life insurance policy from the bank in the amount of the loan. this is an example of
coercion
If an employee terminates her employment which of the following provision would allow her to continue health coverage under an individual policy if requested within 31 days
conversion
An insured is receiving hospice care, his insurer will pay for painkiller but not for an operation to reduce the size of the tumor. what term best fits this arrangement
cost containment
Which of the following terms describes making false statements about the financial condition of any insurer that are intended to injure any person engaged in the business of insurance
defamation
In a disability policy the probationary period refers to the time
during which illness related disabilities are excluded from coverage
which of the following choices best described the blackout period
from the youngest child age 16 until the surviving spouse age 60
What of the following methods of calculating the amount of life insurance needed takes into account the insureds wages years until retirement and inflation
human life value approach
Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?
indemnity
which of the following entities approve all Medicare supplement advertisements
insurance commissioner or director
Which of the following entities has the authority to make changes to an insurance policy
insurers executive officer
which of the following is incorrect concerning Medicaid
it is solely a federally admistatred program
The provision which prevents the insured from bringing any legal action against the company for at least 60 day after the proof of loss is known as
legal actions
All of the following are characteristic of a major medical expense policy except
low maximum limits
Under the Affordable Care Act (ACA): which classification apples to health plans based on the covered cost
metal level claaisfatcion
Which of the following is not true regarding the needs approach method of determine value of an individual life
need is predicated using the number of years until the insured retirement
Which of the following is not true regarding the needs approach method of determine the value of an induvial life
need is predicted using the number of years until the insurers retirement
The coverage provided by a disability income policy that does not pay benefits for losses occurring as the result of the insured's employment is called
nonoccupational coverage
A producer has become disabled in order to keep his business going, what may his designee do
obtain a temp licensee
In long term care insurance what type of care is provided with intermediate care
occasional nursing or rehabilitative care
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?
offer the supplement policy on a guaranteed issue basis
in addition to obtaining an insurance producer license a business entity in order to tract insurance must have at least
one individual licensed insurance producer
in alalbama an insurance company certificate of asuthoritiew is issued for what period of time
perpetual
All of the following are covered by part A of Medicare except
physician and surgeon's services
what type of health care plan allows insureds to select a physicians or hospital from a list of providers without being required to submit claim forms
preferred provider organization
Which of the following statements is an accurate comparism between private and government insurers
private insurers may be authorized to transact insurance by state insurance departments
which services are assoicated with standard and poor and AM best
ratiing the finacial stegienth of insurance companies
A producer is helping a married couple determine the financial needs of their children in the event one or both should die prematurely. This is a personal use of life insurance known as
survivor protection
Which of the following is an example of a producer being involved in an unfair trade practice of rebating?
telling a client that his first premium will be waived if he purchase the insurance policy today
which of the following is not covered under plan a in Medicap insurance
the Medicare part a deductible
Which of the following statements about HRA is true
the account allows rolls over of unused balances at the end of the year at the employers discretion
Which of the following does not have to be disclosed in a long term care policy
the aggerate amount of premiums due
In applying for an original certificate of authority an insurer must submit an application with the appropriate frees and the following information except
the amount of insurance it intends to write
All of the following are ways in which a major medical policy premium is determined except
the average age of the group
which of the following is not a characteristics of group long term disability plan
the benefit can be up to 50% of ones yearly income
in insurance policies the insured is not legally bound to any particular action in the insurance contract but the insurer is legally obligated to pay losses covered by the policy what contract element does this describe
unilateral
all of the following cases show when a small employer medical plan cannot be renewable except
when the employer chooses to renew the plan
which of the following types of insurance policies would perform the function of cash accumulation
whole life
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?
within 90 days or as soon as reasonably possible, but not exceed 1 year
All of the following are correct about the required provisions of a health insurance policy except
a reinstated policy provides immediate coverage for an illness
In insurance transaction fiduciary resposbinblity means
being liable with respect to payment of claims
Prior to issuance of a long term care policy to an applicant age 80 or older the insurer must obtain all of the following except
data of pervious doctor visits
what insurance concept is associated with the name wises and fitch
guides describing company financial integrity
The annual contribution limit of a Dependent Care Flexible Spending Account is set by
the IRS
which of the following is an example of liquidity in a life insurance contract
the cash value available to the policyowner
Regarding Medicare SELECT policies, what are restricted network provisions?
they condition the payment of benefits
An agent and an applicant for a life insurance policy fill out and sign the application. However, the applicant does not wish to give the agent the initial premium, and no conditional receipt is issued. When will coverage begin?
when the agent delivers the policy, collects the initial premium, and the applicant completes an accentuable statement of good health
When is the earliest a policy may go into effect
when the application is signed and a check is given to the agent
Which of the following determines whether disability insurance benefits are taxed
whether the premiums were tax deductible
how long is an open enrollment period for Medicare supplement policies
6 months
A long term care insurance shoppers guide must be provided in the format developed by which of the following
NAIC
Which of the following is not true of basic medical expense plans
coverage for cataphoric medical expenses
Which of the following is true regarding a term health policy
it is nonrenewable
all of the following are correct about the required provisions of a health insurance policy except
a reinstated policy provides immediate coverage for illness
Occasional visits by which of the following medical professionals will not be covered under LTC home health care
attending physicians
What type group rating uses the actual experience of the group as a factor in developing the rates to be charged
experience rating
Workers Compensation benefits are regulated by which entity
state govermenet
A man bought an individual health insurance policy for himself. Which of the following roles does he now legally have?
Both subscriber and insured
An applicant who receives a preferred risk classification qualifies for
Lower premiums than a person who receives a standard risk
Which of the following types of agent authority is also called perceived authority
apparent
Which of the following entities must approve all Medicare supplement advertisements
insurance commissioner or director
Medical savings accounts are only available to groups of how many employees
no more than 50
an employee group with which of the following number of employees would qualify for a medical savings account
23 employees
All of the following statements describe MEWA expect
MEWAs are groups of at least 3 employers
a hospital indemnity policy wil pay
a benefit for each day the insurer is in the hospital
The purpose of managed care health insurance plans is to
control health insurance claims expense
an insured long term care policy is scheduled to pay a fix amount of coverages of $120 per day. the long term care facility only changed $100 per day. how much will the insurance company pay
$120
The relation of earnings to insurance provision allows the insurance company to limit the insures benefits to his/her average income over what period of time
2 years
Who must sign the "Notice Regarding Replacement"?
Both the applicant and agent
Under which of the following disability income plans would benefit the subject to income tax
group
The limits of a health reimbursement account are set by
the employer
Who determines the eligibility and contribution limits in a HRA
the employers determines both
In a group policy, who is issued a certificate of insurance
the individual insured
an insured had $500 left in his health reimbursement account when he quits his job what happens to the money
the insured can have access to the $500 at his previous employers discretion
When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?
the insurer is considered to be notified since the notification to agent equals notification tot he insurer
Which of the following is not a feature of a noncancelable policy
the insurer may terminate the contract only at renewal for certain conditions
Regarding the return of premium option for LTC policies, what happens to the premium if the policy lapses?
the insurer will return a percentage of the premiums paid
all of the folliwng would be a reason that the insurance company name could be disapprove for the use in the state of alabama ecxcept
the name is o long to be printed on a single lien
An HSA holder who is 65 years old decides to use the money in the account for non-health expense. WHich of the following is true?
there will be a tax
Which provision states that the insurance company must pay medical expenses claims immediately
time of payment of claims
All of the following cases show when a small employer medical plan cannot be renewable except
when the employer chooses to renew the plan
