work exam 2
a
Even though "sickness" is a peril covered by a health insurance policy, coverage may be limited or excluded because of all of the following EXCEPT a. exemption periods b. occupational exclusions
a
Medicare Advantage is also known as a. Medicare Part C b. Medicare Part D
b
Andy the producer violates the Insurance Code very intentionally, in order to substantially increase his commissions. How much would he likely be penalized? a. $1000 b. $25,000
a
A health insurance plan which involves financing, managing, and delivery of health care services and involves a group of providers who share in the financial risk of the plan or who an incentive to deliver cost of effective service, is called a. managed care plan b. self-insurer
b
An employee quits her job where she has a balance of $10,000 in her qualified plan. If she decides to do a direct transfer from her plan to a Traditional IRA, how much will be transferred from one plan administrator to another and what is the tax consequence of a direct transfer? a. $8000 tax on growth only b. $8000 no tax consequence
a
Mike is still employed at age 60 and wants to know what health insurance coverage he is eligible to receive. Which of the following options are available to Mike? a. continuation of group health b. reapplication of group health
b
insurance companies that hold a certificate of authority to transact insurance in LA must be examined how often? a. every 4 years b. every 5 years or as often as the Commissioner feels is necessary
b
nontaxable transaction a. rollover b. 1035 exchange
b
which of the following individuals are responsible for making premium payments in an HMO plan? a. payors b. subscribers
b
which of the following is an example of a producer being involved in an unfair trade practice of rebating? a. inducing the insured to drop a policy in favor of another one when it's not in the insured's best interest b. telling a client that his first premium will be waived if he purchased the insurance policy today
a
All of the following are characteristics of group life insurance EXCEPT a. premiums are determined by the age, sex, and occupation of each individual certificate holder b. amount of coverage is determined according to nondiscriminatory rules
a
The three main differences between fixed and variable annuities include all of the following EXCEPT a. mortality b. underlying investments
b
Which of the following is the most common time for errors and omissions to occur on the part of an insurer? a. application process b. policy delivery
a
An insured has a major medical policy with a $500 deductible and 80/20 coinsurance. The insured is hospitalized and sustains a $2,500 bill. What is the maximum amount that the insured will have to pay? a. $900 b. $500
a
An insurer is helping a married couple determine their children's needs, assets, and liabilities in the event that one or both of the spouses should die. What is the term most closely associated with this? a. survivor protection b.survivorship insurace
b
Certain conditions, such as dismemberment or total and permanent blindness, will automatically qualify the insured for full disability benefits. Which disability policy provision does this describe? a. partial disability b. presumptive disability
b
Concerning insurance, the definition of a fiduciary responsibility is a. Commingling premiums collected with agent's personal funds. b. handling insurer funds in a trust capacity
a
How is emergency care covered for a member of an HMO? a. A member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area b. A member of an HMO may receive care at any emergency facility, at the same cost as if in his/her own service area
a
If an insured continually uses the automatic premium loan option to pay the policy premium a. policy will terminate when the cash value is reduced to nothing b. the face amount of the policy will be reduced by the automatic premium loan amount
a
If only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it? a. unilateral b. conditional
a
In respect to the consideration clause, which of the following is consideration on the part of the insurer? a. Promising to pay in accordance with the contract terms b. Explaining policy revisions to the applicant
b
Inspection report may be obtained by an insurance company from a. the agent b. independent investigating firm
b
Insurer examinations must occur no less frequently than every a. 3 years b. 5 years
a
Ron joins the PPO that is provided by his employer. If Ron decides to go to a physician who is not a PPO provider, which of the following will happen? a. PPO will pay reduced benefits b. Ron will be required to pay a higher deductible
a
The owner of a small business applies for a fire insurance policy with limits equal to 100% of the property's value. The owner has huge unsold inventories and a large personal gambling debt. From an underwriting standpoint, this might indicate a. moral hazard b. speculative risk
a
The provision which prevents the insured from bringing any legal action against the company for at least 60 days after the proof of loss is known as a. legal action b. time limit on certain defenses
a
Tyler applied for an individual health insurance policy. While completing the application, his agent told him that all of the following statements would be underwriting factors EXCEPT a. his jobs requires that he flies regularly on a commercial airplane b. his avocations include scuba diving
a
What are 2 components of Universal policy? a. insurance and cash amount b. insurance and death benefit
b
What is a major problem with naming a trust as the beneficiary of a life insurance policy? a. The insured must have the Superintendent's permission to name a trust as the beneficiary b. They are expensive to administer.
