nm (general)

$250

an employee is insured by a group major medical plan that is provided 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 $1000, how much of this benefit would be taxed as income?

he won't collect anything

an insured has an individual disability income policy with a 30-day elimination period. he becomes disabled on June 1st for 15 days. when will he collect on his disability income payments?

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

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

nothing

if an insured is injured while committing an illegal act and his health policy contains the illegal occupation provision, what percentage of the claim will be paid?

10 days

if an insured pays a health insurance premium each month, how long would the grace period be under the policy?

only one party makes a promise

insurance contracts are unilateral in nature. what does that mean?

are limited to covered expenses and are taxable to the business owner

the benefit from business overhead expense insurance policy

to allow the business buyout in case of the owner's disability

what is the purpose of a disability buy-sell agreement?

annual

all other factors being equal, which of the following premium modes would result in the lowest overall premium?

1/1 to 3/31 each year

time periods is the general enrollment period for medicare part B?

within 20 days

under the mandatory uniform provision "notice of claim", written notice of a claim must be submitted to the insurer within what time parameters?

within 10 days of when the policy was delivered

if an insured is not entirely satisfied with a policy issued, the insured may return it to the insurance company and receive a refund of the entire premium paid, at what of the following times?

consideration

an agent delivers a policy to an applicant, who pays the initial premium but refuses to submit a statement of good health. what terms best describes what the applicant has violated?

benefits paid will be those that would have been purchased at the correct age

an applicant misstates his age on his application for a health insurance policy. he states that he is 39, but his actual age is 49. when he files a claim, what will most likely happen?

A

an elimination (waiting) period may NOT have to be satisfied for a disability in which of the following? A. an insured suffers a relapse of a prior disability within 6 months of the initial coverage B. an insured suffered the disability from the results of active duty with the US armed forces C. an insured is disabled from a work-related accident D. an insured contracts an incurable disease

social security

an insured, who is 44 years old, falls while mountain climbing on vacation. he is left paralyzed. after a year, doctors feel he will never recover from his injuries. from what programs will he be able to collect disability income?

monthly

following a covered loss, the time payment of claims provision requires that an insurance company pays disability income benefits no less frequently than

to state what and how much is covered in the plan

what is the purpose of a benefit schedule?

A

which of the following statements is INCORRECT? A. the insurer does not have the right to conduct an autopsy B. the physical exam and autopsy provision gives the insurer the right to examine the insured, at its own expense C. the physical exam and autopsy provision gives the insurer the right to examine the insured as often as may be reasonably necessary while a claim is pending D. the insurer also has the right to conduct an autopsy, if not forbidden by state law

only an executive officer of the company

with respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy?

business overhead insurance

a dentist is off work 4 months due to a disability. his dental assistant's salary would be covered by

B

a major medical expense policy would exclude coverage for all of the follow treatments EXCEPT A. cosmetic surgery B. drug addiction C. eye refraction D. dental care

cross the incorrect answer out, write the correct one beside it, and initial the answer

when filling out an application for insurance, the applicant makes a mistake. if a fresh application were not available, what could the applicant do to properly correct the mistake?

by requiring that the insurance be incidental to the group

in addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health?

skilled care

is a daily nursing and rehabilitative care that can only be provided by medical personnel, under the direction of a physician?

$450

Elaine's basic hospital expense policy has a $500 per day limit for room and board in a hospital for a maximum of 5 days. Elaine got sick and had to spend 3 days in the hospital at 650 a day. how much will Elaine have to pay to cover the rest of her room and board charges?