EXAMFX

The beneficiary is then responsible for a portion of prescription drug costs.

Once the initial benefit limit in Medicare Part D is reached, how is the beneficiary affected?

Tax deductible to employer

Premiums paid by an employer for group health insurance are

Obtain the consent of the insured

Prior to paying a claimant under a professional liability policy, the insures must

Insurers

The Minnesota Life and Health Insurance Guaranty Association was created to protect all of the following EXCEPT

A specified period of time that a person joining a group has to wait before becoming eligible for covergae.

The Probationary period is

Skilled care

Which of the following is a daily nursing and rehabilitative care that can only be provided by medical personnel, under the direction of a physician?

Relation to Earnings to Insurance

Which of the following optional provisions allows the insurers to limit benefits to an insured's average income over the last 2 years?

Insuring Clause

Which of the following policy provision is a general statement identifying the insured, the insurance company , and the types of loss that will be covered?

Residual benefit

Which of the following terms relates to disability income insurance?

Drug Addiction

A Major Medical Expense policy would exclude coverage for all of the follow treatments EXCEPT

30 days

A Medicare supplement policy must have a free-look period of at least

Family

A husband and wife both incur expenses, that are attributed to a single major medical insurance deductible. Which type of deductible do they have in their policy?

Misdemeanor

A producer who failed to comply with the state continuing education requirement is guilty of a

2,500

A retail shop owner is insured under a business overhead expense policy that pays max monthly benefit of $2,500. His actual monthly expenses are $3,000. If the owner becomes disabled, the monthly benefit payable under his policy will be

Maliciously criticize another Insurnace company

Agents may be found guilty of defamation if they make false statements that are intended to

Mental illness

All of the are excluded from coverage in an individual health insurance policy EXCEPT

Premiums are tax deductible as business expense

All of the following are TRUE regarding key person disability income insurance EXCEPT

The parties that hold a group health insurance contract are the employees and the employer

All of the following are characteristics of group health insurance plans EXCEPT?

Supplement Social Security coverage

All of the following would be classified as "limited insurance coverage" EXCEPT

Representation

An applicant for a disability insurance policy has a heart condition of which they are unaware and therefore they answer no to the question pertaining to heart problems on their application. Their answer is considered to be

$5,000 it is not carried to the next year

An employee has a Flexible Spending Account (FSA) with a $5000 annual benefit. This year the employee use $3,000. What would be the amount of the benefit available to the employee next year?

Within 60 days

An employee that becomes ineligible for group coverage because of termination of employment or change in status, must exercise extensions of benefits under COBRA

31 days is defined as the time period for what on the DNC registry

An individual recently lost her job. She intends to convert her group policy to an individual policy. In order to avoid proving insurability, the conversion must occur within

Mirespresntation

An insurance agent visits a potential client and explains various types of policies. The customer displays lack of interest, so the agent guarantees higher dividends than he knows would be possible. Which term describes what the agent has done?

in 12 months

An insurance producer renewed his license 12 months ago. When will he need to renew it again?

He won't collect anything

An insured has an individual disability income policy with a 30-day elimination period. He becomes disabled June 1st for 15 days. when will he collect on his disability income payments?

Reaches age 65

An insured purchased a health insurance with a renewability clause that sates the policy is "Guaranteed Renewable." This means that as long as the required premiums are paid, the policy will continue until the insured

15 days

An insured suffered a loss and notified her insurance company. The insurer must provide a claim form to the insured within

20%

Core benefits are included in all Medicare supplemental policies. What percentage of part B coin insurance is required?

Ban representation of an examinee by an attorney

During a hearing, the Commissioner can do any of the following EXCEPT

24 hours of continuing education

For each licensing, licensees must complete

Copay

HMO members pay a small fee when they see their primary care physicians, this fee is called a

Service

HMOs are known as what type of plans?

2 years

If a license is revoked, that person cannot apply for another license for another

300 from 25 - 300 per offense

If a producer transacts insurance without being appointed by that insurer, for all offenses, the insurer will pay

10 days for weekly is 7 for all other modes is 31

If an insured pays a health insurance premium each month, how long would the grace period be under the policy?

By requring that the insurance be incidental to the group

In addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health?

Stock insurers are owned by the stockholders and issue nonparticipating policies.

In contrasting stock insurers with mutual insurers, which statement is true?

Mode of premium payment.

In health insurance, the length of the grace period varies according to the

30 days

Minnesota, Medicare supplement insource policies must provide a free look period of

50%

Partial disability usually pays what percent of the total disability benefit?

Employee paid group disability income

Regarding health insurance, all of the following are tax-deductible EXCEPT

Consideration of the insurer and insured must be equal.

Regarding the consideration clause, which of the following is NOT correct?

Receive income tax free by the individual

The benefits in Medical Expense Insurance are

Countersignature

To be valid, an insurance policy must have all of the following EXCEPT

Never

Under the Affordable Care Act, when would pregnancy be considered a pre-existing condition?

Within 20 days

Under the mandatory uniform provision "Notice of Claim", written notice of a claim must be submitted to the insurer within what time parameters?

60 days after the written proof of loos has been submitted

Under the mandatory uniform provision Legal Actions, an insured is prevented from bringing a suit against the insurer to recover on a health policy prior to

Nonsurgical services a physician provides

What does Basic Medical Expense cover?

It becomes part of the contract.

What happens to an insurance application after the policy issue?

Comprehensive Health Insurance Act (CHIA)

What is Minnesota initiative helps people who are unable to buy health insurance coverage in the normal market from private insurers?

