State Exam Simulator

Which of the following types of care is typically not covered in a Long-Term Care policy?

Acupuncture

All of the following entries are classified under the four principal areas of Florida insurance law EXCEPT

An agent's commission

All of the following statements regarding group health insurance is true, EXCEPT:

An individual policy is given to each member

Which of the following acts is an agent NOT authorized to do on behalf of an insurer

Authorize claim payments

The insurer must provide a prospective buyer with a(n)

Buyer's Guide and Policy Summary

Which of the following can an agent provide to help a prospective client understand and purchase the most appropriate product?

Buyer's guide

In Florida, which of the following is considered an Unfair Trade Practice?

Coercion

Which of the following is an example of an Unfair Trade Practice?

Coercion

Which of the following areas of state regulation is NOT protected by the savings clause in ERISA?

Commerce

All of the following are eligibility requirements for an association group EXCEPT

Contributory plans require a minimum of 25 participants

M becomes disabled and is unable to work for six months. M dies soon after from complications arising from this disability. M has a Disability Income policy that pays $2,000 a month. Which of the following statements BEST describes what is owed to her estate?

Earned, but unpaid benefits

Which of the following is NOT a consequence for placing business with an unauthorized insurer?

First degree misdemeanor

In Florida, when agents recommend changes be made for existing coverage, the agent must follow established procedures. The name of this rule is called the

Flordia Replacement Rule

Which organization was established to provide funds to protect an insured in the event of an insurer's insolvency?

Florida Life and Health Insurance Guaranty Association

With Accidental Death and Dismemberment policies, what is the purpose of the Grace Period?

Gives the policyowner additional time to pay overdue premiums

For which of the following expenses does a Basic Hospital policy pay?

Hospital room and board

How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy?

If the primary beneficiary dies before the insured

Which of the following claims are typically excluded from Medical expense policies?

Intentionally self-inflicted injuries

According to Florida law, which of the following statements accurately describes an admitted mail order insurance company?

It may solicit insurance business by mail without the assistance of a licensed agent

Stranger Originated Life Insurance (STOLI) has been found to be in violation of which of the following contractual elements?

Legal Purpose (Insurable Interest)

What is the main reason for regulating the insurance industry?

Maintain the solvency of insurance companies

Which Unfair Trade Practice involves making a false statement on an insurance application in order to receive money from an insurer?

Misrepresentation

Which of the following is NOT an unfair claim settlement practice?

Needing written documentation of claim details

How can an agent-in-charge have more than one location?

Only if the agent-in-charge is present when insurance activity occurs

Which of the following types of insureds are life insurance companies allowed to make policy rate discriminations against?

People that smoke

Which action could result in a hearing being ordered by the Department of Financial Services?

Performing insurance transactions without a license

Which Long Term Care insurance statement is true?

Pre-existing conditions must be covered after the coverage has been in force for six months

How does group insurance differ from individual insurance?

Premiums are lower

What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?

Premiums may increase at time of renewal

T is covered by two health insurance plans: a group plan through his employer and his spouse's plan as a dependent. Under the Model Group Coordination of Benefits provision, when T files a claim, his employer's plan is considered the:

Primary carrier

Which of these is NOT a type of agent authority?

Principal

An insured covered by Accidental Death and Dismemberment (AD&D) insurance has just died. What will happen if the primary beneficiary had already died before the insured and contingent beneficiary?

Proceeds will go to the contingent beneficiary

What is the purpose of the Life and Health Insurance Guaranty Association?

Protects policyowners against insolvent insurance companies

Which of these is NOT a legal entity for selling life insurance in Florida?

Risk management advisers

P is a producer who notices 5 questions on a health application were not answered. What actions should P take?

Set up a meeting with the applicant to answer the remaining question

Which mode of payment is NOT used by health insurance policies?

Single premium

A mutual insurance company and a stock insurance company have one main difference between them. What is this major contrast?

Stock company is owned by its shareholders. Mutual company is owned by its policyholders.

A "reimbursement policy" pays what amount of covered Long-Term Care expenses?

The Actual covered expenses up to the daily maximum

A policy of adhesion can only be modified by whom?

