Missed Questions WI 22-03

Insurers are prohibited from ever increasing rates

All of the following are true regarding small group coverage in Wisconsin EXCEPT: Insurers are prohibited from ever increasing rates Small groups begin with 3 or more eligible individuals Small employer insurers may establish minimum participation and employer contributions Small group polices are guaranteed issue

Failing to report a criminal prosecution taken against the agent in another jurisdiction

All of the following violations may result in an agent's imprisonment EXCEPT Failing to report a criminal prosecution taken against the agent in another jurisdiction Embezzling funds from the insurer Knowingly obtaining information about a consumer under false pretenses Engaging in the business of insurance after being convicted of breach of trust

The old policy should stay in force until the new policy is issued

An agent is in the process of replacing the insured's current health policy with a new one. What would be proper action?

Fair Credit Reporting Act

An applicant is denied insurance because of information found on an investigative consumer report. Which of the following requires that the insurance company supply the applicant with the name and address of the consumer reporting agency?

Lloyd's Association

An insurance organization that does not issue insurance policies but provides a meeting place for underwriters to conduct business is known as a

$120 a day (Most LTC policies will pay the benefit amount in a specific fixed dollar amount per day, regardless of the actual cost of care)

An insured's long-term care policy is scheduled to pay a fixed amount of coverage of $120 per day. The long-term care facility only charged $100 per day. How much would the insurance company pay? 80% of the total cost 20% of the total cost $120 a day $100 a day

The notice contains an offer to renew the policy by written request

An insurer refuses to renew a policy written by an intermediary whose contract has been terminated. This is allowed if

Prior to submitting the application

At what point during the policy application process must replacement forms be completed?

It is fully funded by Social Security taxes (FICA)

Concerning Medicare Part B, which statement is INCORRECT? It is fully funded by Social Security Taxes (FICA) It is known as Medical Insurance It offers limited prescription drug coverage It provides partial coverage for medical expenses not fully covered under Medicare Part A

2 or more

HIPPA applies to groups of

5 years

How long must the agent keep copies of the disability insurance replacement forms on file?

180 days

If an insurer decides to discontinue providing group health insurance in general, how many days before discontinuance must a notice be sent to the Commissioner and the to each employer?

12 months

If reasonably possible, a notice of proof of loss claim must be provided to the insurer within what period of time after the time required by the policy?

60 days

If the payment of a specific premium or subscription fee is required to provide coverage for a child, the policy may require that notification of the child's birth and payment of the required premiums or fees be furnished to the insurer within how many days after the date of birth?

One hearing aid, per ear, per child, every 3 years

In a disability policy, coverage for the cost of hearing aid coverage for children may be limited to

The first day of the disability and the day the insured starts receiving benefits

In a disability policy, the elimination period refers to the period between

Prior to the time of application

In the case of producer solicitation, at what point must a long-term care Shopper's Guide must be presented to the applicant?

100%

S is a sole business proprietor who owns a medical expense plan. What percentage of the cost of the plan may he deduct?

15 employees

The Pregnancy Discrimination Act specifically prohibits pregnancy discrimination by employers with a minimum of how many employees?

A flat amount

The benefits for individual disability plans are based on

An individual who was previously covered by group health insurance for 6 months is eligible

Under HIPPA, which of the following is INCORRECT regarding eligibility requirements for conversion to an individual policy? The gap of coverage for eligibility is a period of 63 days or less An individual who was previously covered by group health insurance for 6 months is eligible An individual who used up COBRA continuation coverage is eligible An individual who doesn't qualify for Medicare may be eligible

At least the value of Social Security benefits

Under the Age Discrimination in Employment Act, if the obligation of the employer to provide retiree health benefits, what will an individual younger than 65 receive in benefits each year?

Holiday pay

Welfare benefits include all of the following EXCEPT Day care benefits Health care benefits Workers compensation Holiday pay

The insurer assumes the risk of paying the cost of medical expenses occurring during the policy period

What is a characteristic of a conventional full-insured plan?

They pay deductibles or copayments that are not paid by Medicare

What is the purpose of a Medicare Carve-Out of Supplements

The insurer's

When an applicant applied for Medicare supplement insurance, whose responsibility is it to confirm whether the applicant has an accident or sickness policy in force?

The Federal Department of Labor

Which authority enforces COBRA laws?

The aggregate amount of premiums due

Which of the following does NOT have to be disclosed in a LTC policy? Any riders or endorsements The aggregate amount of premiums due The meaning of the terms "reasonable" and "customary" Any limitations or conditions of eligibility for LTC benefits

Insurance Commissioner or Director

Which of the following entities must approve all Medicare supplement advertisements? Insurance Commissioner or Director NAIC Consumer Protection Agency Federal Association of Insurers

Antibiotics

Which of the following hospice expenses would NOT be covered in a cost-containment setting? Special hospital bed Antibiotics Tylenol Morphine

Dentures

Which of the following is NOT considered to be a basic service under a nonscheduled plan? Endodontics Oral Surgery Fillings Dentures

AM Best

Which of the following produces evaluations of insurers' financial status often used by state departments of insurance? AM Best NAIC Consumer's Guide SEC

The insurer

Who guarantees a conventional fully-insured group plan?

3 days

Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained?

$5,000

if a person does not comply with an order issued within 2 weeks after the Commissioner has given notice, for EACH DAY that the violation continues, the Commissioner may pay a fine of up to

Mental illness

in health underwriting, it would be inappropriate to decline a risk using any of the following factors except: Mental illness Genetic characteristics Marital Status Blindness

8 hours

once an individual is licensed for life or accident and health insurance, how many hours of training must the producer complete initially to sell long-term care insurance?

6 months

the free-look period does not apply to single-premium, short-term policies if the period of coverage is less than