licensing

An insured files for an accident and health insurance policy claim eight days after the premium due date. The benefit payable is $500 and the overdue premium is $200. Assuming that the policy pays on a first-dollar basis and contains the unpaid premium provision, how much will the insurer pay?

$300

An agent who willfully violates the insurance code may, after a hearing, pay UP TO _________ per violation as a penalty

$5,000

What minimum percentage of all eligible employees must participate in a group life insurance plan if the premiums are completely paid for by the employer?

100%

the health insurance premiums paid for by each partner in a partnership is considered to be

100% tax deductible

In Virginia, at least _____ employee(s) are needed for a small employer medical plan

2

An insured must notify an insurer of a medical claim within how many days after an accident?

20

In Virginia, a grace period of ___ days is required for a life insurance policy paid on an annual basis

31

One becomes eligible for Social Security disability benefits after having been disabled for

5 months

An agent must maintain customer records for _______ year(s) following the completion date of the insurance transaction.

5 years

An insured MUST wait ___ days to bring legal action against an insurer after written proof of loss has been received by the insurer.

60

Larry wants to purchase an individual disability income policy to provide continuous income while disabled. He is also covered by a two-month wage continuation benefit from his employer. What should the policy elimination period be for his individual policy?

60 days

what is a juvenile life insurance policy?

A life policy that covers the life of a minor

An individual currently owns a long-term care policy. At the time of application for similar coverage, which item must be signed by the applicant and retained by the insurer?

A replacement notice

Which of the following statements accurately describes the "time limit on certain defenses"?

After a stated period of time, claims cannot be denied due to material misrepresentation on the application

Traditional individual retirement annuity (IRA) distributions must start by

April 1st of the year following the year the participant attains age 70 1/2

the Change of Occupation provision in a disability income policy states that, in the event the insured changes to a less hazardous occupation, which of the following may apply?

Benefits can be increased in the event of a covered claim

Who normally pays the premiums for group credit life insurance?

Borrower

A preferred provider plan and an indemnity plan are similar in what way?

Both pay on a fee-for-service basis

For employees covered in multiple states under a group health plan, jurisdiction rules cannot alter

COBRA laws

which of the following provisions allows an insured or the insurer to terminate the policy?

Cancelable provision

all of these considered to be a violation of the Federal Fraud and False Statements Act EXCEPT

Claims reimbursement

An agent must notify the Bureau of Insurance for

Conducting business under an assumed name

the affordable care act's premium rating process includes each of the following EXCEPT

Employment status

which of the following health insurance provisions requires that the application becomes part of the policy?

Entire contract clause

An agreement is reached when an insurance contract is formed. Which of the following is NOT considered to be an element of an agreement?

Equity

Which statement concerning an adjustable life insurance policy is FALSE?

Evidence of insurability is required when there is a charge in premium

Which life insurance policy option allows the policyowner to have coverage equal to the net death benefit of the lapsed policy?

Extended term nonforfeiture option

A consumer who has been recently denied insurance, credit, or employment based on an unfavorable consumer report MUST be advised as such. Which of the following does this statute originate from?

Fair Credit Reporting Act

John has a criminal record in which he was convicted of a felony that involved dishonesty. Under Federal law, how would John be able to engage in insurance transactions?

Given written consent by the state insurance regulatory agency

which of these encourage adverse selection in an indemnity dental plan?

Having multiple or periodic open periods

Tom has a qualified retirement plan with his employer that is currently considered to be 80% "vested". How can this be interpreted?

If Tom's employment is terminated, 20% of the funds could be forfeited

A characteristic of preferred provider organizations (PPO) is

If services is obtained outside the PPO, benefits are reduced and costs increase

All of these are duties that a producer may be required to perform when delivering an insurance policy EXCEPT

Leave a conditional receipt with client

Which of these is NOT used as selection criteria in the underwriting process of a life insurance application?

National origin

Medicare Supplement insurance requires an individual to be at least how old for open enrollment?

No minimum age

Which of the following health insurance plans charges a premium that cannot be increased?

Noncancelable

which of these is NOT an Unfair Claims Settlement Practice?

Offering to settle a claim by arbitration

All of these statements correctly describe an aleatory contract EXCEPT

Only one party makes any kind of legally enforceable offer

Under which circumstances would inflation protection NOT be included in a long-term policy?

Policyowner declines the coverage in writing

In Virginia, which of the following records are not required to be maintained by an agent?

Premium quotes for polices not accepted

Which of these is NOT an Unfair Claims Settlement Practice?

Refusing to pay persons bringing false or fraudulent claims

which of these actions by an agent would NOT likely result in license suspension or revocation?

Sharing compensation with another similarly-licensed agent

Which of the following does a Medicare Advantage enrollee typically pay for?

Small co-pay per visit or per service

which statement concerning the Entire Contract provision in an individual accident and health insurance policy is TRUE?

The agent doesn't have the authority to change the policy or waive its provisions

Why might it be beneficial for an employee to purchase private disability income insurance for workplace injuries when he/she is already covered by worker's compensation?

