ch.19.2
The California Insurance Code defines "policy" as
Written contract
Pete is a life agent who has misappropriated fiduciary funds to his own use. What is Pete guilty of?
Theft
Which of the following is NOT covererd by the family and medical leace act (FMLA)?
Traveling overseas with a spouse
Who does a life settlement broker represent?
Individual wanting to sell their life policy to a third party
MRMIP is a
state program that offers health coverage to California residents who are not able to obtain coverage due to pre-existing conditions
Which of the following is NOT a valide reason to replace existing long-term care policy?
New policy has higher premium with fewer benefits
How many "activities of daily living" must an insured be UNABLE to perform in order to meet the chronically ill requirement of a Long-Term Care policy?
2
An individual who transacts life, disability, or life and accident and health insurance on behalf of an insurer is called
life agent
According to the California insurance code, how is the word "may" interpreted?
permissive
ABC Insurance Company paid an insured $35,000 for hosptital costs, and $20,000 for physical therapy treatments. ABC later discovers thsi was fraudulent claim. How much may the insured by fined?
$170,000
Any changese in background information that occur after a produce application has been submitted or a license has been issued MUST be reported to the insurance commissioner within
30 days
According to PPACA, what is a health benefits exchange?
An entity to which individuals and small businesses can have access to affordable health coverage
What is an insurance solicitor authorized to do?
Help an agent or broker sell insurance
According to the California Insurance Code, what term is used to describe a fact so important it could affect the policy premium?
Materiality
The cost of services charged by the Health Insurance Couseling Advocay Program (HiCap) is
No cost
Kimberly is an employee on leave under the Family and Medical Leave Act (FMLA). What will happen to her group health coverage?
She continues to be enrolled during the leave
Why is a life insrance policy's delivery date important?
The free-look period begins on the policy delivery date
Failure to report background changes within 30 days as required under sections 1729.2 of the california insurance code could subject a license or applicant to
all of these
According to the california insurance code, which of the following is not an example of an insurable event?
an insured suffers a financial loss in the state lottery
Life insurance surpluss must be distributed to policyowners at what frequency?
annually
How is an agent's first year commission calculated for a replacement long-term policy?
based on the difference between the new and original policy annual premiums
Which entity has juristiction over health care coverage providers?
department of insurance
An insurance policy issued in California may be called comprehensive long-term care insurance policy if benefits are provided for
institutional (nursing facilities) and home care
According to the california insurance code, who is responsible for submittig a life agents appointment?
insurere
Which word implies permissiveness according to the California Insurance Code?
may
A representation may be altered or withdrawn
only before the insurance is in effect
Which type of juristiction required an insurer to have its rates accepted by the insurance department prior to using them?
prior approval
According to the california insurance code, what is the maximum penalty per violation for anyone who unwillfully commits an unfair method of competition?
$5000
How long must a policy be in force before an insurer is prohibited from denying claims based on misstatements made on the health policy application?
2 years
According to the PPACA, an adult can be covered by a parent's health care plan until what age?
26
The free-look period for life insurance policyowners age 60 or older is
30days
How long must life agents keep their transaction records?
5 years
When selling a long term care insurance rider to an applicant, a life agent must take into consideration all of these factors EXCEPT
Attending physiciams statement
Where must you specifically reside to qualify for MRMIP?
California
Which of the following actions is NOT allowed by health HiCap counselors?
Charge a fee
According to the california code governing claim settlement practices, which of the following is not considered to be an act of unfair discrimination?
Denial of claim based on reckless behavior
Jim is applying to become an insurance agent and has a past misdemeanor conviction that was later expunged due to California Penal Code 1203.4. Which of the following statements is correct?
Jim must still disclose the convistion on his insurance license application
The california insurance code has authorized standards for names used by life insurance agenst. which of the followig, if any, are automatically acceptable for lance manyon, a holder of the CLU designation?
Lance Manyon insurance services
MRMIP stands for
Major Risk Medical Insurance Program
Both the federal and state governments jointly finance which health insurance entitlement program?
