Pennsylvania xcel final
In long term care policy, the right to examine period is
30 days
In accident and health plans, premiums paid less frequent than monthly require a minimum grace period of at least
31 days
Under Pennsylvania statute, first year commission for long-term care insurance may not be greater than
50% of the first year premium
In Pennsylvania, an insurer may backdate policy issue not more than how many months from the date of a life insurance application?
6 months
If a health insurance claim is not promptly paid, legal action may be taken against the insurer after
60 days from the date proof of loss is furnished
In Pennsylvania, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period that a new group health plan can apply. This rule is applicable as long as there has been no gap in creditable coverage for a period greater than
63 days
In Pennsylvania, what's the requirement for a minor to receive proceeds from a death benefit?
A guardian must be appointed
A Modified Endowment Contract (MEC) is best described as
A life insurance contract which accumulates cash values higher than the IRS will allow
A plan in which an employer pays insurance benefits from a fund derived from the employer's current revenues is called
A self-funded plan
Which of these is considered to be a Living Benefit option in a life insurance policy?
Accelerated death benefit
A long-term care policy typically provides all of the following levels of cares except
Acute care
A policyowner may change two policy features on what type of life insurance?
Adjustable Life
An underwriter's primary responsibility to an insurer is to protect against
Adverse selection
How does life insurance create an immediate estate?
After first premium is paid, the face amount may be available to the beneficiary
What amount will be paid under a policy where the insured misstated his/her age?
An amount the premium would have purchased at the correct age
Which of the following is considered to be the period when the accumulated value in an annuity is paid out
Annuitization phase
According to life insurance contract law, insurable interest exists
At the time of application
An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before
Bringing legal action against the insurer
How are health plans classified according to the Affordable Care Act?
Bronze, Silver, Gold, Platinum
In which of the following relationships would there not be insurable interest?
Business owner to business customers
Which of these is not considered a form of insurance advertisement?
Buyer's guide
Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have?
Calendar-year deductible
An order issued by the commissioner that prohibits a specific practice listed in the order is called a
Cease and desist order
Which of the following is not part of an insurance contract?
Certificate Authority
Which of the following is not a required provision in an accident and health insurance policy
Change of occupation
A policy that allows a policyowner to temporarily give up ownership rights to secure a loan is called a
Collateral assignment
A health insurance policy where the insurer has the right to terminate the policy for reasons other than the insured's health is called
Conditionally renewable
A form of medical health insurance covering the treatment and care of gum disease is called
Dental expense insurance
A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?
Dental treatment is needed to repair an injury
Lisa has recently bought a fixed annuity. Which of these is considered to be a disadvantage of owning this type of annuity?
During periods of inflation, annuitants will experience a decrease in purchasing power of their payments
Which prohibited act involves a producer spending a client's insurance premiums for his/her own personal use?
Embezzlement
Which of these would limit a company's liability to provide insurance coverage?
Exclusion
Fraternal Benefit Society has each of the following characteristics EXCEPT
Exist For profit
A life insurance rider that allows an individual to purchase insurance as they grow older, regardless of insurability, is called a
Guaranteed insurability rider
Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a
Guaranteed insurability rider
Tom has a rider on his disability income policy that guarantees the right to increase his benefits without a medical exam. What kind of rider is this?
Guaranteed insurability rider
What is the required Renewability status of all Medicare supplement policies?
Guaranteed renewable
Which of the following is not included under a health benefit plan
Hospital indemnity plan
Which of the following provisions protects a Pennsylvania policyowner from an innocent mistake made on the application over 2 years ago
Incontestability provisions
A policyowner is prohibited from making any changes to the policy without the beneficiary's written consent under which beneficiary designation?
Irrevocable beneficiary
Violating Pennsylvania insurance law may result in which of the following Insurance Department actions?
Issuance of a cease and desist order after a hearing
Which of the following statements is true about medicaid?
