Pennsylvania State Health and Life Insurance Exam

Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?

20 days

Which of the following must the patient pay under Medicare Part B

20%

Prior to license renewal, all insurance producers must successfully complete a minimum of

24 Credit Hours

A producer has successfully completed 52 hours of CE. How many CE will go towards this upcoming reporting period?

24 hours this reporting period. 24 the period following. 4 hours lost

If an insurer terminates a producer, the insurer must notify the commissioner within how many days?

30 Days

Employer health plans must provide primary coverage for individuals with end-stage renal disease before medicade becomes primary for how many months?

30 months

In order to qualify for conversation from a group life policy that has been terminated to an individual policy of the same coverage, a person must have been insured under the group plan for how many years?

5 years

According to the telemarketing sales rules, what are the permissible calling hours for telemarketing calls?

8am until 9pm

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

90 Days

Jason is insured under his employers group health insurance. He splits the cost of the premiums with his employer. This is an example of

A Contributory Plan

A straight Life policy has what type of premium?

A level annual premium for the life of the insured

Which of the following statements is incorrect?

A licensee is barred from charging a fee in addition to a commission to a person for the sale, solicitation or negotiation of a contract of insurance for commercial business

Insurance companies may be classified according to the legal form of their ownership. The type of company organized to return any surplus money to their policyholders is

A mutual insurer

Which of the following persons is required to hold a producer license?

A person who negotiates insurance contracts

In reference to the standard medicare supplement benefits plans, what does the term standard mean?

All providers will have the same coverage

Your client plans to retire at age 50. He would like to purchase an annuity that would provide income from the tie he retires to the age when social securities and other pension funds become available.

Annuity Certain

Which of the following hospice expenses would not be covered in a cost-containment setting?

Antibiotics

Bob purchased a policy to provide coverage on himself, his wife Linda, and their two children, John and Kristen. All of the would need to prove insurability except.

Any children born to them after the inception of the contract

In a replacement situation, all of the following must be consider except

Assets

Which of the following is not an enrollment period for medicare part a applicants?

Automatic Enrollment

Which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium?

Automatic Premium Loan

Which of the following provisions in annuity contracts allow the owner to te surrender the annuity if interests rates drop to a specified level.

Bail-out

A person applying for a manager or exclusive general agent license must meet all of the following criteria EXCEPT

Be responsible for at least 25% of total commissions collected by the office that he or she manages

Which of the following would not be considered an expectation to the national do not call list?

Calls based from outside the United States

The act of voluntarily giving up insurance by the insured is called

Cancellation

When the commissioner suspects a person is violating an insurance law or other regulation...

Cease and Desist

Forcing a client to buy insurance from a particular lender as a condition of granting a loan is defined as

Coercion

Which of the following authorities is authorized to issue a temporary insurance producers license?

Commissioner

Combination plans are composed of two types of plan features: Basic and...

Comprehensive

An Applicant for an individual Health policy failed to complete the application properly. Her stay at the hospital was not covered by insurance because she has not met the conditions specified in the...

Consideration Clause

The gatekeeper of an HMO helps

Control Specialists costs

Which of the following would not be considered an unfair and deceptive practice?

Controlled Business

According to the entire contract provision, what document must be made part of the insurance policy?

Copy of the original application

Which component increases in the increasing term insurance?

Death Benefit

A policy which covers medical costs related to a specific condition is called a

Dread Disease Policy

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the

Entire Contract Clause

The authority granted to an agent through the agents contract is referred to as

Express Authority

Which nonforfeiture option has the highest amount of insurance protection?

Extended Term

An applicant is denied insurance because of information found on a consumer reports...

Fair Credit reporting act

Under a 20-pay whole life policy, in order for the policy to pay the death benefit to the beneficiary, the premiums must be paid

For 20 years or until death, whichever occurs first.

Which of the following is an example of an agent's fiduciary responsibilities?

Forwarding premiums to the insurer

Events or conditions that increase the chances of an insured loss occurring are referred to as

Hazards

A health Insurance policy lapses but is reinstated within an acceptable time frame. How soon from the reinstatement date will coverage for accidents become effective?

Immediately

Which authority is not stated in an agents contract but is required for the agent to conduct business?

Implied

Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?

Indemnity

The section of the health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the

Insuring Clause

Which of the following is not a metal level of coverage offered under the patient protection and affordable care act?

Iron

Which of the following best describes a misrepresentations?

Issuing sales material that are exaggerated

An insurer invests the money it receives from premiums paid by the insureds. Which of the following is true regarding the interest earned on these investments?

It is used to lower premiums

Which of the following is true regarding a single life settlement option?

It provides income the beneficiary can't outlive

Which of the following statements is TRUE concerning the accidental death rider?

It will pay double or triple the face amount.

