Test 4

Long-Term Care policies issued in Iowa MUST be

Guaranteed

According to the Time Payment of Claims provision, how soon must an insurer pay for a covered medical expense after proof of loss has been submitted?

Immediately

What is one of the roles of the Commissioner?

Enforce state insurance laws

A producer does not have the authority to change a policy or waive any of its provisions. The health provision that best describes this statement is called the

Entire Contract

In a life insurance contract, the policy, application, and riders or endorsements are considered to be the

Entire Contract

Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy

Entire Contract

The act of an insurance company publishing misleading information about its policy's provisions is called

False advertising

The Insurance company that Jack represents has been placed into rehabilitation, but Jack continues to tell his clients the company is "financially strong" and he uses an outdated financial rating to back up his claim. What unfair trade practice has Jack committed?

False financial statements

Which of the following is a standard provision of the conversion privileges in a Group Life Policy?

Group Life coverage can be converted to an individual policy at regular rates on an attained-age basis

Which of the following is a requirement to be eligible for a group life policy in Iowa?

Group must be formed for a purpose other than obtaining insurance

T applied for a Disability Income policy and has a history of back injuries. The insurer issued the policy with a statement that excludes coverage for back injuries. This statement is called a(n)

Impairment rider

Which Accident and Health policy provision addresses preexisting conditions?

Time limit on certain defenses

Group Life policies in Iowa are required to contain a conversion privilege that allows for conversation

To an individual policy for a stated period of time

Why would the commissioner examine the records of an insurance company?

To determine the solvency of the company

An insurance company that conducts business in Iowa and was incorporated in Iowa is called a(n) ______ insurer.

Domestic

G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills?

The insured

Under the Affordable Care Act (ACA), health coverage is provided for dependents up to the age of

26

A producer must notify the Insurance Division within ____ days of a felony conviction

30

How many days must the insured wait to take legal action against a health insurer after submitting written proof if the insurer refuses to pay?

60

In health insurance policies, a waiver of premium provision keeps the coverage in force without premium payments

After an insured has become totally disabled as defined in the policy

Which of the following BEST describes how pre-admission certification is used?

Used to prevent nonessential medical costs

An example of false advertising would be

An insurer exaggerating its dividends in a magazine advertisement

According the the affordable care act (ACA), which of the following coverages is NOT required?

Coverage for cosmetic surgery

Iowa's 10-day free-look period for life insurance policies begins at the

Date of delivery

During an insurance transaction, who does the producer represent?

Insurer

Which situation does NOT require a producer to provide a suitability statement to the annuit company?

When a producer discusses annuities in general with a client, but no specific recommendation is made

An example of life insurance policy replacement would be?

cash surrender an existing whole life policy and purchasing a new whole life policy

Health insurance benefits NOT covered due to an act of war are:

excluded by the insurer in the contract provisions

Under an individual Health Insurance policy, the Time Limit of certain defenses provision states that nonfraudulent misstatements first become incontestable two years

from the date that the policy was issued

Information obtained from a phone conversation to the proposed insured can be found in which of these reports?

inspection report

Who issues Medicare Supplement policies

insurance companies

If an insurance company issues a Disability Income policy that it cannot cancel or for which it cannot increase premiums, the type of renewability that best desribes this policy is called

noncancellable

The Notice of Claims provision requires a policyowner to:

notify an insurer of a claim within a specified time

An example of unfair discrimination would be

offering different terms of coverage for different policyowners having the same risk classification

An example of rebating would be

returning a portion of a premium as inducement to purchase insurance

An example of an unfair claims settlement practice is

turning down a claim without providing the basis of denial

Before holding a hearing regarding an agent's unfair or deceptive practice, the Insurance Commissioner MUST give how many days notice?

10

A group life insurance policy insured may assign up to ____ of the insured's coverage.

100%

To be classified as a small employer, an employer must employ

2-50 employees

When an employee is terminated, how long does this employee have to convert group life coverage to an individual plan?

31 days

The Commissioner of Insurance is the chief officer of the Iowa Insurance Division and is appointed by the Governor for a __ year term.

4

The Commissioner of Insurance is the chief officer of the Iowa Insurance Division and is appointed by the Governor for a ____ year term

4

The waiting period for a pre-existing condition under a Medicare Supplement policy may NOT go beyond

6 Months

Inflation protection is not required in a partnership long-term care policy if the individual is at least how old at issue

76

What is Iowa's definition of Life insurance replacement?