b
What is surplus lines insurance? a. Insurance in excess of a standard policy's coverage b. Insurance placed with an unauthorized insurer
b
What is the advantage of reinstating a policy instead of applying for a new one? a. The cash values have gained interest while the policy was lapsed b. The original age is used for premium determination
b
What policy component must decrease in decreasing term insurance? a. cash value b. face amount
b
Which nonforfeiture option has the highest amount of insurance protection? a. reduced paid-up b. extended term
b
Which of the following products requires a securities license? a. equity indexed annuity b. variable annuity
b
Which of the following would NOT be true regarding a $100,000 20-year level term policy? a. If the insured dies before the policy expired, the beneficiary will receive $100,000 b. At the end of 20 years, the policy's cash value will equal $100,000
a
Which types of insurance companies marketing long-term care insurance coverage must establish procedures to assure that any comparison of policies by its agents will be fair and accurate? a. Every company is required to establish marketing procedures. b. mutual and stock companies
a
Who is responsible for making sure that agents are properly trained in the use of the suitability standards for LTC policies? a. insurer b. commissioner
b
an insurer wishes to compare the info given in an insurance application with previous insurance applications by the same applicant but for different companies. What organization can help the insurer accomplish this? a. NAIC b. MIB
b
in forming an insurance contract, when does acceptance usually occur? a. when an insurer accepts an application b. when an insurer approves a prepaid application
b
which of the following is true regarding taxation of accelerated benefits under a life insurance policy? a. there is a 10% penalty for early distributions of the death benefit b. they are tax free to terminally ill insured
b
which of the following is usually true of a participating life insurance policy? a. may be converted to a term life policy b. pays dividends to policyowners
b
with the cash refund option, when the annuitant dies, what would the beneficiary receive? a. cash refund of the amount paid into the annuity b. the refund of the original amount minus the payments already made
a
Who makes up the Medical Information Bureau? a. insurers b. hospitals
b
A life insurance policyowner skips her premium payment, but the policy does not lapse. Instead, the premium amount is deducted from the cash value of the policy. What type of policy is this? a. adjustable life b. universal life
a
A married couple's retirement annuity pays them $250 per month. The husband dies and his wife continues to receive $125.50 per month for as long as she lives. When the wife dies, payments stop. What settlement option did they select? a. joint and survivor b. joint annuity
b
Fixed annuity contract provides for a. protection from inflation b. level benefit payments
a
all of the following could own group life insurance EXCEPT a. group needed low-cost insurance b. a group sponsored by an employer
b
all of the following statements describe a MEWA except a. MEWAs can be self-insured b. MEWAs are groups of at least 3 employers
b
which of the following hospice expenses would NOT be covered in a cost containment setting? a. Tylenol b. antibiotics
a
Regarding the concept of creditable coverage, the number of days of coverage spent under the group plan will be used to reduce the 12-month waiting period for pre-existing conditions coverage if the employee doesn't have a break in coverage of more than a. 63 days b. 31 days
a
all other factors being equal, the least expensive first-year premium payment is found in a. annually renewable term b. decreasing term
b
the term "illustration" in a life insurance policy refers to a. depiction of policy benefits and guarantees b. presentation of non-guaranteed elements of a policy
b
under SIMPLE plans, participating employees may defer up to a specified amount each year, and the employer then makes a matching contribution up to an amount equal to what % of the employee's annual wages? a. 5 b. 3
b
what limits the amount that a policyowner may borrow from a whole life insurance policy? a. face amount b. cash value
b
what provisions can reduce the disability benefit base upon the insured's current income? a. waiver of monthly premium b. relation of earnings to insurance
b
which of the following best describes what the "annuity period" is? a. the period of time spanning from the accumulation period to the annuitization period b. the period of time during which accumulated money is converted into income payments