Life and health
What process will the insurance company use to monitor the insured's hospital stay to make sure that everything is proceeding according to schedule?
Concurrent review
When both parties to a contract must perform certain duties and follow rules of conduct to make the contract enforceable, the contract is
Conditional
All of the following are true about group disability income insurance EXCEPT
Coverage applies both on and off the job
Prior to issuance of a Long-Term Care policy to an applicant age 80 or older, the insurer must obtain all of the following EXCEPT
Date of previous doctor visit
Which of the following is NOT an example of a valid insurable interest?
Debtor in the life of the creditor
If an insured changes his payment plan from monthly to annually, what happens to the total premium?
Decreases
Which of the following is NOT a term for the period of time during which the annuitant or the beneficiary receives income?
Depreciation period
When twin brothers applied for life insurance from company A, the company found that while neither of them smoked and both had a very similar lifestyle, one of the twins was in a much stronger financial position than the other. Because of this, the company charged him a higher rate for his insurance. This practice is considered
Discrimination
In disability income insurance, the time between the onset of the injury or sickness and when benefits begin is known is
Elimination period
All of the following may be excluded from coverage in a Major Medical Expense policy EXCEPT
Emergency surgery
OBRA requires which disease to be covered by an employer for 30 months before Medicare becomes the primary mode of coverage?
End-stage renal failure
The provision that states that both the printed contract and a copy of the application from the contract between the policyowner and the insurer is called the
Entire contract.
Under a typical health insurance policy, claims that result from injuries while the insured was intoxicated or under the influence of drugs are generally
Excluded
Circulation deceptive sales material to the public is what type of unfair trade practice?
False advertising
Under which installments option does the annuitant select the amount of each payment and the insurer determines how long they will pay benefits?
Fixed amount
In disability income insurance, the own occupation definition of disability applies
For the first 2 weeks of a disability
What phase begins after a new policy is delivered?
Free-look period
In a direct transfer, how is money transferred from one retirement plan to a traditional IRA?
From trustee to trustee
What provision in an insurance policy extends coverage beyond the premium due date?
Grace period
Which of the following policies is characterized by a provision where the premiums are lower in the early years of the policy and increase over time to a point where they become level for the remainder of the policy?
Graded premium whole life
In insurance transactions, fiduciary responsibility means
Handling insurer funds in a trust capacity
Which of the following methods of calculating the amount of life insurance needs to take into account the insured's wages, years until retirement, and inflation?
Human life value approach (HLVA)
Which authority is NOT stated in an agent's contract but is required for the agent to conduct business?
Implied
Which of the following factors about the insured determines the amount of disability benefit that the insured will receive?
Income
Which type of hospital policy pays a fixed amount each day that the insured is in a hospital?
Indemnity
Which of the following is true regarding HIV testing for life insurance purposes is NOT true?
Insurers are barred from requesting HIV testing
An insured purchased a life insurance policy. The agent told him that depending upon the company's investments and expense factors, the cash values could change from those shown in the policy at issue time. This policy is a
Interest-sensitive whole life
Which document is used to assess risk associated with an applicant's lifestyle and character?
Investigative consumer report
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
Which of the following best describes annually renewable term insurance?
It is level term insurance
In which of the following situations is it legal to limit coverage based on marital status?
It is never legal to limit coverage based on marital status
Which of the following is usually true of a participating life insurance policy?
It may pay dividends to policyowners
Which of the following applies to the 10-day free-look privilege?
It permits the insured to return the policy for a full refund of premiums paid.
A couple receives a set amount of income from their annuity. When teh wife dies, the husband no longer receives annuity payments. What type of annuity did the couple buy?
Joint life
Which of the following is the basis for a claim against an insurance policy?
Loss
If a business owner becomes totally disabled, a Business Overhead Expense policy will pay all of the following EXCEPT
Loss of the owner's income
Which of the following is NOT considered a misrepresentation as it pertains to unfair trade practices?
Making comparisons between different policies
Using a class designation for beneficiaries means
Naming beneficiaries as a group
All of the following are factors that an underwriter could use to select and classify risk EXCEPT
National origin
The primary eligibility requirement for Medicaid benefits is based upon
Need
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
Who is involved in completing the agent's report?
Only the agent
Which of the following explains the policyowner's right to change beneficiaries, choose options, and receive proceeds of a policy?
Owner's rights
What is the major difference between a stock company and a mutual company?
Ownership
Which of the following statements is INCORRECT concerning Medicare Part B coverage?
Part B coverage is provided free of charge when an individual turns age 65
Which of the following is another term for the accumulation period of the annuity?
Pay-in period
All of the following are covered by part A of medicare EXCEPT
Physician's and surgeon's services
A guaranteed renewable health insurance policy allows the
Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class
Who might receive dividends from a mutual insurer?
Policyholders
Which of the following individuals must have insurance interest in the insured?
