LAH Exam
Maximum age for qualification of a catastrophic plan
30
In groups of ___ or more there is little to no medical information required for group underwriting
50
An insured pays a weekly premium of $10 for her health insurance. What would be the duration of the grace period under her policy?
7 days
A hospital indemnity policy will pay
A benefit for each day the insured is in a hospital.
In order for a nonresident licensee to become a resident producer in New York, the licensee must
Apply within 90 days of becoming a resident.
At what point must an Outline of Coverage be delivered?
At the time of application or upon delivery of the policy
Insurers may change which of the following on a guaranteed renewable health insurance policy?
Rates by class
For which of the following reasons can a temporary license be issued?
To service the existing business
warranties are statements that are guaranteed to be true (TRUE/FALSE)
True
Which concept is associated with "exclusion ratio"?
annuity payments
in an equity index annuity what does the annuitant receive as their rate of return
fixed amount
An insured owns a $50,000 whole life policy. At age 47, the insured decides to cancel his policy and exercise the extended term option for the policy's cash value, which is currently $20,000. What would be the face amount of the new term policy?
$50,000
When an annuity is written, whose life expectancy is taken into account?
Annuitant
How is care provided regarding inpatient hospital care for HMO members?
Care can be provided outside of the service area.
An insured receives an annual life insurance dividend check. What term best describes this arrangement?
Cash option
Before an agent can transact business in New York, every insurer, fraternal benefit society or HMO must file with the Superintendent which of the following?
Certificate of appointment
What is the clause that describes the method of paying the death benefit in the event that the insured and beneficiary are both killed in the same accident?
Common Disaster Clause
A long stretch of national economic hardship causes a 7% rate of inflation. A policyowner notices that the face value of her life insurance policy has been raised 7% as a result. Which policy rider caused this change?
Cost of Living Rider
What type of insurance would be used for a Return of Premium rider?
Increasing Term
Who is responsible for making sure that agents are properly trained in the use of the suitability standards for LTC policies?
Insurer
Who is the beneficiary in a credit disability income policy?
The lending institution
The policyowner of a Universal Life policy may skip paying the premium and the policy will not lapse as long as
The policy contains sufficient cash value to cover the cost of insurance.
Whose responsibility is it to make certain that an application for insurance is filled out completely and correctly?
The producer
Under an extended term nonforfeiture option, the policy cash value is converted to
The same face amount as in the whole life policy.
Who assumes the risk regarding variable annuities?
annuitant
All of the following entities regulate variable life policies EXCEPT: SEC The Insurance Department The Guaranty Association Federal Government
Guaranty Association
What is not considered for HLVA
Predicted needs of the family after the insured's death.
What do limited health insurance policies cover
They only cover specific accidents or diseases.
Providing care on an outpatient basis is a characteristic of an HMO plan? (TRUE/FALSE)
True
Which of the following provisions must be included on the first page of a Medicare supplement policy, which states the insurer's right to change premium amounts?
continuation provision
The Patient Protection and Affordable Care Act's deductions for premiums for individuals are tax ___
credits
A man decided to purchase a $100,000 Annually Renewable Term Life policy to provide additional protection until his children finished college. He discovered that his policy required a premium (increase/decrease) at each _______
increase, renewal
The current interest rate on an equity indexed annuity is often based on
index such as Standard and Poors 500
what is the most common example of risk retention when it comes to insurance
paying premiums
A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called
prepaid plan
Warranties are guaranteed to be true (TRUE/FALSE)
true
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
According to OBRA, what is the minimum number of employees required to constitute a large group?
100
SIMPLE Plans require no more than _____ employees
100
SIMPLE Plans require no more than how many employees?
100
What number amount classifies the difference between small and large employers?
100
The time limit of certain defenses provision prohibits insurers from denying a claim due to misrepresentation, as long as the policy has been in force for at least
2 years.
When a health insurance policy is purchased in the state of New York, the insured may return the policy to the insurer and receive a premium refund within the maximum period of
20 days
Under the New York State Disability Benefit Law, no employee may be entitled to benefits for more than how many weeks after 52 consecutive calendar weeks or during any one period of disability?
26 weeks
How long is the open-enrollment period under an employer group health insurance plan?
30 Days
If licensees have administrative action taken against them, they must file this with the Superintendent within
30 Days
Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months?
30 Months
An insured pays a yearly premium of $1500 for her health insurance. What would be the duration of the grace period under her policy?
31 days
What is the waiting period on a Waiver of Premium rider in life insurance policies?
6 months
A hospital indemnity policy will pay
A benefit for each day the insured is in a hospital. dependent on the amount of time confined to a hospital
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
If during the underwriting process an insurer obtains personal information about an applicant from the applicant, when must the insurer provide notice of its information practices?
