Florida health insurance

If an agent does not notify the insurer of an address change, what is the maximum penalty that can be imposed for a one-time offense?

$250

L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay?

$900 (deductible + 20% of the bill after the deductible (20% of $2,000])

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?

10 days

Under special circumstances, continuing education requirements may be extended beyond the 2-year period for a maximum period of

12 months

An agent delivers a life insurance policy to the proposed insured. The insured makes a decision not to accept the policy. The insured may return the policy for a full refund of premium within how many days?

14 days

When a disabled dependent child reaches the age limit for coverage, how long does the policyowner have to provide proof of dependency in order for the dependent to remain covered under the policy?

31 days

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?

5 days

Which of the following documents delivered to the policyowner includes information about premium amounts, cash values, surrender values and death benefits for specific policy years?

A policy summary

Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain

A statement that is sufficiently clear to identify the insured and the nature of the claim

Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?

Adult day care

If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered

An unfair trade practice

The death protection component of Universal Life Insurance is always

Annually renewable term

Which statement accurately describes the Change of Beneficiary provision?

Any policy that has a death benefit must also have a Change of Beneficiary provision.

Which of the following provides coverage on a first-dollar basis?

Basic expense

Under which nonforfeiture option does the company pay the surrender value and have no further obligations to the policyowner?

Cash surrender

To legally transact insurance in this state, an insurer must obtain which of the following?

Certificate of authority

All of the following are duties and responsibilities of producers at the time of application EXCEPT

Change any incorrect statement on the application by personally initialing next to the corrected statement.

An individual has just borrowed $10,000 from his bank on a 5-year installment loan requiring monthly payments. What type of life insurance policy would be best suited to this situation?

Decreasing term

The provision that states that both the printed contract and a copy of the application form the contract between the policyowner and the insurer is called the

Entire contract

If a change needs to be made to the application for insurance, the agent may do all of the following EXCEPT

Erase the incorrect answer and record the correct answer

All of the following are dividend options EXCEPT

Fixed period installments

Under the Privacy Rule for HIPAA, protected information includes all individually identifiable health information

Held or transmitted in any form.

To be eligible for a Health Savings Account, an individual must be covered by a

High deductible health plan

All of the following are differences between individual and group health insurance EXCEPT

Individual insurance does not require medical examinations, while group insurance does require medical examinations.

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the

Insuring clause

Which provision of a life insurance policy states the insurer's duty to pay benefits upon the death of the insured, and to whom the benefits will be paid?

Insuring clause

An applicant who receives a preferred risk classification qualifies for

Lower premiums than a person who receives a standard risk.

Which provision concerns the insureds duty to provide the insurer with reasonable notice in the event of a loss?

Notice of claim

An insured has health insurance that covers them at work and at home. This policy was written on what basis?

Occupational

A rider attached to a life insurance policy that provides coverage on the insured's family members is called the

Other-insured rider

In respect to the consideration clause, which of the following is consideration on the part of the insurer?

Promising to pay in accordance with the contract terms

When a whole life policy lapses or is surrendered prior to maturity, the cash value can be used to

Purchase a single premium policy for a reduced face amount.

Adjust the claim benefit to reflect the insured's true age

Rates by class

All of the following are true regarding rebates EXCEPT

Rebates are allowed if it is in the best interest of the client.

An agent offers a client free tickets to a sporting event in exchange for the purchase of an insurance policy. What is the agent guilty of?

Rebating

Disability income policies can provide coverage for a loss of income when returning to work only part-time after recovering from total disability. What is the benefit that is based on the insured's loss of earnings after recovery from a disability?

Residual disability

What is the best way to change an application?

Start over with a fresh application

If a life insurance policy has an irrevocable beneficiary designation

The beneficiary can only be changed with written permission of the beneficiary.

A corporation is the owner and beneficiary of the key person life policy. If the corporation collects the policy benefit, then

The benefit is received tax free

An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?

The capital amount in a lump sum

Who examines the books and records of insurance companies in Florida?

