Exam 8
the insured's policy has a deductible that is applied between the exhaustion of basic plan limits and the commencement of excess coverage. this is called a
Corridor deductible
which two are Activities of Daily Living
Eating and dressing
any insurer that provides claim forms must include which of the following statements?
"For your protection CA law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison"
in a group life plan, unmarried children may be covered as dependents until age
21
in a group life plan, a dependent child attending an educational institution may be covered until age:
24
If an insurer inadvertently is found guilty of unfair trade practices while issuing, renewing and servicing a policy, the insurer could be prosecuted for how many violations?
3
which of the following is NOT covered by the CLHIGA
Group stop loss plans
which of the following is NOT true regarding Managing General Agents
They do not collect premium money from producing broker-agents
all of the following apply to an insurance broker (not an insurance agent), except
a broker is appointed by an insurer to transact insurance
which of the following is NOT excluded by group life
accidental injury
the federal law known as COBRA does which of the following
allowing for, and providing protection of ex-employees, as well as their dependents by providing them the same conversion and extension benefits for group health insurance benefits as those given to existing employees
if a dependent child covered by a group life plan is incapable of self-support, coverage under the plan may continue up to age
any age
if a physician is paid through a Preferred Provider Organization (PPO), the normal way of paying him/her is:
by payment directly for each service
an insurer owned by a parent company that provides insurance to cover the parent company's loss exposures is a:
captive insurer
Medicare part b does/is not
cover the expense of virtually all drugs prescribed by a doctor
which of the following conditions would NOT be included among the chronic illness triggers of a LTC policy?
deafness
which of the following could be used to pay off the mortgage ona home, providing a death benefit that equals the amount of outstanding debt on the home, no more and no less?
decreasing the term insurance
in which of the following qualified pension plans are benefits linked to the employee's years of service and/or amount of compensation?
defined benefit plan
a waiting period between the onset of disability and the time when benefits begin is the
elimination period
the rules regarding life insurance policy illustrations are intended to ensure all of the following except
ensure that the illustration specifies that both guaranteed and non-guaranteed elements will continue unchanged for all years shown
in order to qualify for social security retirement benefits the worker must be
fully insured
life insurance illustrations showing premiums, values, credits or charges that are not determined at issue demonstrate:
non-guaranteed elements
Every insurer offering individual life insurance policies or annuities to senior citizens that use non-guaranteed elements in illustrations must provide a statement to that effect. Which of the following is correct regarding this statement?
non-guaranteed elements must be in bold print
In a group life policy with a death benefit of more than $50,000
premium cost for insurance above $50,000 is taxable as income to the insured
when a corporation ceases to exist entirely, their insurance license
terminates
when an insurer presents an illustration for life insurance, all of the following are prohibited, except
using the insurer's "disciplined current scale" in the illustration
the usual amount of death benefit in an industrial life insurance policy is
less than $2,000
the MINIMUM number of employees for group life insurance in CA is
2
all of the following are covered by CLHIGA, EXCEPT
Employer self-funded plans
an ESOP invests in
Employer stock
all of the following are required to be included in life insurance illustrations EXCEPT
a statement that the benefits in the illustration are guaranteed
a disability income policy covers injuries suffered by an insured on or off the job is called?
an occupational policy
which of the following allows employees to share in the financial success of the company
profit-sharing plan
a parent who lives at home is being cared for by an adult daughter on a full time basis. Which of the following would provide care if the daughter needs a period of seperation?
respite care
if an insurer indicates that an illustration will be used, they must do which of the following
send a summary status report to the policy owner annually
an insurance company which is owned by individuals who purchase shares of stock in the company, share in profits in proportion to shares owned, and vote for a board of directors is known as what type of insurer
stock insurer
In a Worker's compensation contract, Part One provides payments for which of the following?
sums the employer is legally required to pay under State Workers' Compensation Laws
if an insurer knowingly allows one of its agents to mislead a member of the public in order to induce the person to change their existing insurance, the Commissioner may
suspend the insurer's certificate of authority for the class of business involved
the social security age of retirement is dependent upon
the individual's date of birth
Which of the following is the definition of morbidity?
the likelihood of illness o injury
what does a stop-loss provision in a medical expense insurance plan set a maximum for?
the limit of out-of-pocket expense payments covered each year under a policy
eligibility for social security retirement benefits is based on
the number of quarters earned
what does the phrase "life insurance creates an immediate estate" mean?
the total death benefit will be paid to a beneficiary on the death of the insured
Medicare Part A, begins automatically at age
65