At the time of policy delivery
Do equity indexed annuities earn lower interest rates than fixed annuities? (TRUE/FALSE)
FALSE
sellers need to be terminally ill for life settlement policies (TRUE/FALSE)
FALSE
there are situations in which it is legal to limit coverage based on marital status? (TRUE/FALSE)
FALSE
Patient protection and ACA offers individual tax deductions for premiums paid? (TRUE/FALSE)
FALSE (its a tax credit not a tax deduction)
An annuity owner must be the party to receive benefits. (TRUE/FALSE)
False
Contracting with insurance companies is a characteristic of an HMO plan? (TRUE/FALSE)
False
Section 457 Deferred Compensation plan has a vesting requirement? (TRUE/FALSE)
False
warranties are statements that are true to the best of the applicants knowledge (TRUE/FALSE)
False
An individual is purchasing a permanent life insurance policy with a face value of $25,000. While this is all the insurance that he can afford at this time, he wants to be sure that additional coverage will be available in the future. Which of the following options should be included in the policy?
Guaranteed insurability option
Guarantee of insurability option in long-term care policies allows the insured to
Increase benefit levels without providing proof of insurability
What type of benefit helps to pay for accidental injuries that are not severe enough to qualify as disabilities?
Medical Reimbursement Benefit
According to the Future Increase Option Rider (FIO) is the death of a spouse a qualifying event to increase an insured's benefit level?
No (These are ages 25, 28, 31, 34, 37 and 40; marriage; and the birth of a child.)
An insured has health insurance that covers them at work and at home. This policy was written on what basis?
Occupational
According to New York law, hearings ordered by the Superintendent must be
Open to the public.
Which option for Universal life allows the beneficiary to collect both the death benefit and cash value upon the death of the insured?
Option B
What type of policy contains a coverage that is only activated upon the insured's losses reaching a certain level?
Partially funded plan
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?
Policy request
What describes the specific information about a policy?
Policy summary
A medical insurance plan in which the health care provider is paid a regular fixed amount for providing care to the insured and does not receive additional amounts of compensation dependent upon the procedure performed is called
Prepaid plan.
An insurer is preparing to pay disability income benefits to an insured. In order to prevent overinsurance, the insurer monitors the income of the insured before submitting payment. Which rule corresponds to this behavior?
Relation of earnings to insurance
Your client has a Social Insurance Supplement (SIS) rider on his disability policy. After he becomes disabled, he receives payments from the company. Shortly thereafter, he also begins receiving Social Security benefit payments. Which of the following will happen?
The SIS payment will be reduced dollar-for-dollar by the Social Security benefit payment.
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.
Regarding the return of premium option for LTC policies, what happens to the premium if the policy lapses?
The insurer will return a percentage of the premiums paid.
Encouraging early treatment is a characteristic of an HMO plan? (TRUE/FALSE)
True
Providing free annual checkups is a characteristic of an HMO plan? (TRUE/FALSE)
True
The insured can continue to report to work and continue to receive benefits for partial disability (TRUE/FALSE)
True
What is the name of a clause that is included in a policy that limits or eliminates the death benefit if the insured dies as a result of war or while serving in the military?
War or military service
Partners in a business enter into a buy-sell agreement to purchase life insurance, which states that should one of them die prematurely, the other would be financially able to buy the interest of the deceased partner. What type of insurance policy may be used to fund this agreement?
any
when do payments stop in installments for a fixed amount
at death of annuitant
How are beneficiaries defined in class designation
by class, not by name
An insured receives an annual life insurance dividend check. What term best describes this arrangement?
cash option
What is the difference between a limited health insurance policy and a dread disease policy?
dread disease policy is for extra coverage and is a rider
The insurer can increase the policy premium on an individual basis with a guaranteed renewable provision (TRUE/FALSE)
false
What type of plan is a Section 457 Deferred Compensation plan
nonqualified plan
How are dividends taxable in participating policies
not taxable
In the event of a loss, business overhead insurance will pay for
ongoing business expenses of a small business owner while they are disabled and unable to work. (Not salary, loss of profits of medical bills)
What term is used to describe when a medical caregiver contracts with a health organization to provide services to its members or subscribers, but retains the right to treat patients who are not members or subscribers?
open panel
In a life settlement contract, who does the life settlement broker represent?
owner
Partial disability covers full-time-working insureds who are unable to
perform some, but not all, of their regular job duties or can no longer work full-time
Federal law makes it illegal for any individual convicted of a crime involving dishonesty or breach of trust to work in the business of insurance affecting interstate commerce without
receiving written consent from an insurance regulatory authority.
Annuities are most popular to fun what kind of investment
retirement
For what reasons can a temporary license be issued?
service the existing business
The minimum number of persons to be insured under a group health insurance plan is established by
state law
An independent adjuster may be a firm who acts on behalf of
the insurer
Who is the owner of a life settlement contract
the person selling the contract
