Series 17-55
Maximum amount of coinsurance in New York
25%
What percentage of prescription drug cost is the insured responsible for paying in part D of Medicare
25%
Medicare supplement renewal commissions paid in the third year must be as high as a commission of which year
2nd
How long does a licensee have to notify the superintendent of a change of address?
30 days
How often does the code require examination of domestic life insurance?
5 years
How long can an agent backdate an application for?
6 months
How long is an open enrollment period for Medicare supplement policies?
6 months
Open enrollment. Period for Medicare supplement policies.
6 months
What is the waiting period on a waiver of premium rider in life insurance policies
6 months
Under the affordable care act, a special enrollment period Allows an individual to enroll in a qualified health plan within how many days of a qualifying event.
60 days
Minimum percentage for medical care in an individual health plan
80%
How long after the date of issue may an insurer cancel an accident and health policy
90 days
What do Deferred annuities do
Accumulate retirement funds, accumulate funds in an IRA, and fund a child's college education
The amount of position or supplier bills for a particular service or supply
Actual charge
What can an independent adjuster include?
Affirm who acts on behalf of the insurer
Which documentation grants Xpress authority to an agent
Agent contract with the principal
How can a new physician be added to the PPOs approved list
Agree to follow the PPO standards and charge the appropriate fees.
Cash option
Allows an insurer to send the policyholder an annual non-taxable dividend check
Pure Life Annuity
Also known as life only or straight life, income payments sis at the Newton's death, and there are no refunds or payments to survivors
What is an independent adjuster?
Any person firm association of corporation who acts on behalf of an insurer in the work of investigating and adjusting claims
In order for a nonresident license, you to become a resident producer in New York, the licensee must
Apply within 90 days of becoming a resident
How long can an insurer contest of fraudulent statement in a health insurance application?
As long as policy is in force
When was Agents submit license renewal applications to the superintendent?
At least 60 days before the license expires
What type of benefit plan is in conjunction with the health benefit plan committee
Basic coverage benefit plan
Who receives the annuity benefits if an annuitant dies during the accumulation period?
Beneficiary
What do you need to legally transact insurance in New York?
Certificate of authority
How are all medical expense health insurance sold two individuals or small groups rated
Community rated
How much must all medical expense health insurance sold to individuals or small groups be rated
Community rated
Health insurance plan that covers all accidents and sicknesses that are not specifically excluded from the policy is referred to as
Comprehensive plan
The report that provides the underwriter with information about insurance applicant credit
Consumer report
What provision must be on the first page of Medicare supplement policy this also states the insurance right to change premium amounts
Continuation provision
When selling insurance policy to family, what kind of business is this?
Controlled
Specific, dollar amount that must be paid by an HMO member for a Service
Copayment
Embezzlement
Criminal act of taking money belonging to someone else
What's the most common policy used in credit life insurance?
Decreasing term
Needs approach method
Determined by predicted needs of the family after the premature death of the insured, which is assumed to happen immediately
What is one qualifying event under cobra?
Divorce
What do fixed annuities provide?
Equal monthly payments for life, minimum guaranteed rate of interest, and future income payments
Misrepresentation
False or misleading statements with intent to defraud another
Benefits for an individual disability plans are based on
Flat amount
When an HSA holder is 65 years old, uses money in the account for a non-health expense, what happens
Gets taxed
What two types of interest rates the universal life policy have
Guaranteed and current
Two types of flexible spending accounts
Health care accounts and dependent care accounts
To be eligible for a health savings account an individual must be covered by
High Deductible Health Plan
reimbursement
How benefits are provided when benefits are paid directly to the insured under a health insurance policy
The annual contribution limit of a dependent care flexible spending account is set by
IRS
What happens to the premium in long-term care policies one benefit Lengthens
Increases
What does the notice regarding replacement do?
Informs applicant of 30 day free look provision of the replacing policy
Who has authority to make changes to an insurance policy
Insurer's executive officer
What determines the interest rates paid to the owner of a fixed annuity?
