NYS Life Accident and Health

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

The employer

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

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?

5 days

Any licensed person whose activities affect interstate commerce and who knowingly makes false material statements related to the business of insurance may be imprisoned for up to

10 years

If a person qualifies for Social Security disability benefits after the 5 months 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

Which of the following statements concerning buy-sell agreements is true?

Buy-sell agreements are usually funded with a life insurance policy

What type of an interest rate is guaranteed in universal life policies?

Contract interest rate

The purpose of managed care health insurance plans is to

Control health insurance claims expenses

An individual has a $200,000 convertible term life insurance policy. If he chooses, he can

Convert a whole life policy for the same face amount without proof of insurability

All of the following statements are true regarding tax-qualified annuities EXCEPT

Employer contributions are not tax deductible

What type of rating is used for group health policies?

Experience rating

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

All of the following are features of catastrophic plans EXCEPT

High premiums

Who would be allowed catch-up contributions into an IRA plan?

Individuals age 50 or older

Which health insurance provision ensures that multiple policies that provide the same benefits on an expense-incurred basis pay a proportionate share of a claim?

Insurance with Other Insurers

Cash Value guarantees in a whole life policy are called

Nonforfeiture values

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

Prevent claimants from profiting from an injury or sickness

All of the following are considered to be supplemental benefits under an HMO plan except

Preventative services

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 the performance of the test

Which of the following is correct regarding selecting a primary care physician in a PPO plan?

The insured may choose medical providers not found on the preferred list

Which entity has the option of including optional provisions in a health insurance policy?

The insurer

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

The owner of a shop

When an insured terminates membership in the insured group, the insured can convert to what type of individual life insurance?

Whole like without proof of insurability

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

5%

If compensation is authorized, it must be made in writing, including the amount of compensation and signed by the person to be charged. How long must a copy of this record be kept?

At least 3 years

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

Risk retention

An employer has 15 employees and offers a group health plan to all employees. If an employee remains on the group plan and signs up for Medicare, which coverage will be primary?

Medicare

Which of the following statements is NOT correct regarding Medicare?

Medicare Advantage must be provided through HMOs

What is the name of the state marketplace that helps New York residents shop for and enroll in health insurance plans?

New York State of Health

Annuities certain limit the amount paid by the annuity to a certain fixed

Period or fixed amount

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

Persons receiving Medicaid are not eligible

All of the following are ways in which a Major Medical policy premium is determined EXCEPT

The average age of the group

What is the maximum fine for violating a cease and desist order?

$5,000

How long after the date of issue can the insurer cancel an accident and health policy?

90 days

Under the New York State Disability Benefit Law. which of the following individuals would most likely be covered?

A teacher working for a private school

What is it called when a doctor accepts the Medicare approved amount?

Assignment

The part of Medicare that helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care, is known as

Part A

Who is the beneficiary in a credit disability income policy?

The lending institution

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

Which of the following is NOT a common exclusion found in most health policies?

Dental procedure due to birth defect

To purchase insurance, the policyowner must face the possibility of losing money or something of value in the event of loss. What is this concept called?

Insurable interest

What does an annuity protect the annuitant against?

Living longer than expected

Medicare Part B covers all the following EXCEPT

Long-term care services

Under an extended term nonforfeiture option, the policy cash value is converted to

The same face amount as in the whole life policy

An insurance agent who represents multiple companies on a nonexclusive basis and earns commissions on personal sales is working in what kind of marketing system?

Independent Agency System

Who might recieve dividends from a mutual insurer?

Policyholders

Medicare Part A services do NOT include which of the following?

Private Duty Nursing

A licensed life agent wrote a policy that covers the life of his brother. Since the policyowner was related, the agent refunded the commission earned on this policy to the insured. This would be considered

Rebating

What type of insurer uses a formal sharing agreement?

Reciprocal insurers

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

Being permanently disabled

Which of the following terms refers to the nontaxable portion of each annuity benefit payment?

Cost base

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

Currently insured

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 expense as a result of the accident. Darryl's disability Income policy will pay

Darryl's loss of income

J is receiving fixed amount benefit payments from his late wife's insurance policy. He was told that if he dies before all of the benefits are paid, the remaining amount will go to the contingent beneficiary. Which settlement option did J choose?

Fixed amount

Contributions to Roth IRAs are

Not tax deductible

What is the purpose of a benefit schedule?

To state what and how much is covered in the plan

Which of the following riders pays a beneficiary a death benefit that is double or triple the face amount if the insured's death was caused by an accident as defined in the policy?

An Accidental Death Rider

Variable life insurance is regulated by all of the following entities EXCEPT

The U.S. Department of Treasury

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 Medicare program, and you use 3 years of nursing home care, or 6 years of home care.

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

Which of the following is NOT a Medicaid qualifier?

Insurability

Which of the following refers to "own occupation" disability?

Insured is unable to perform duties of the occupation for which they were educated and trained

All of the following are considerations under the needs approach planning for life insurance EXCEPT

Insured's income

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

Intermediate Care

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

The premium is based on the age of each insured

All of the following are true regarding the waiver of cost of insurance rider EXCEPT

The rider expires when the insured reaches age 60

The dividend option in which the policyowner uses dividends to purchase a term policy for one year is referred to as the

One-year term option

What will effect 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

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

If a certificate of appointment is terminated, a statement must be filed with the Superintendent within

30 days

If licensees have administrative action taken against them, they must report this to the Superintendent within

30 days

Which of the following used to be called Medicare Choice Plans?

Medicare Advantage (Part C)

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

Dollar limits on essential benefits

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

What is the purpose of the New York Partnership for LTC?

It combines LTC insurance and Medicaid to help people prepare for nursing home care

Which of the following is NOT covered under a long-term care policy?

Acute care in a hospital

Which of the following types of care could be provided at a community center?

Adult day care

Which of the following is NOT true regarding the Life with Guaranteed Minimum annuity settlement option?

It does not guarantee that the entire principal amount will be paid out

Which of the following is NOT true regarding policy loans?

Money borrowed from the cash value is taxable

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

Renewability provision

An insured's health insurance policy pays benefits according to a list which indicates the amount that is payable under each type of covered treatment or procedure. That means the policy provides benefits on what basis?

Scheduled

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

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?

The employee is totally disabled

An underwriter is reviewing the medical questions in the application and needs further information due to a medical situation the applicant had in the past. What will the underwriter require?

Attending Physician Statement