Which of the following is not true regarding the accumulation period of an annuity

It would not occur in a deferred annuity

If a life insurance policy increases significantly in face amount when the insured reaches a specified age, what type of policy is this?

Jumping Juvenile Policy

Which of the following best describes the unfair trade practice of defamation?

Making derogatory oral statements about another's financial conditions

Which of the following programs is made up of 4 parts, where the first part is paid for by FICA, and the second part is financed by premiums and payroll taxes?

Medicare

Under an individual disability policy, the MINIMUM schedule of time in which claim payments must me made to an insured is

Monthly

In a long-term care policy, pre-existing condition limitations

Must appear as a separate paragraph and be clearly labeled

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

What was created to keep telemarketers from calling consumers who do not wish to be contacted?

National Do not call registry

What is the major difference between a stock company and mutual company

Ownership

Which of the following allows the insurer to relieve a minor insured from premium payments if the minors parents have died or become disabled

Payor benefits

The clause of loss insured against in an insurance policy are known as

Perils

Which of the following must be present in all medicare supplement plans?

Plan A

Which of the following individuals must have insurable interest in the insured?

Policy Owner

Based on Human Life Value Approach, which of the following is not used to calculate an individual's value of life?

Predicted needs of the family after the insured's death

Which of the following is correct concerning the taxation of premiums in a key-person life insurance policy?

Premiums are not tax deductible as business expenses

A long-term care shoppers guide must be presented at what point

Prior to the time of application

Which of the following licensees is classified as a representative of the insurance company and not allowed to represent and insured or claimant?

Producer

The insurance company underwriter could find information concerning the personal activities and character of an applicant from which of the following reports?

Producers report

If an employee wants to enter the group outside of the open enrollment period, to reduce adverse selection, the insurer may

Require evidence of insurability

Under the fair credit reporting act, if the consumer challenges the accuracy of the information contained in his or her report, the reporting agency must

Respond to the consumer's complaint

A domestic insurer issuing variable contracts must establish one or more

Separate Accounts

Which of the following is an example of a peril covered in an accident and health insurance policy?

Sickness

A person steps off a streetcar and trips and breaks his ankle. This type of injury can be described as

Sudden and Unforeseen

All of the following are unfair claims settlement practices except

Suggesting negotiations in settling the claim

Which of the following would help prevent a universal life policy from lapsing?

Target Premium

Which of the following entities must approve all continuing education courses in the state?

The commissioner

According to the privacy of consumer financial information regulation, if a consumer decides to opt out, this means

The consumer directs the licensee not to disclose the consumers nonpublic personal financial information to a third party

Which of the following statements about group life is correct?

The cost of coverage is based on the ratio of men and women in this group

Which of the following statements concerning group health insurance is correct?

The employer is the policy holder

An insurance advertisement exaggerates the benefits of an insurance policy, due to human error at the insurers advertising agency. Who will the department of Insurance hold accountable for the exaggeration?

The insurer

Which of the following is not a feature of a guaranteed renewable provision?

The insurer can increase the policy premium on an individual basis

If another governmental agency takes legal action against a licensee, whose responsibility is it to report the action?

The licensee

All of the following are true of an annuity owner except

The owner must be the party to receive benefits

A licensee serving in the military is unable to fulfill her continuing education requirement. What would the licensee have to do to renew the license?

They are exempt as long as they are on active duty, and for 6 months afterwards

How are employer contributions to health reimbursement accounts treated in regards to taxation?

They are tax deductible

Why do group health providers usually require a certain amount of participation in the plan by eligible employees

To guard against adverse selection and reduce cost

Should an insurance company deny a claim submitted by and insured without providing to that insured a prompt reason...

Unfair claims methods and practices regulation

An insured receives a monthly summary for his life insurance policy. He notices that the cash value of the policy is significantly lower this month than it was last month. What type of policy does the insured have?

Variable

A person who gives money as consideration for a life insurance policy or intrest in the death benefits of a life insurance policy is called a

Viatical settlement purchaser

Under what condition are group disability income benefits received by an employee NOT taxable as income

When the benefits received are equal or less than the employees percentage of the contribution

If an applicant for a life insurance policy and person to be insured by the policy are two different people, the underwriter would be concerned about

Whether and insurable interest exists between the individuals.

How soon after the due date should the insurer pay the agent appointment fees?

Within 30 days

Can an individual who belongs to a POS plan use an out-of-network physician?

Yes and they may use any preferred physician, even if not part of the HMO

A group blanket health policy is best suited for which of the following?

a summer camp

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

A typical accidental death & dismemberment policy covers all of the following losses except

income

Which of the following is not true about a group annuity?

it can be owned by individual employees

Which of the following is true regarding the spendthrift clause in life insurance policies?

it can protect the policy proceeds from creditors of the beneficiary

Which of the following statements is correct regarding a whole life policy?

the policy owner is entitled to policy loans