Insurer's guaranteed minimum rate of interest
What kind of insurance is annually Renewable term insurance
Level term insurance
cease and desist order
Licensee must stop the violation he or she is suspected of doing
Why would an agent backdate an application
Lower the premium
When do insurance licenses expire?
On the birthday of every odd number year
Which option for universal life allows the beneficiary to collect both of death benefit in cash value upon the death of the insured
Option B
Rider attached to a life insurance policy that provides coverage on the insurance family members
Other insured rider
Joint life policy
Pays death benefit upon death of the first insured
indemnity
Pays fixed amount each day The insured is hospitalized.
What does the employee retirement income security act monitor?
Pension, profit-sharing stock, bonuses, and most welfare benefit plans
Share care long-term care policies
Pockets to split the total benefits of two policies
Who receives dividends from mutual insurer
Policyholders
In long-term care policies, when benefit period lengthens
Premium increases
What are required provisions of a health insurance policy?
Proof of loss forms must be settled in 15 days, 31 day, grace, period, the entire contract clause
What does health insurance do?
Provide payments for loss of income
Omnibus Budget Reconciliation Act (OBRA)
Provide primary coverage for disabled individuals under age 65 who are not retired
Who Represents the insured in the investigating of a claim
Public Adjuster
What does the ownership provision do?
Receive a policy loan, sign a policy, designate a beneficiary
Standard Risk
Represents majority of people in their age with similar lifestyles
Reinstatement provision
Requires policy owner to pay all overdue premiums with interest before the policy is reinstated
What do annuities fund?
Retirement plans
Which type of retirement account does not require the owner to start taking distributions at age 73
Roth IRA
Examples of risk retention
Self insurance, deductibles, copayment
How can annuities be funded?
Single payments or periodic payments
Fixed amount
The annuitant selects the amount of each payment, and the insurance determines how long will pay benefits
What happens if a nonmember physician is utilized under the point of service plan?
The attending physician will be paid a fee for service, but the member patient will have to pay a higher coinsurance amount.
What happens when a policy has an irrevocable beneficiary designation?
The beneficiary can only be changed with written permission of the beneficiary
What happens when an annuitant dies when the annuity is in the accumulation Stage
The beneficiary receive the greater of the money paid into the annuity or the cash value
When can a temporary license be issued?
The death of an agent, an agent, disability, and agents time in the military service
Who can revoke a producers license?
The department of financial services
What happens during an IRA direct transfer
The full amount gets reinvested from one plant to another
In a group policy, who is issued a certificate of insurance
The individual insured
If an insurer over, pays on a claim, who can't recover the excess
The insurance guaranty association
What isn't considered when underwriting group insurance?
The insured's medical history
Who guarantees a conventional fully insured group plan
The insurer
In the return of premium option for long-term care policies what happens to the premium if the policy lapses
The insurer will return the percentage of the premiums paid
An insurer over paid on a claim, the insurer may recover the excess from
The other insure, another organization involved in the claim, the person on the benefit has been paid
Who is the owner of a life settlement contract
The seller of the contract
What is true regarding optional benefits with long-term care policies?
They are available for an additional premium
Another name for administrative services only arrangement
Third-party administrator
What's the best reason to purchase life insurance rather than annuity?
To create an estate
When can a temporary license be issued?
To service the existing business
What does a policy assignment do
Transfer right of ownership from the owner to another person
Interest sensitive life insurance policy
Universal life
How are death benefits paid enjoying life policies
Upon the first death only
Health insurance grace period durations based upon premiums
Weekly = 7 days, monthly = 10 days, all others = 31 days
open panel
When a medical caregiver contracts with the health organization, to provide services to its members or subscribers, but we change the rate to treat patients who are not members for subscribers
The difference between the Medicare approved amount for a service or supply and the actual charge
excess charge
Who bears all of the investment risk in a fixed annuity?
insurance company
All advertisements are the responsibility of the
insurer
What is the shortest? Possible elimination period for a group short term disability benefits provided by an employer.
0 days