The chief financial officer

An individual applied for an insurance policy and paid the initial premium, the insurer issued a conditional receipt, five days later the applicant had to submit to a medical exam. If the policy is issued what would be the policy's effective date?

The date of the medical exam

Which of the following statements concerning group health insurance is CORRECT?

The employer is the policy holder

Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to

The insured.

If a policy includes a free-look period of at least 10 days, the Buyer's Guide may be delivered to the applicant no later than

With the policy

An insured buys a 5-year level premium term policy with a face amount of $10,000. The policy also contains renewability and convertibility options. When the insured renews the policy in 5 years, what will happen to the premium?

it will increase because the insured will be 5 years older than when the policy was originally purchased.

Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be best for Ray?

50-50

If the insured under a disability income insurance policy changes to a more hazardous occupation after the policy has been issued, and a claim is filed, the insurance company should do which of the following?

Adjust the benefit in accordance with the increased risk

An insured misstated her age on an application for an individual health insurance policy. The insurance company found the mistake after the contestable period had expired. The insurance company will take which of the following actions regarding any claim that has been issued?

Adjust the claim benefit to reflect the insured's true age

When an insured purchased her disability income policy, she misstated her age to the agent. She told the agent that she was 30 years old, when in fact, she was 37. If the policy contains the optional misstatement of age provision

Amounts payable under the policy will reflect the insured's correct age.

What is the term used for an applicant's written request to an insurer for the company to issue a contract, based on the information provided?

Application

Which of the following is INCORRECT regarding a $100,000 20-year level term policy?

At the end of 20 years, the policy's cash value will equal $100,000.

To comply with Fair Credit Reporting Act, when must a producer notify an applicant that a credit report may be requested?

At the time of application

What document describes an insured's medical history, including diagnoses and treatments?

Attending physician statement

Which of the following best describes fixed-period settlement option?

Both the principal and interest will be liquidated over a selected period of time.

A policy available to business owners that provides payment for normal business expenses in the event that the owner is disabled is called

Business overhead expense

Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following elements EXCEPT

Conditions

An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the

Consideration Clause

Contracts that are prepared by one party and submitted to the other party on a take-it-or-leave-it basis are classified as

Contracts of adhesion.

An insurance producer just sold an insurance policy to his sister. What kind of business is this?

Controlled

A key person insurance policy can pay for which of the following?

Costs of training a replacement

All of the following are true about group disability Income insurance EXCEPT

Coverage applies both on and off the job

What characteristic makes whole life permanent protection?

Coverage until a death or age 100

A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is known as

Critical illness

What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?

Diagnostic and preventative care

What is the goal of the HMO?

Early detection through regular checkups

When an employee terminates coverage under a group insurance policy, coverage continues in force

For 31 days

How long must insurers maintain records of the information collected from senior consumers and other information used in making recommendations that were the basis for insurance transactions?

For 5 years after the insurance transaction is completed by the insurer

When doing business in this state, an insurance company that is formed under the laws of another state is known as which type of insurer?

Foreign

All of following are the general qualifications for an agent's license EXCEPT

Have a high school diploma

Which of the following entities can legally bind coverage?

Insurer

Who must pay for the cost of a medical examination required in the process of underwriting?

Insurer

In health insurance, if a doctor charges $50 more than what the insurance company considers usual, customary and reasonable, the extra cost

Is not covered

Which of the following best describes a misrepresentation?

Issuing sales material with exaggerated statements about policy benefits

Which of the following statements is NOT true concerning Medicaid?

It consists of 3 parts: Part A: hospitalization, Part B: doctor's services, Part C: disability income.

What is the purpose of a conditional receipt?

It is intended to provide coverage on a date earlier than the date of the issuance of the policy.

Which of the following is NOT true regarding a nonqualified retirement plan?

It needs irs approval

Which of the following is true about the premium on the children's rider in a life insurance policy?

It remains the same no matter how many children are added to the policy.

Which statement is not true regarding a straight life policy?

It's premium steadily decreases over time, in response to growing its cash value

The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as

Legal actions

Under workers compensation, which of the following benefits are NOT included?