The benefits arising from a worker's compensation claim could be inadequate to replace the loss of income

Group health issued in Virginia must identify any exclusions, limitations or reductions in coverage on which of the following?

The certificate of coverage

Which of the following is true regarding a person receiving a waiver of premium benefit?

The insured must be disabled for a period of time

The Optionally Renewable provision allows what party to cancel the contract?

The insurer

Which of the following does medical expense insurance NOT typically cover?

Treatment in a government facility

which of these is NOT an advantage of term life insurance?

a cash benefit will be provided if the insured is alive at the end of the policy period

After an applicant reads and signs an insurance application, he/she should be conscious of the fact that

a false statement could lead to loss of coverage

The absolute assignment of a life insurance policy results in

all incidents of ownership transferred to the assignee

Carlos the agent has sold an insurance policy and will be sharing the commission with another individual. Which of the following individuals may Carlos share the commission with?

another licensed but unappointed agent

according to HIPAA regulations, which of the following may reduce a medical plan's pre-existing conditions exclusion?

any period of prior coverage

A policyowner pays the first annual premium for a $50,000 life insurance policy and dies one month after the policy effective date. Which of these statements is normally true?

beneficiary receives $50,000 income tax-free

In a disability buy-self agreement, the policies funding the agreement are owned by the

business entity

which statement regarding the waiver of premium rider is accurate?

cash payment is not directly provided to the policyowner

An agent who attempts to intimidate is engaging in

coercion

An insurance application requires an applicant to make a full, accurate disclosure of the risk factor involved. Using this criteria, an insurance policy is considered what type of contract?

contract of utmost good faith

Any employee insured under a group life insurance plan is normally

covered with term life insurance

the premiums for a group life credit policy must be paid for by the

creditor

In a speech to a local association, an agent incorrectly stated that XYZ Insurance Company is in financial difficulty and not paying claims. The agent may be guilty of

defamation

how often must the commission examine each domestic insurance company?

every 5 years

death benefits from a life insurance policy are normally considered to be

exempt from federal income tax

Which benefit supplement added to a life insurance policy insures an entire family?

family term rider

which of these may not be deducted from premium payments or the cash value of a variable life insurance policy?

federal premium taxes

Rick owns a variable universal life policy and chooses a variable death benefit option. What will typically happen to the death benefit as a result of this selection?

fluctuate with changes in the cash amount

Death proceeds from a life insurance policy are typically included in a deceased insured's gross estate

for federal income tax records

All individual long-term care policies delivered in Virginia MUST be renewable

for life

When the disclosure of an insured's nonpublic information is involved, what is the insurer obligated to do?

give notice, explain, and allow opting out

What can be expected when a preferred provider organization (PPO) patient decides to use a non-PPO?

higher out-of-pocket expenses

according to the affordable care act, coverage may be restricted

if intentionally false statements were offered

If the State Corporation Commission believes that an agent is incompetent or untrustworthy, it has the authority to perform all of the following functions EXCEPT

incarcerate the agent

the medical information bureau consists of members from which group?

insurance companies

Who is protected with the "other insurance with this insurer" provision?

insurance company

Which health policy clause specifies the amount of benefits to be paid?

insuring

After an insurance application has been originated, the producer normally

is the major personal contact to the insured

health care can be better controlled by utilizing preadmission testing. preadmission testing can reduce the

length of hospitalization

During the early years of a whole life insurance policy, the cash value will normally be

less than the total premiums paid

which of these is not a common life insurance nonforfeiture option?

life income annuity

field underwriting by a producer

may result in the disclosure of hazardous activities of the applicant

according to the affordable care act (ACA), the proportion of premium revenues spent on clinical services and quality improvements is called the

medical loss ratio

In Virginia, false advertising is an example of

misrepresentation

all of the following are covered under the most dental plans EXCEPT for

mouth cancer

In Virginia, any person acting as an agent for an unlicensed insurer is

permissible only if acting as a licensed surplus lines broker

which of these is NOT a factor that influences group health insurance underwriting?

physical exams of group members

How is the insured protected if a payor benefit rider is attached to the life insurance policy?

premium payments are waived in the event the premium payor dies or becomes disabled

A Guaranteed Renewable provision allows

premiums which can only be increased per rate class

Statements made by an insured on an accident and health insurance application are considered to be

representations

Licensed agents in Virginia are authorized to

solicit, receive, and forward applications to the insurer

Kelly purchases a heath insurance policy issued on a conditionally renewable basis. The insurance company has a right to refuse of the policy for

specific reasons stated in the contract

Under a key person disability income policy, benefits will be received as

tax free income to the business

Medicare Part A does NOT provide coverage for

the first 3 pints of blood

the Virginia Life, Accident, and Sickness Insurance Guaranty Fund protects an insured in the event of

the insurers insolvency

what is considered the collateral on a life insurance policy loan?

the policy's cash value

Virginia requires that an insurance agent must complete ___ hour(s) of continuing education on the subject of ethics every reporting period

three

what is the primary reason for the State Corporation Commission's examination of an agent's insurance records?

to determine compliance with state insurance laws and regulations

What would be the disadvantage of naming a trust as beneficiary of a life insurance policy?

trust administration less would reduce policy proceeds

Persuading an insured, to the insured's detriment, to switch policies is called

twisting

In Virginia, once a life insurance policy has been in force for ___ year(s), it becomes incontestable

two

under what circumstances does an accident and health insurer have the right to request an autopsy?

when not prohibited by state law

what is the maximum number of employees an employer may have for qualified medical savings accounts?