Basic surgical expense insurance

What specific kind of insurance is often written in conjunction with hospital expense policies and includes surgeon's and anesthesiologists' fees?

Only if the individual is not identified

When may HIV-related test results be provided to the MIB?

A producer returning a part of her commission to her clie, as an inducement to buy

Which of the following best describes a rebate?

General

Which of the following is NOT a cause of loss form for commercial lines insurance?

Business profession

Which of the following is NOT an indicator of a competent party?

The old policy must stay in force until the new policy is issued

Which of the following is a requirement for replacement of health policies?

Paying a claim

Which of the following is consideration on the part of an insurer?

Annual

Which of the following premium modes would result in the lowest overall premium?

The Medical Information Bureau assists underwriters in evaluating and classifying risks.

Which of the following statements concerning the Medical Information Bureau is correct?

The insurer does not have the right to conduct an autopsy

Which of the following statements is INCORRECT?

All additional provisions written by insurers are cataloged by their respective states.

Which of the following statements is NOT true regarding health insurance policy provisions?

January 1 through March 31 each year

Which of the following time periods is the general enrollment period for Medicare Part B?

One party accepts the exact terms of the other party's offer

Which statements best describes agreement as it relates to insurance contracts?

100%

Your client is sole proprietor and wishes to include his family on a medical expense plan. How much of the cost of the medical expense plan can be deducted since he is (considered self-employed)??

Owned by its stockholder

A stock insurer is defined as an insurer

To cover the employer's administration costs

An employee is covered under COBRA. His previous premium payment was $100 per month. His employer now collects $102 each month. Why does the employer collect an extra $2?

Renewability provision

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

Loss of Income while hospitalized

An insured was seriously injured in a skiing accident that required him to be hospitalized for 5 weeks. His medical expense policy covered all of the following EXCEPT

Indemnity

An insured's hospital policy states that it will pay him a flat fee of $75 per day for cha day he is hospitalized. The policy pays benefits on what basis?

3 days

An insurer must notify the consumer in writing that an investigative consumer report has been requested, within how many days of the initial request?

The producer's commission schedule

As a part of the policy approval process, the Commissioner may require the insurer to provide all of the following, EXCEPT

Preferred Provvider Plan

Ed is covered under a health plan provided by his employer. He was told that his insurance would pay the majority of the covered expenses if he would choose to see a provider in his plan's list. If Ed chose to be treated by a provider who was not on the list, his portion of the bill would be greater. Ed is covered under a/an

David's treatment will be covered on the same basis as other benefits.

Five-year-old David has been diagnosed by a psychiatrist as being emotionally handicapped. David requires extensive treatment for his condition. His parents' health insurance plan covers standard inpatient hospital and medical expenses. Which of the following is true?

Monthly

Following a covered loss, the Time Payment of Claims provision requires that an insurance company pay disability income benefits not less frequently than

0%

If an insured is injured while committing an illegal act and the insured's health policy contains the illegal Occupation provision, what percentage of the claim will be paid?

Returned to the insured on a short rata basis

If the insurer cancels a health policy that contains an optional cancellation provision, by giving the insured 5 days prior written notice , any unearned premium will be

Motor Carrier

In a Commercial Auto Coverage policy, which of the following coverage forms applies to automobiles transporting property for a commercial enterprise?

A percentage of the cost of service that the insured and the insure share.

In health insurance, what is coinsurance?

Provide proof of continued disablement to the insurer

In order for a disabled dependent to receive coverage through an insured's group helth insurance plan after the dependent reaches limiting age, the insured must

Conformity with State Statutes

In the event an insurance policy does not satisfy the regulatory standards of an insured's home state, which of the following provisions would amend the policy to meet the state standards?

Only one party makes a promise

Insurance contracts are unilateral in nature. What does that mean?

Submit the description in their own words on a plain sheet of paper

Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy?

Promote interest in insurance coverage

Insurers are forbidden to do all of the following with their ADs EXCEPT

Yes, it is possible as long as both are licensed for the line of business.

Is it ever possible for more than one producer to split the commissions on a case in this state?

Collect premium for in-force policies and explain coverages to clients that have existing policies written by her father

J works part time in her father's insurance agency, but she doesn't have an insurance license. She may perform all of the following activities EXCEPT

90 days

Under the mandatory uniform provision Proof of Loss, the claimant must submit proof of loss within what tome period after the loss?

1,000 its 100 to 1,000

What is the Max penalty per offense for transacting insurance without a certificate of authority?

The SIR

What is the deductible of a personal liability umbrella policy called?

To state what and how much is covered in the plan.

What is the purpose of a benefit schedule?

To allow the business buyout in case of the owner disability.

What is the purpose of a disability buy-sell agreement?

To exclude coverage for a specific impairment

What is the purpose of the impairment rider in a health insurance policy?

Immediately

When an insured reinstated his major medical policy, he was involved in an accident that required hospitalization. When would this accident be covered upon reinstatement of the policy?

The insurance company that is examined

When an insurer examination is order by the Commissioner, who pays for the cost of the examination?

At not time.

When may an insurer advertise its membership in the Minnesota Insurance Guaranty Association?

Insurance with other insurers

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?

Offering an inducement of something of value not specified in the policy

Which of the following best defines the unfair trade practice of rebating?

Probationary Period

Which of the following is NOT mandatory under the Uniform Provision Law as applied to accident and health policies?

Complications from pregnancy

Which of the following is NOT normally an excluded cause of disability in an individual disability income policy?

Insurer can increase the premium above what is stated in the policy if claims experience is greater than expected.

Which of the following is NOT true regarding a noncancellable policy?