Guaranteed Exam

According to the Time Limit on Certain Defenses provision, statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been in force for a minimum of how many years?

2 years

A change in a health insurance policy will only be valid if approved by

A CEO of the insurer

In health insurance, what is coinsurance?

A percentage of the cost of service that the insured and the insurer share

This state provides a temporary license for all of the following EXCEPT?

A producer's retirement

An applicant has a Medicare supplement policy and is enrolled in Medicare Part C. Which of the following would a producer or issuer be permitted to do under the guidelines?

Begin new supplement coverage after the current Part C plan expires

Prior to soliciting or negotiation long-term care insurance in this state, a producer is required to do which of the following?

Complete a one-time 8-hour training course

An employee dies having 6 quarters of coverage during the previous 13-quarter period. What status of coverage does the employee have under Social Security?

Currently insured

Which of the following is an example of a physical hazard?

Diabetes

All of the following are features of catastrophic plans EXCEPT?

High premiums

Which of the following are members of and financially support the Medical Information Bureau?

Insurance companies

Which of the following is NOT true regarding an optionally renewable policy?

Insurer can only cancel the policy for reasons stipulated in the contract

Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by her insurer. What is the name of this agreement?

Insuring Clause

If a producer replaces a Medicare supplement plan with a more comprehensive plan, the insurer must

Issue coverage without evidence of insurability

An example of an alien insurer doing business in this state is one formed under the laws of

Mexico

An agent who includes a statement which, when taken in context of the whole presentation, may tend to mislead or deceive the persons addressed has committed

Misrepresentation

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

Misrepresentation.

Which of the following would qualify as a suspicious transaction and would require filing of an SAR?

Multiple wire transfers from the account in the amount of 5,000

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

Never

Among people in the same class and life expectancy, which of the following factors can be used to influence premium rates?

Occupation

An insurer can decide to not renew an Optionally Renewable policy

On the premium due dates

A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT

Part A deductible

Which of the following terms relates to disability income insurance?

Residual Benefit

Before an insurer may transact business in a specific state, they must apply for a license or Certificate of Authority from the state department of Insurance

Solvency requirements

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?

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

All of the following are unfair claims settlement practices EXCEPT

Suggesting negotiations in settling the claim

All of the following are true of a Multiple Employer Trust (MET) EXCEPT

The employee has a right of conversion upon leaving the group coverage

The elimination period in a disability income policy is better known as

The period of time an insured must wait after the onset of an illness or injury before benefits begin

Answer to questions in an insurance application are called representations and, as such, they are

believed to be true to the best of the applicant's knowledge

Carlo's health insurance policy pays benefits according to a list which indicates the amount that is payable under each type of covered treatment or procedure. Carlo's policy provides benefits on a

scheduled basis

An employee is insured by a group major medical plan that is provider through her employer. The employer contributes 75% of the premium and the employee contributes the remaining 25%. If the insured received a benefit from this policy in the amount of 1,000, how much of this benefit would be taxed as income?

0

What is a prerequisite for receiving a commission from an insurance transaction?

An appropriate license

All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT?

An association of 35 people.

All of the following are changes to health insurance plans introduced by the PPACA EXCEPT

Full-cost coverage for all medical expenses

Which statement best describes "agreement" as it relates to insurance contracts?

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

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

Only if the individual is not identified

Which of the following is a preferred solution for reducing the cost of hospitalization?

Outpatient services

In some cases, in order for an insurer to legally disclose privileged information to appropriate sources, the insured must sign an authorization form. What is the maximum amount of time that can legally pass between the completion of the form and the disclosure of information?

1 year

If an insured submits a written proof of loss, what is the maximum amount of time after submittal that the insured has to intiate legal action?

3 years

Which of the following is provided by an HMO?

Both financing and patient care

An employer is no longer able to afford the group health insurance plan and the plan terminates. However, one of the employees continues to receive coverage under the plan. Which of the following explains the reason for the continued coverage?

The employee is totally disabled.

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

Employee paid group disability income

All of the following health insurance disability benefits are income tax free EXCEPT

Employer-paid group disability