50 employees

in a long-term care policy issued in Virginia, any provision limiting preexisting conditions may not exceed

6 months

proceeds of a life insurance policy claim may be issued to a minor ONLY if

a guardian has been appointed to receive proceeds on behalf of the minor

Disability income insurance normally excludes coverage for disabilities that arise from

active military duty

A statement MUST be signed by the ________ for any illustrations used in the sale of a life insurance policy.

agent

Before an individual is permitted to act as an insurance agent, he/she must hold a valid insurance license and be ____ by an authorized insurer

appointed

what happens to the death benefit of a life insurance policy if the insured elects a partial payment from the accelerated (living) benefit provision?

reduced

A life insurance policy's waiver of premium rider has the ability to

relieve the insured of premium payments following an initial waiting period after the insured becomes totally disabled

When a health insurance policy includes a Mandatory Second Surgical Opinion provision, the insured must

seek a second opinion for specified elective surgeries

the highest mortality rate belongs to which group?

Age 70 males

A policyowner has just borrowed from a life insurance policy's cash value. Which of these statements is true?

In the event of death, the loan amount is deducted from the policy proceeds

An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before

bringing legal action against the insurer

Which report contains information regarding an individual's general reputation and credit standing?

consumer report

If dividend option choices are offered on a whole life insurance policy, the policy MUST

contain a statement that dividends are NOT guaranteed

An annuity's accumulation period may

continue after the purchase payments stop

When a sum of money undergoes capital liquidation, that sum will

decrease in size

Group life plans sold in Virginia typically contain a conversion option. If the insured elects this option, the new policy

does NOT require evidence of insurability

which of the following would permit an insurer to delay a covered disability policy exam?

elimination period

Non-occupational disability coverage is designed for

employees who suffer non-work related disabilites, since work-related disabilities are covered by Workers' Compensation

A(n) ______ insurance company conducts business in a state outside the one in which it is domiciled.

foreign

An annuity contract may be returned for a full refund during the

free look period

An insured may be required to sign which document at policy delivery to ensure there has not been any adverse medical conditions since the time of the application?

good health statement

which of these would not be a valid reason to add the waiver of premium rider to a life insurance policy?

it allows a policy loan to cover premium payment if the policyowner becomes totally disabled

In regards to health insurance, what is meant by the term "primary policy"?

it is the policy that will pay up to its limit before any other policy pays

an insurance policy may be issued with a preferred insurance premium in all of these situations EXCEPT

living in a rural area

In a disability income contract, an insured is considered to be totally disabled under the presumptive disability provision if he/she

loses the ability to speak

Each of the following will trigger a benefit under the presumptive disability provision, EXCEPT

loss of any one limb

The annuitant in a single premium deferred annuity (SPDA)

makes only one premium payment

the pre-existing conditions exclusion under a small employer medical plan

may be partially or fully satisfied by having creditable coverage with a previous employer

Karen is considering replacing her individual accident and health insurance policy with another individual policy. She has had issues in the past with her gall bladder that would be considered a pre-existing condition. How will a pre-existing conditions exclusion affect Karen's new insurance contract?

may reduce her benefits

what is considered a valid reason for an insurer's refusal to pay policy proceeds directly to a minor?

minors are normally not capable of handling money in a reasonable manner

Periodic health claim payments MUST be made at least

monthly

what is the minimum age required for open enrollment in Medicare Supplement insurance?

no minimum age required

Rick the agent handles insurance premiums in an untrustworthy manner. His actions could find him guilty of

not acting as a fiduciary

The premiums paid by an employer for his employee's group life insurance are usually considered to be

partially deductible to the employee

When an insurer discovers (during the claim process) that the insured's age was accidentally misstated on the life insurance application, the insurer will likely

pay an amount the premiums would have purchased at the insured's actual age

Employers often purchase life insurance on a key employee in order to

pay for finding and training a replacement if the employe dies prematurely

what happens to a life insurance policy when the policy loan balance exceeds the cash value?

policy will no longer be in force

A group health certificate for coverage issued in Virginia MUST contain a(n)

summary of policy features and benefits

How is an insured's accident and health claim handled by an insurer if it occurs during the policy's grace period?

the unpaid premium may be subtracted from the reimbursement

The major medical deductible carryover period normally applies to expenses incurred during the last ___ months of the plan year.

three

Misrepresenting pertinent policy provisions relating to coverage after a loss is a(n)

unfair claims settlement practice

how long does protection normally extend to under a limited pay whole life policy?

until age 100

when does interest income for a flexible premium deferred annuity get reported for federal income taxes?

upon receiving distributions from the contract