It is funded by federal, state, and local taxes
What happens to interest earned if the annuitant dies before the payout start date
It is taxable
Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?
It would be considered taxable income to the employee
Which type of life insurance is normally associated with payor benefit rider
Juvenile insurance
The authority granted to a licensed producer is provided via the
Law of Agency
In Pennsylvania, completion of continuing education is required upon license renewal for which of the following?
Licensed individuals qualified in major lines of insurance
An insurance company may only pay commission to a
Licensed producer appointed by the insurer
Low frequency diseases can be exclusively covered by what kind of health insurance policies?
Limited policies
The IRS states that a taxpayer's medical expenses that exceed 7.5% of their adjusted gross income is tax deductible. Which of these is considered a medical expense under this rule
Long term care insurance premiums
An employer is issued a group medical insurance policy. The single contract is know as
Master policy
An employer is issued a group medical insurance policy. This single contract is know as
Master policy
Which of these gaps in Medicare coverage is addressed with Medicare supplemental insurance?
Medicare in-hospital deductible
During the first two years a life insurance policy is in force, the insurer may contest a policy for all of the following reasons except
Misstatement of age in the application
A beneficiary has just received a claim payment for a life insurance policy. Which of the following is TRUE regarding the federal income tax liability owed?
No federal income tax is owed on life insurance proceeds
The document that describes policy features, benefits, exclusions and riders in a long-term care policy is known as the
Outline of Coverage
Which clause defines total disability as being unable to perform the major duties of the insured's regular occupation?
Own occupation clause
What is know as the immediate specific event causing loss and giving rise to risk?
Peril
In what form do disability income policies typically pay benefits
Periodic income
Which of these is considered to be a document that describes the critical segments of a life insurance policy
Policy summary
During the accumulation period, who can surrender an annuity?
Policyowner
Replacement regulation is designed to protect the interests of
Policyowners
All of the following are functions of an insuring clause except
Primarily describes the free-look period
The branch of dentistry which deals with replacement of missing parts
Prosthodontics
The branch of dentistry which deals with the replacement of missing parts is called
Prosthodontics
How are survivorship life insurance policies helpful in estate planning
Provide funds to help pay taxes
What is the primary reason for buying an annuity?
Provide future economic security
When hmo to a ppo, the ppo
Provided a greater choices of providers
The Commissioner is responsible for all of the following EXCEPT
Recommending insurers
Which of the following is an example of a producer's fiduciary duty?
Recording receipt and remittance of premiums due to the insurance company
All of the following are considered to be nonforfeiture options available to a policyowner except
Reduction of premium
A policyowner may exercise which of these dividend options that uses the dividend to pay all or part of the next premium due?
Reduction of premium dividend option
An annuitant dies during the distribution period. What kind of annuity will return to a beneficiary the difference between the annuity value and the income payments already made?
Refund annuity
According to the affordable care act, what metal tier is required to have an actuarial value of 70% with covered individual paying 30% through deductibles, co-pays, and other cost sharing features
Silver plan
A life insurance producer licensed in commonwealth of Pennsylvania is authorized to
Solicit, receive and forward applications to the insurer
An insurer has the right to recover payment made to the insured from the negligent party. These rights are called
Subrogation
Which of these is not a characteristic of accelerated death benefit option
The benefit can be offered as a rider at a specific extra cost or may be at no cost
What does the word "level" in level term describe?
The face amount
In which of the following situations would the insurer be liable for a loss
The insured suffered an injury as an innocent bystander during a bank robbery
A partial surrender is allowed in which of the following life policies?
Universal Life
Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?
Unpaid premium
Which type of policy combines the flexibility of a universal life policy with investment choices?
