State exam study guide
L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay?
1. $2,500 (the entire bill) 2. $900 (deductible + 20% of the bill after the deductible [20% of $2,000]) 3. $500 (amount of deductible) 4. $1,000 (deductible + 20% of the entire bill)
Which nonforfeiture option has the highest amount of insurance protection?
1. Conversion 2. Decreasing Term 3. Reduced Paid-up 4. Extended Term
One of the differences between group underwriting and individual underwriting is that there is little or no medical information required regarding plan participants in groups of
1. Fewer than 50. 2. 50 or more. 3. 100 or more. 4. 25 or more.
What is the maximum age for qualifying for a catastrophic plan
30
Within how many days must a producer respond to an inquiry from the Commissioner?
30 days
Partners in a business enter into a buy-sell agreement to purchase life insurance, which states that should one of them die prematurely, the other would be financially able to buy the interest of the deceased partner. What type of insurance policy may be used to fund this agreement?
Any form of life insurance
Which of the following are NOT fundable by annuities?
Death Benefits
Group disability income insurance premiums paid by the employer are
Deductible by the employer as an ordinary business expense
Which of the following is not considered to be a basic service, under a nonscheduled plan?
Dentures
Which of the following regulatory authorities participated in creating the National Do Not Call Registry?
FTC
Which type of care is NOT covered by Medicare?
LTC
Which of the following would be the best option that would help the surviving spouse of the insured to put her child through daycare after the insured's death?
Life insurance proceeds
The Gramm-Leach-Bliley Act was passed to
Protect private customer information filed with a financial institution.
an insured owes his insurer a premium payment. since then he incurs medical expenses. the insurer deducts unpaid premium amount form the claim amount and pays the insured the difference. what provision allows this
Unpaid premium
The Omnibus Budget Reconciliation Act of 1990 requires that large group health plans must provide primary coverage for disabled individuals under
age 65 who are not retired
which of the following would be considered a non-medical insurance application
an application on which the medical information is completed by the applicant and the agent only
Under the fair credit reporting act individuals rejected for insurance dire to information contained in a consumer report
must be informed of the source of the report
Which renewability provision are you most likely to see on a travel accident policy?
period of time
Which of the following is an example of apparent authority of an agent appointed by an insurer
the agent accepts a premium payment after the end of the grace period
an insurer wishes to compare the information given in an insurance application with previous insurance applications by the same applicant but for different companies. what organization can help the insurer accomplish this
The MIB
An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?
The PPO will pay reduced benefits.
Which of the following is NOT a characteristic of a group long-term disability plan?
The benefit can be up to 50% of one's yearly income.
under which of the following circumstances can financial institutions share insurance coverage information with 3rd parties for the purpose of soliciting the purchase of insurance
if a consumer does not sign and return the notice of disclosure within 30 days
the policyholder wants to make sure that upon is death the life policy will pay a portion of the proceeds annually to his spouse, but that the principal will be paid to their children when they reach a certain age. which settlement option should the policy-owner choose?
interest only option
Which of the following statement best describes the effect the Accelerated Benefit provision would have on the benefits paid to the beneficiary
it will decrease the benefits paid to the beneficiary
consumer report
provide info on the consumers credit, character, reputation, pr habits
28. 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?
1. 10 days 2. 30 days 3. 60 days 4. 90 days
In classifying a risk, the Home Office underwriting department will look at all of the following EXCEPT
1. Applicant's present occupation. 2. Applicant's past income. 3. Applicant's past medical history. 4. Applicant's present physical condition.
How are state Insurance Guaranty Associations funded?
1. By the Department of Insurance 2. By NAIC 3. By the Government 4. By their members - authorized insurers
4. What is the tax consequence of amounts received from a Traditional IRA after the money was left in the tax-deferred account by the beneficiary?
1. Capital gains tax on distributions plus 10% penalty.
In reference to fixed annuities, what comprises most of a life insurance company's general account?