Policyowner
All of the following are examples of risk retention EXCEPT
Premiums
The following areas are regulated by the Insurance Department EXCEPT
Producer commission schedules
What would a physician utilize if he/she wanted to know if a treatment is covered under an insured's plan and at what rate it will be paid out?
Prospective review
Which nonforfeiture option provides coverage for the longest period of time?
Reduced paid up
A policyowner who is also the insured wants to name her husband as the beneficiary of her life policy. She also wishes to retain all of the rights of ownership. The policyowner should have her husband named as the
Revocable beneficiary
Adverse selection is a concept best described as
Risks with higher probability of loss seeking insurance more often than other risks
To sell variable life insurance policies, an agent must receive all of the following EXCEPT
SEC Registration
If an immediate annuity is purchases with the face amount at death or with the cash value at surrender, that would be considered a
Settlement option
A licensed counselor MAY NOT perform which of the following duties?
Solicit business as an insurance producer
Which of the following statements is correct about a standard risk classification in the same age group with similar lifestyles?
Standard risk is representative of the majority of people
In a case where the primary beneficiary predeceases the insured, in the event of the insured's death, the death benefit proceeds will be paid to
The contingent beneficiary
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
The policyowner of an adjustable life policy wants to increase the death benefit. Which of the following statements is correct regarding the change?
The death benefit can be increased by providing evidence of insurability
The period of time immediately following a disability during which benefits are not payable is
The elimination period
In a group policy, who is issued a certificate of insurance?
The individual insured
An insured purchased a noncancellable health insurance policy 1 year ago. WHich of the following circumstances would NOT be a reason for the insurance company to cancel the policy?
The insured is in an accident and incurs a large claim.
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 premium?
The insured's premium will be waived until she turns 21
Who is the beneficiary in a credit disability income policy?
The lending institution
Which of the following is NOT covered under Plan A in medigap insurance?
The medicare part A deductible
All of the following are general requirements of a qualified plan EXCEPT
The plan must provide an offset for social security benefits
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 is true regarding METs?
They allow several small employers purchase less expensive insurance together
When employees are actively at work on the date coverage can be transferred to another insurance carrier, what happens to coinsurance and deductibles?
They carry over from the old plan to the new plan
Which of the following is NOT true regarding Equity Indexed Annuities?
They earn lower interest rates than fixed annuities
Which of the following is true regarding benefits paid to disabled employees?
They may be subject to taxation if the premium was paid by the employer
In insurance policies, the insured is not legally bound to any particular action in the insurance contract, but the insurer is legally obligated to pay losses covered by the policy. What contract element does this describe?
Unilateral
An insured owes his insurer a premium payment. Since then, he incurs medical expenses. The insurer deducts the unpaid premium amount from the claim and pays the insured the difference. What provision allows for this?
Unpaid premium
A medical expense policy that establishes the amount of benefit paid based upon the prevailing charges which fall within the standard range of fees normally charged for a specific procedure by a doctor of similar training and experience in that geographic area is known as
Usual, customary, and reasonable
Which of the following is a statement that is guaranteed to be true and if untrue, may breach an insurance contract?
Warranty
When may an insured deduct unreimbursed medical expenses paid under a long-term care policy?
When the expenses exceed a certain percentage of the insured's adjusted gross income
An employee has group life insurance through her employer. After 5 years, she decide to leave the company and work independently. How can she obtain an individual policy? She can convert her group policy to an individual policy without proof of insurability
within 31 days of leaving the group plan
If an agent's license was revoked for violations of the statutes on rebating or illegal inducement, how soon after the date of revocation can the agent apply for a new license?
1 year
A temporary license in this state is valid for a maximum of
180 days
Which of the following must the patient pay under Medicare Part B?
20% of covered charged above the deductible
How long is the open-enrollment period under an employer group health insurance plan?
30 days
Within how many days does a licensee have to inform the commissioner of a change of address?
30 days
For how many years is an insurer required to maintain a complete file of its advertisements?
4 years
How long is an open enrollment period for Medicare supplement policies?
6 months
In order for costs to be covered under a dental plan, what is the minimum interval that must pass between routine dental exams?
6 months
What is the waiting period on a Waiver of Premium rider in life insurance policies?
6 months
According to the PPACA rules, what percentage of health care costs will be covered under a bronze plan?
60%
If a licensee does not earn 24 hours of continuing education by the license review date, the license would be suspended for up to how many days?
90 days
Which of the following is NOT covered under a long-term care policy?
Acute care in a hospital
All of the following can qualify as a trust EXCEPT
An employer insuring at least 5 employees for the benefit of that employer
Under HIPAA, which of the following is INCORRECT regarding eligibility requirements for conversion to an individual policy?
An individual who was previously covered by group health insurance for 6 months is eligible.
Which of the following types of agent authority is called "perceived authority"?
Apparent
Which of the following polices covers all members of the insured group without requiring individual or without issuing individual policies?
Blanket disability
Which of the following is true 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
Under which nonforfeiture option does the company pay the surrender value nad have no further obligations to the policyowner?
Cash surrender