Medi-Cal
People with low income can be provided with medical assistance through which program?
Medi-Cal
What is required afer a life agent sells an insurance policy to an applicant without being appointed by the insurer?
Notice of appointment must be submitted to the commissioner
Which of the following is NOT an accurate description of Access for Infants and Mothers Program (AIM)?
Only women who have private insurance plans with a maternity-only deductibles or copayment greater that $1500
What is the purpose of the pre-existing condition insurance plan (PCIP)?
PCIP was created by the PPACA for people rejected by private health insurers due to pre-existing conditions
What effect did the pregnancy discrimination act have on health industry?
Pregnancy must be treated as any other medical condition
What does the term "illustration" mean when used in the phrase "life insurance policy illustration", according to the California Insurance Code?
Presentation of policy features that include non-guranteed elements
Which of the following is nto condidered to be an act of insurance solicitation?
Publishing a magazine where one of the advertisers is an insurer
All of these are reasons the commisioner may disapprove a licensee's request to use a fictitious name except
The name is the licensee's actual name
According to the californis insurance code, what is "insurance"
a contract
What is an "insurance broker" according to california insurance code?
a person compensated for transacting insurance on behalf of another person with an insurer
What is the insurance term the state of california uses for an insurer that is eligeible to transact business in this state?
admitted
When an insurer has met the qualifications necessary to transact business in California, it is said to be
admitted
An insurance company entitled to transact business in california is called
admitted carrier
Which of the foloowing is NOT considered to be an unfair claims settlement practice?
advising a claimant to hire an attorney
Insurance agents and brokers must make their insurance records acailable to the commisioner
at all times
In what order are people on the MRMIP waiting list allowed to enroll?
based on the date an individuals application is received
The California Insurance Code allows an individual how many days to cancle a life policy for a full-refund?
between 10 and 30 days
A person who asserts a right of recovery under an insurance policy is called
claimant
Before an insurer is allowed to test an individual for HIV, what must be completed?
consent form
An agent's attempt to stop the replacement of an existing life insurance policy is known as
conservation
When handling premiums for an isnured, an agent is acting in which capacity?
fiduciary
In california, an insurer organized under the state laws of Oregon is called a
foreign insurer
According to the PPACA, the medical enrollemt tier that has 80% actuarial value is called
gold
What prevents a life insurance policy from being rescinded by the insurer afer being in force for two years?
incontestablility clause
Which of the following is not protected under the california life and health guarantee association?
insurers
Which of the following does the california insurance code not require an insurance policy to specify?
insurers financial rating
Which of the following is NOT a primary objective of insurance regulation?
interpret policy provisions
What type of license is required for an individual who charges a fee to review an insured existing life insurance polic?
life and disability analyst
Which of the following does the california department of insurance (CDI) have no juristiction over?
medicare
According to section 1729.2 of the californis insurance code, which of these does not qualify as "background information"?
mesdemeasnor charges filed, not resulting in a conviction
Which of the following acts is not a federal offense committed by an insurance agent?
missrepresentation
When intentional concealment is involved, what course of action is the injured party entitled to?
rescission of the contract
Under the california inssurance code, a licensee's license number must be printed at what sized on all price quotes
same size as numbers...
the californis life and health insurance guaranteee association covers all of these types of policies, except
self funded plans
Anyone employed in California to assist an insurance agent in transacting insurance is called an insurance
solicitor
Which of the following does not have to be included on life insurance policy illustractions?
statement that all values and benefits are guaranteed
What does the term "indemnity" mean as it pertains to insurance?
to make whole
An insurer that has beed found using higher rates based on race, religion, or ethnicity is said to be engaging in
unfair discrimination
An agent has advertised that the insurer to which the agent is appointed with is a member of the Insurance Guarantee Association. This agent has committed a(n)
unfair method of competition
Pauls has an existinf annuity and is sold a new one, in which the new policy holder no greater financial benefit to him than the existing contract. this is considered
unnecessary replacement
According to PPACA, how long can an adult be covered as a dependent under their parents' insurance plan?
up to age 26