The insurance company

Who does an agent represent during the solicitation of insurance?

The insurance company

J is an agent who has induced an insured through misrepresentation to surrender an existing insurance policy. What is J guilty of?

Twisting

A Business Overhead Expense policy would cover which of the following if a business owner becomes disabled?

Utilities and office rent

T and S are named co-primary beneficiaries on a $500,000 Accidental Death and Dismemberment policy insuring their father. Their mother was named contingent beneficiary. Five years later, S dies of natural causes and the father is killed in a scuba accident shortly afterwards. How much of the death benefit will the mother receive?

0

Advertising gifts not to exceed ___ are allowed to be given by an agent to a prospective client.

25

Within how many days must a licensee notify the Department of Financial Services of a change in address?

30

V is insured under an individual Disability Income policy with a 30-day Elimination period. On July 1, he is involved in an accident and temporarily disabled. He returns to work on December 1. How many months of benefit are payable?

4

Florida requires that an insurance agent must complete __ hours of continuing education on the subject of law and ethics every two years.

5

In Florida, what is the maximum percentage of controlled business an agent may produce?

50%

Qualified Long-Term Care policies may take into consideration an applicant's pre-existing conditions for a maximum of not more than __ month(s) prior to the effective date of coverage.

6

According to Florida law, an additional lapse notice must be issued after the standard grace period has expired for policyowners age

64 years or older

An individual has a Major Medical policy with a $5,000 deductible and an 80/20 Coinsurance clause. How much will the INSURED have to pay if a total of $15,000 in covered medical expenses are incurred?

7000

During the application process, the agent's primary responsibility is to

he insurance company

G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills?

him the insured

With a Basic Medical Expense policy, what does the hospitalization expense cover?

hospital room and board

A life insurance policy would be considered a wagering contract WITHOUT:

insurable interest

A foreign insurance company doing business in Florida

is a company that was formed under the laws of another state

In Florida, an element of an insurance transaction would be

issuing an insurance contract

Which of the following situations does a Critical Illness plan cover?

leukemia

Which of the following is NOT a limited benefit plan?

life insurance policies

Pre-hospitalization authorization is considered an example of:

managed care

Convincing a prospective insured to buy an insurance policy based on exaggerations is called

misrepresentation

Which type of insurance company allows their policyowners to elect a governing body?

mutual

An example of rebating would be

offering a client something of value not stated in the contract in exchange for their business

An example of unfair discrimination would be

offering different terms of coverage for different policyowners having the same risk classification

Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured?

ppo

Who owns a stock company?

stockholders

An example of an unfair claims settlement practice is

turning down a claim without providing the basis of denial

An agent who makes misleading statements that lead to the termination of an existing insurance policy so that a new policy with another insurer can be taken out has committed

twisting

What is the primary factor that determines the benefits paid under a disability income policy?

wages

All of the following will result in the suspension of an agent's license EXCEPT

acting with fiduciary responsibility

Q purchases a $500,000 life insurance policy and pays $900 in premiums over the first six months. Q dies suddenly and the beneficiary is paid $500,000. This exchange of unequal values reflects which of the following insurance contract features?

aleatory

An example of an unfair trade practice is

an agent making a material misrepresentation to the insured

An applicant's medical information received from the Medical Information Bureau (MIB) may be furnished to the:

applicant's physician

An applicant who pays the initial premium at the time of application is typically given a(n)

conditional receipt

A prospective insured completes and signs an application for health insurance but intentionally conceals information about a pre-existing heart condition. The company issues the policy. Two months later, the insured suffers a heart attack and submits a claim. While processing the claim, the company discovers the pre-existing condition. In this situation, the company will:

continue coverage but exclude the heart condition

An insurance company incorporated under the laws of the state in which its home office is located is called a(n) ____ company.

domestic

In Florida, an insurer domiciled and incorporated in this state is called a(n)

domestic company

In Florida, an insurer licensed to conduct business in Florida, but domiciled in New Jersey, is called a(n)

foreign company

The Life and Health Insurance Guaranty Association is

funded by admitted insurance companies through assessments