A transaction in which a new policy is bought and an old policy is terminated

Which of these is NOT a required group life policy provision?

Accidental Death and Dismemberment

When is a Group Health policy required to provide coverage for a newborn child?

At the moment of birth

P is a Major Medical policyowner who is hospitalized as a result of injuries sustained from participating in a carjacking. How will the insurer most likely handle this claim?

Claim will be denied

A Disability Income policyowner recently submitted a claim for chronic neck problem that has now resulted in total disability. The original neck injury occurred before the application was taken 5 years prior. The neck injury was never disclosed to the insurer at the time of the application. How will the insurer handle this claim?

Claim will be paid and coverage will remain in force

Which of these is a requirement for obtaining a resident insurance producer license in this state?

Complete a prelicensing examination

T the producer is trying to dissuade a policyowner from replacing an existing insurance policy. This action taken by T is called

Conservation

Which is the sate's high-risk pool coverage for residents who cannot obtain coverage through the traditional insurance market?

Iowa comprehensive Health Insurance Association

Which of the following actions will an insurance company most likely NOT take if an applicant, who has diabetes, applies for a disability income policy?

Issue the policy with an altered Time of Payment of Claims provison

Which type of plan normally includes hospice benefits?

Managed care plans

Which of the following are Not managed care organizations

Medical Information Bureau

Periodic health claim payments MUST be made at least

Monthly

A Medicare Supplement policy can be cancelled by the insurer for

Nonpayment

T the producer is replacing a client's existing insurance policy with a new one. Prior to policy delivery, which form must the client be provided with?

Notice Regarding Replacement

What must be signed by both the producer and applicant when existing life insurance policy is being reissued with a reduction in cash value

Notice Regarding Replacement

If a Medicare Supplement policy involves replacement, it must be verified on a question located

On the application

The insured and insurance company will share the cost of covered losses under which health policy feature?

Payment of Claims provision

Which of these is considered a mandatory provision?

Payment of claims

What must the policyowner provide to the insurer for validation that a loss has occurred?

Proof of loss

Which of these individuals would require continuing education?

Resident Producer

In order to terminate a producer's appointment, the insurer MUST

Send notice of the termination to the commisioner

Which mode of payment is NOT used by health insurance policies?

Single premium

Which of the following statements about the classification of applicants is INCORRECT?

Substandard applicants are never declined by underwriters

Obtaining information from the applicant to determine whether an insurance or annuity product is appropriate is called

Suitability

T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called

Time limit on certain defenses

If an individual is covered under an Accidental Death Policy and dies, an autopsy can be performed in all these situations, EXCEPT:

When the state prohibits this by law

What is considered to be a characteristic of a Conditionally Renewable Health Insurance policy?

Premiums may increase at time of renewal

P is self-employed and owns an Individual Disability Income policy. He becomes totally disabled on June 1 and receives $2,000 a month for the next 10 months. How much of this income is subject to federal income tax?

0

After purchasing an individual health insurance contract, policyowners have ____ days from the date receiving the policy to return it for a full refund for any reason.

10

Which of the following unfair trade practices involves a producer who makes malicious statements about another person's financial condition?

Defamation

An agent takes an individual Disability Income application, collects the appropriate premium, and issues the prospective insured a conditional receipt. The next step the insurance company will take is to

Determine if the applicant is an acceptable risk by completing standard underwriting procedures

J is a producer who recently told a claimant that his rights might be impaired if he does not complete a release form within a specified time. What could this producer be found guilty of?

Coercion

Which of the following correctly explains the actions an agent should take if a customer wants to apply for an insurance policy?

Complete the application and review the information with the customer prior to obtaining the customers signature then send the application off to the insurance company

An insurance company receives E's application for an individual health policy. E did not complete all of the medical history questions because she could not remember the exact dates. E signed the policy and submitted it to the insurance company anyway. A few weeks later, E suffers a heart attack and is hospitalized without completing the medical history questions and paying the initial premium. E is not insured. Which of the following clauses details the conditions that E did not meet?

Consideration clause

XYZ Corp was issued a group health policy for its employees. Under this plan a

Policy must be issued to XYZ, and a certificate must be issued to each employee

A(n) _______ sells, solicits, or negotiates insurance on behalf of insurance companies for compensation

Producer