1. Cash accumulation for any reason 2. A person's retirement 3. Estate liquidation 4. Death benefits
Under a typical health insurance policy, claims that result from injuries while the insured was intoxicated or under the influence of drugs are generally
1. Covered, but an extra premium is charged when a claim is filed. 2. Covered with a 90 days' waiting period. 3. Excluded. 4. Covered.
The life insurance policy clause that prevents an insurance company from denying payment of a death claim after a specified period of time is known as the
1. Reinstatement clause. 2. Insuring clause. 3. Misstatement of Age clause. 4. Incontestability clause.
26. Partners in a business enter into a buy-sell agreement to purchase life insurance, which states that should one of them die prematurely, the other would be financially able to buy the interest of the deceased partner. What type of insurance policy may be used to fund this agreement?
1. Term insurance only 2. Permanent insurance only 3. Universal life insurance only 4. Any form of life insurance
Which of the following is NOT a characteristic of a group long-term disability plan?
1. The benefit can be up to 66 and 2/3% of one's monthly income. 2. The benefit can be up to 50% of one's yearly income. 3. The elimination period is the same as in the short-term plan's benefit period. 4. The benefit period may be to age 65.
during replacement producers must provide a list of insurance policies still in force, in addition they must list policies sold during the past..
5 years
Which policy component decreases in decreasing term insurance
Face amount
producers are responsible to collect and disperse premiums and return premiums or other funds. which insurance term is associated with this
Fiduciary capacity
if a court ordered payment for a loss that was not covered in the policy even if it was clearly worded it would be an example of which legal concept?
Reasonable expectations
Paul is a producer in Ohio and wants to become a producer in Pennsylvania. The Commissioner will waive certain examination requirements, provided that Ohio would waive these same requirements if a Pennsylvania producer sought licensure in Ohio. What term is used to describe this phenomenon?
Reciprocity
With regards to premium rates, which of the following statements is NOT true?
The Commissioner sets all insurance premium rates used in Pennsylvania.
Regarding long-term care policies, which of the following would NOT be included in activities of daily living?
bathing
How are state Insurance Guaranty Associations funded?
by their members
What is the tax consequence of amounts received from a Traditional IRA after the money was left in the tax-deferred account by the beneficiary?
income tax on distributions and no penalty
when a person applies for medicare supplement insurance whose responsibility is it to conform that the applicant does not already have accident or sickness insurance in force?
insurer
what is not a benefit of a POS plan?
it allows guaranteed acceptance of all applicants
all of the following are considered to be supplemental benefits under HMO plan except
preventive services
regarding medicare select polices, what are restricted network provisions
they condition the payment of benefits
What is the main purpose of a retained asset account?
to serve as a temporary storage of fund for the beneficiary
which of the following are the people/entities who effectuate a viatical settlement contract?
viatical settlement providers
How many eligible employees must be included in a contributory plan?
75%
which of the following best describes the difference btw pure life and life with guaranteed min settlement option
life with guaranteed min will pay the remaining principal to the beneficiary
Every insurer marketing Long-Term Care insurance must establish marketing procedures to ensure all of the following EXCEPT
a) LTC policies are marketed effectively to prospective insureds.
which of the following reports will provide the underwriter with the information about an insurance applicant's credit
consumer report
23. An insured has chosen joint and 2/3 survivor as the settlement option. What does this mean to the beneficiaries?
3. The surviving beneficiary will continue receiving 2/3 of the benefit paid when both beneficiaries were alive.
One of the differences between group underwriting and individual underwriting is that there is little or no medical information required regarding plan participants in groups of
50 or more.
If a licensed person is moving to Pennsylvania, he or she may become licensed as a resident if they submit a completed application within how many days of establishing residence in Pennsylvania with proof of licensing from their prior home state?
60
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
. If a licensed person is moving to Pennsylvania, he or she may become licensed as a resident if they submit a completed application within how many days of establishing residence in Pennsylvania with proof of licensing from their prior home state?
90
an insured is involved in an accident that renders hi permanently deaf, although he does not sustain any other major injuries. the insured is still able to perform his current job. to what extent will he recieve presumptive disability benefits
full benefits