Variable universal life policy
All of these statements concerning whole life insurance are false except
When a whole life policy is surrendered, income taxes may be owed
For Pennsylvania Insurance Code violations, the Commissioner may assess a(n)
administrative penalty
People with higher loss exposure have the tendency to purchase insurance more often than those at average risk. This is called
adverse selection
Fixed period settlement options are considered to be a form of a(n)
annuity
Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him?
assisted living
A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called a
association or labor group
The commissioner has the right and duty to
audit insurer financial reports and conduct market studies
An insured dies from what appears to be accidental causes. When confirming the cause of death, which of these actions by the insurer takes precedence?
autopsy
Under a group life policy, the insurer will issue an individual _____ to the policyowner for delivery to each person insured.
certificate
Life insurance policies will normally pay for losses arising from
commercial aviation
A waiver of premium rider allows an insured to waive premium payments if the insured is
completely and permanently disabled
Field underwriting performed by producer involves
completing the application and collecting initial premium
In order for a contract to be valid, it must
contain an offer and acceptance
Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)
conversion
All of these are standard exclusions found in a life insurance policy EXCEPT
disability
Benefits provided by a Medicare Supplement policy must NOT
duplicate Medicare benefits
Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the
employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan
The limited period of time given to all members to sign up for a group health plan is called the
enrollment period
A professional liability for which producers can be sued for mistakes of putting a policy into effect is called
errors and omissions
A producer is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with this client?
financial objectives
When collecting insurance premiums from a client, a producer must
forward premiums to the insurer on a timely basis
Fixed annuities provide each of the following except
hedge against inflation
For licensing purposes, if an applicant has a home or office location in the state of Pennsylvania, this would be consistent with which of the following?
home state
Sharing 50% of a producer's commission with the insured is an example of
illegal inducement
Which type of beneficiary should be named if the insured wants to give explicit directions on how the policy proceeds should be paid?
individual
Who assumes the investment risk with a fixed annuity contract?
insurer
An example of a primary care physician would be a
internist
Non-admitted Insurer
is not afforded protection by the guaranty fund
A life insurance policy written on one contract for two people in which it is payable upon the first death is called
joint
A common exclusion with Vision plans is
lasik surgery
Commissions may be shared by
licensed and appointed Producers
Someone needing custodial care at home would require which type of coverage?
long term care
Which of the following is considered to be a point of service (POS) plan)
managed care plan
An insurer would be committing Unfair Discrimination if coverage was denied based upon
marital status
In contrast to a guaranteed renewable policy, a noncancellable policy
may never raise premiums
A guaranteed issue insurance policy has no
medical underwriting
A beneficiary change can occur
normally at any time during the policy term
A nonparticipating policy will
not pay dividends
How are contributions made to a Roth IRA handled for tax purposes?
not tax deductible
Which of the following is not an example of utilization review?
ongoing inspection of accident prone individuals
A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n)
optional renewability clause
A policyowner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this injury would make him eligible for benefits under which provision?
partial disability
States that have "no loss no gain" laws require a replacing policy to
pay for ongoing claims under the policy it replaces
The federal employees benefit program consists of two types of health plans for federal civilian employees. The two plans are fee-for-service and
prepaid
Who can receive an insurance commission?
producer
What is the automatic continuance of insurance coverage referred to as?
renewal
Under the subrogation clause, legal action can be taken by the insurer against the
responsible third party
Long term care policies may provide coverage for claims arising from
senile dementia
Which of the following is the Pennsylvania insurance department not responsible for?
shareholders
Health insurance involves two perils, accident and?
sickness
Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called
skilled nursing care
A policyowner can receive an immediate payment before the insured dies by using a(n)
viatical settlement contract
Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds
will no longer provide insurance protection
Kate has a Major Medical Plan with a 75/25 coinsurance and a deductible of $25. How much will she have to pay if she, not having met any of her deductible, visits the doctor and receives a bill for $125?
$50
An insured may return their accident and health policy within ____ days of policy delivery
10 days
Kathy pays a monthly premium on her health insurance policy. How long is her grace period?
10 days
The typical long-term care insurance policy is designed to provide a minimum of ___ years of coverage
1 year