Missed questions on practice exam

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? a) Only the surgery is covered under the plan b) Both a deductible and coinsurance payments will be required c) The plan will not cover the expenses due to the hazardous avocation d) The plan will not cover the expenses because the elimination period is not satisfied.

Both a deductible and coinsurance payments will be required

How many hours of Continuing Education are required to maintain a Counselor's license?

None, does not apply with a Counselor's license

If an insured purchases an insurance policy with a large deductible, what risk management technique is the insured exercising?

Retention

If an applicant submits the initial premium with an application, which action constitutes acceptance? a) The applicant submits a statement of good health b) The producer delivers the policy c) The insurance company receives the application and initial premium d) The underwriter approve the application

The underwriter approve the application

An employee that becomes ineligible for group coverage because of termination of employment or change in status, must exercise extension of benefits under COBRA

Within 60 days of separation

All the following health insurance disability benefits are income tax free EXCEPT a) Employee-paid group disability b) Key-person disability benefits c) Personally-owned individual disability insurance d) Employer-paid group disability

Employer-paid group disability

Only the agent is involved in completing the agent's report. The agent's statement is

Not included in the "entire contract"

In health insurance, the length of the grace period varies according to the a) Age of the insured b) Mode of premium payment c) Length of the waiting period d) Length of the benefit period

Mode of premium payment

What type of insurer uses a formal sharing agreement?

Reciprocal Insurers

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

continue to increase

The Commissioner has determined that a producer is ineligible for appointment by insurer. The Commissioner must notify the insurer within

5 days of determination

A disability income policy has a waiting period of 7 days. If the insured is disabled for 15 days, how many days of benefits will the policy pay?

8 days becuase of the elimination period

All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT a) Dollar limits on essential benefits b) Guaranteed renewability c) Coverage for emergency services d) Coverage for pre-existing conditions

Dollar limits on essential benefits

Regarding major medical plans

Higher stop-loss means lower premium

Once the initial benefit limit in Medicare Part D is reached, how is the beneficiary affected?

The beneficiary is then responsible for a portion (25%) of the prescription drug costs

An agent tells an insured that if he replaces his current insurance policy with a newer one, his dividends will be higher and his premiums will be slightly lower. The policy, however would not offer either one of these things, what type of misrepresentation is being committed?

Twisting

All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT a) Single employer with 14 employees b) An association of 35 people c) Labor Union d) Multiple employer trust

An association of 35 people

Which of the following provisions gives an employee the right to obtain individual health coverage without proof of insurability after group coverage has been terminated?

Conversion Provision

An elimination(waiting) period may NOT have to be satisfied for a disability in which of the following? a) An insured is disabled from a work-related accident b) An insured contracts an incurable disease c) An insured suffers a relapse of a prior disability within 6-months of the initial covered disability d) An insured suffered the disability from the results of active duty with the US Armed Forces

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

If a life insurance company uses HIV testing as a part of its underwriting, when must an applicant be notified of the procedure?

Prior to performance of the test

If the insurance premiums were not tax deductible, what other taxation will this affect? a) Taxation of interest b) Taxation of the policy's cash value c) Federal tax income d) Taxation of benefits

Taxation of benefits

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

The employer

Which of the following is provided by skilled medical personnel to those who need occasional medical assistance of rehabilitative care? a) Skilled care b) Intermediate care c) Custodial care d) Home health care

Intermediate care

Which of the following is NOT true of the agent's implied authority? a) It is incidental to express authority b) It is given to an agent by the insurance company that tis not specifically communicated c) It is specifically stated in the contract d) It is assumed by the agent in order to transact the business of insurance

It is specifically stated in the contract

What is another term for a health insurance policy subscriber?

Participant

Which of the following documents used in the underwriting process contains specific medical details about an applicant? a) Agent's report b) Application c) Attending Physician's Statement(APS) d) Statement of Good Health

Attending Physician's Statement(APS)

Which of the following statements is true of a Combination Dental Plan? a) It uses a nonscheduled basis for other dental services b) It covers diagnostic and preventive care on a scheduled basis c) It is also known as the comprehensive plan d) It is a combination of scheduled and nonscheduled dental plan

It is a combination of a scheduled and a nonscheduled dental plan.

What is a subscriber?

People who sign up for pre-paid health plans, such as HMOs.

In contrasting stock insurers with mutual insurers, which statement is true? a) Nonparticipating policies can pay out dividends to the policyholders b) Mutual insurers are owned by the shareholders and issue participating policies c) Stock insurers are owned by the shareholders and issue nonparticipating policies d) Stock dividends are tax free while policy dividends are taxable

Stock insurers are owned by the shareholders and issue nonparticipating policies

An employer is no longer able to afford the group health insurance plan and the plan terminates. However, one of the employees continues to receive coverage under the plan. Which of the following explains the reason for the continued coverage? a) The employee is totally disabled b) The employee is an executive covered under the plan c) The employee's health savings account pays for the coverage d) A nonforfeiture value is in place

The employee is totally disabled

Which of the following is TRUE regarding premium in a 10-year level premium policy? a) The premium will decrease at the end of the term b) The premium will be level for the first few years of the policy, but will increase by the 10th year c) The premium will remain level for 10 years d) The premium will remain the same at renewal

The premium will remain level for 10 years

An insurance agent visits a potential client and explains various types of policies. The customer displays a lack of interest, so the agent guarantees higher dividends than he knows would be possible. Which term describes what the agent has done? a) Rebating b) Twisting c) Defamation d) Misrepresentation

Misrepresentation

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

within 20 days of the loss or as soon as reasonable possible

Which of the following would NOT trigger the payment of Accelerated Death Benefits? a) Terminal Illness b) Requiring an organ transplant for the insured to survive c) Being permanently institutionalized d) Being permanently disabled

Being permanently disabled (accelerated death benefit does not cover disability)

All of the following are places where care can be administered for a medical plan EXCEPT a) Urgent care centers b) Eye centers c) Doctor's office d) Surgicenters

Eye centers

All the following are features of catastrophic planes EXCEPT a) High Premiums b) Out-Of-Pocket Costs c) High Deductibles d) Essential Benefits

High Premiums

Which of the following is NOT a Medicaid qualifier? a) Residency b) Insurability c) Income level d) Age

Insurability

An individual buys a disability policy May 1 with a waiver of premium rider. The insured becomes disabled June 1. It is determined the insured is permanently totally disabled on July 1; and he receives his first benefit payment of July 15. When does the waiver of premium provision start?

June 1

Ed is covered under a health plan provided by his employer. He was told that his insurance would pay the majority of the coever expenses if he would choose to see a provider in his plan's list. If Ed chose to be treated by a provider who was not on the list, his portion of the bill would be greater. Ed is covered under a/an

Preferred Provider Plan

An insured wants to cancel her health insurance policy. Which portion of the contract would explain cancellation rights?

Renewability provision

Which of the following is a daily nursing and rehabilitative care that can only be provided by medical personnel, under the direction of a physician? a) Skilled care b) Intermediate care c) Custodial care d) Assisted living

Skilled care

What is the exclusion ratio used to determine?

The annuity benefit to be excluded from taxes