NYS Life, Health and Accident
An insured's disability income policy includes an additional monthly benefit rider. For how many years can the insured expect to receive payment from the insurer before Social Security benefits begin?
1
What is the maximum period that an insurer would pay benefits in accordance with an Additional Monthly Benefit rider?
1 year
Any licensed person whose activities affect interstate commerce and who knowingly makes false material statements related to the business of insurance may be imprisoned for up to
10 years
Under the Affordable Care Act, what percentage of preventive care must be covered without cost sharing?
100%
Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?
Adult day care
Which of the following would be deducted from the death benefit paid to a beneficiary, if a partial accelerated death benefit had been paid while the insured was still alive?
Amount paid with the accelerated benefit, plus the earnings lost by the insurance company in interest income from the accelerated benefit
Which of the following would be considered a nonmedical insurance application?
An application on which the medical information is completed by the applicant and the agent only
Which of the following best describes rescission?
An insurer cancels a policy after it has been issued and refunds all paid premiums.
Which of the following is another name for a primary care physician in an HMO?
Gatekeeper
The Patient Protection and Affordable Care Act includes all of the following provisions EXCEPT
Individual tax deduction for premiums paid.
The clause that protects the proceeds of a life insurance policy from creditors after the death of the insured is known as the
Spendthrift clause.
What is necessary in order to be eligible to receive benefits from a long-term care policy?
The insured must be unable to perform some activities of daily living.
Which of the following is NOT required on an illustration used in the sale of a life insurance policy?
The name of the primary and secondary beneficiaries
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?
7 days
According to the Medical Loss Ratio (MLR), what is the minimum percentage of health coverage premium that must be applied to actual medical care in a large group health plan?
85%
In New York, how must all medical expense health insurance sold to individuals or small groups be rated?
Community rated
The main purpose of ERISA is to ensure that
Employees receive the pension and other benefits promised by their employers.
Under the Fair Credit Reporting Act, individuals rejected for insurance due to information contained in a consumer report
Must be informed of the source of the report.
Which of the following is NOT true regarding the Needs Approach method of determining the value of an individual's life?
Need is predicted using the number of years until the insured's retirement.
Which of the following is NOT among the goals of a Medicare supplement application?
Presuming the applicant is eligible for Medicaid, based on the nature of the policy
A man's physician submits claim information to his insurer before she actually performs a medical procedure on him. She is doing this to see if the procedure is covered under the patient's insurance plan and for how much. This is an example of
Prospective review.
Which of the following statements concerning a Simplified Employee Pension plan (SEP) is INCORRECT?
SEPs are suitable for large companies.
Which of the following is NOT covered under Plan A in Medigap insurance?
The Medicare Part A deductible
Which of the following is another name for a primary care physician in an HMO?
The Medicare Part A deductible
Life settlement contracts must be approved by which of the following?
The Superintendent of Insurance
Which statement accurately describes group disability income insurance?
The extent of benefits is determined by the insured's income.
Twenty-five days after a health insurance policy is delivered, the policyowner decides that she would like to return the policy and receive a refund of premium. Which of the following is true?
The policyowner will not receive a refund because the free-look period is over.
An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true?
The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off.
Which of the following is the closest term to an authorized insurer?
admitted
What does "liquidity" refer to in a life insurance policy?
cash values can be borrwed at any time
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
According to the Future Increase Option Rider (FIO), which of the following is NOT a qualifying event to increase an insured's benefit level?
death of a spouse
All of the following may be excluded from coverage in a Major Medical Expense policy, EXCEPT
emergency surgery
Health coverage becomes effective when the
first premium has been paid and the application has been approved
A lucky individual won the state lottery, so the state will be sending him a check each month for the next 25 years. What type of annuity products are they likely to use to provide these benefits?
immediate annuity
In long-term care (LTC) policies, as the benefit period lengthens, the premium
increases
Who makes up the Medical Information Bureau?
insurers
Medicare Advantage is also known as
medicare part c
When an insurer combines two periods of disability into one, the insured must have suffered a
recurrent disability
What type of care is Respite care?
relief for a major care giver
Medicaid is sponsored by what kind of sources?
state and fed
The Affordable Care Act requires all U.S. citizens and legal residents to have qualifying health care coverage. This is known as
the individual mandate