Legal benefits

Variable Whole Life insurance is based on what type of premium?

Level fixed

A policy will pay the death benefit if the insured dies during the 20-year premium-paying period, and nothing if death occurs after the 20-year period. What type of policy is this?

Level term

Which of the following terms means a result of calculation based on the average number of months the insured is projected to live due to medical history and mortality factors

Life expectancy

Which of the following is an example of a limited-pay life policy?

Life paid up to 65

An insured has a life insurance policy that requires him to only pay premiums for a specified number of years until the policy is paid up. What kind of policy is it?

Limited pay life

If a settlement option is not chosen by the policyowner or the beneficiary, which option will be used?

Lump sum

When replacing life insurance, the duties of the replacing insurance company include all of the following EXCEPT

Maintaining a copy of the Notice Regarding Replacement and all sales proposals used for at least 5 years.

A 65-year-old enrolls for benefits under Medicare Part B and submits an application for a Medicare supplement policy two months later. For which of the following reason may the insurer deny the application?

Material misrepresentation

Which of the following statements is correct?

Medicare will cover nursing home care if it is part of the treatment for a covered illness.

What is the term for how frequently a policyowner is required to pay the policy premium?

Mode

An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits?

No benefits

Which of the following provisions is mandatory for health insurance policies?

Physical examination and autopsy

An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?

Revocable

Which of the following determines the length of time that benefits will be received under the Fixed-Amount settlement option?

Size of each installment

Which of the following is NOT covered under Basic Hospital Expense Coverage?

Surgeons fees

A producer is helping a married couple determine the financial needs of their children in the event one or both should die prematurely. This is a personal use of life insurance known as

Survivor protection

Which of the following is called a "second-to-die" policy?

Survivorship life

Children's riders attached to whole life policies are usually issued as what type of insurance?

Term

Which of the following, when attached to a permanent life insurance policy, allows the policyowner to customize the policy to provide an additional amount of temporary insurance on the insured, or allows amounts of temporary insurance to cover other family members?

Term rider

Nonforfeiture values guarantee which of the following for the policyowner?

That the cash value will not be lost

If an agent is in the military, which of the following is true?

The agent cannot sell a policy to another active military person who is of a lower rank.

Which of the following is NOT true regarding the annuitant?

The annuitant cannot be the same person as the annuity owner.

Which is true regarding obtaining underwriting sources?

The applicant must be informed of the sources contacted and how the information is being gathered.

Which of the following is true about the requirements regarding HIV exams?

The applicant must give prior informed written consent.

Which of the following is NOT the consideration in a policy?

The application given to a prospective insured

An employee insured under a group health policy is injured in a car wreck while performing her duties for her employer. This results in a long hospitalization period. Which of the following is true?

The group plan will not pay because the employee was injured at work.

A father owns a life insurance policy on his 15-year-old daughter. The policy contains the optional Payor Benefit rider. If the father becomes disabled, what will happen to the life insurance premiums?

The insured's premiums will be waived until she is 21.

A policy with a 31-day grace period implies

The policy will not lapse for 31 days if the premium is not paid when due

Which of the following statements is correct regarding a whole life policy?

The policyowner is entitled to policy loans.

An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre- existing condition. Which of the following is true?

The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off.

How must a replacing producer respond to an applicant wishing to replace existing life insurance?

The producer must provide the applicant with a Notice Regarding Replacement.

Which of the following best defines target premium in a universal life policy?

The recommended amount to keep the policy in force throughout its lifetime

Which of the following is NOT true of life settlements?

The seller must be terminally ill

What is the purpose of a fixed-period settlement option?

To provide a guaranteed income for a certain amount of time

Insurers usually do not reimburse claimants for 100% of income lost due to disability. What is the reason for insurer limitations on coverage amounts?

To provide an incentive for the insured to return to work

When an insurer issues an individual health insurance policy that is guaranteed renewable, the insurer agrees

To renew the policy until the insured reaches age 65

Which characteristic does NOT describe managed care?

Unlimited access to providers