Exam FX
How long must insurers maintain records of the information collected from senior consumers and other information used in making recommendations that were the basis for insurance transactions?
For 5 years after the insurance transaction is completed by the insurer
An insured becomes disabled at age 22 and can no longer work. She meets the definition of total disability under Social Security. What other requirement must the insured have met to receive Social Security disability benefits?
Have accumulated 6 work credits in the past 3 years
Which of the following entities has the authority to make changes to an insurance policy?
Insurer's executive officer
If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?
Nothing
Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the
Notice Regarding Replacement.
Medicare Part A services do NOT include which of the following?
Outpatient Hospital Treatment
At what age are individuals become INELIGIBLE for Florida Healthy Kids coverage?
19
Continuing education requirements must be met every
2 years.
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?
20% of covered charges above the deductible
Within how many days of the termination of the insured's group coverage must the insured notify the insurer of the decision to convert to individual coverage?
31 days
What is the maximum allowed value of promotional gifts that an agent may give to a prospective insured?
$100
The Florida Health Insurance Coverage Continuation Act requires insurers that sell health plans to small employers to offer in those plans a right to elect to continue coverage, without providing evidence of insurability, to employees who lose their coverage and are unable to replace it. The premium rate for this coverage may NOT exceed
115% of the regular group rate.
When does the initial enrollment period for Medicare Part B begin?
3 months before the insured's 65th birthday
When a disabled dependent child reaches the age limit for coverage, how long does the policyowner have to provide proof of dependency in order for the dependent to remain covered under the policy?
31 days
Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be best for Ray?
50/50
Which of the following is true regarding the agent's appointments?
A person may hold several appointments at one time.
Which of the following would best describe total disability?
A person's ability to work is significantly reduced or eliminated for the rest of his/her life.
What level of authority is given to the Office of Insurance Regulation with respect to examination of insurer's activities to determine compliance Unfair Trade Practice laws?
Absolute
An insurance producer just sold an insurance policy to his sister. What kind of business is this?
Controlled
How many pints of blood will be paid for by Medicare Supplement core benefits?
First 3
Which provision allows the policyholder a period of time, while coverage is in force, to examine a health insurance policy and determine whether or not to keep it?
Free Look Period
The agent in charge of an agency must hold which of the following licenses?
General lines
A Medicare supplement plan must have at least which of the following renewal provisions?
Guaranteed renewable
In insurance transactions, fiduciary responsibility means
Handling insurer funds in a trust capacity.
An insurer publishes intimidating brochures that portray the insurer's competition as financially and professionally unstable. Which of the following best describes this act?
Illegal under any circumstances
A Health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?
Immediately
A guaranteed renewable disability insurance policy
Is renewable at the insured's option to a specified age.
A 65-year-old enrolls for benefits under Medicare Part B and submits an application for a Medicare supplement policy two months later. For which of the following reason may the insurer deny the application?
Material misrepresentation
Which of the following programs expands individual public assistance programs for people with insufficient income and resources?
Medicaid
Under the Affordable Care Act, which classification applies to health plans based on the amount of covered costs?
Metal level classification
Which of the following documents must be provided to the policyowner or applicant during policy replacement?
Notice Regarding Replacement
During replacement of life insurance, a replacing insurer must do which of the following?
Obtain a list of all life insurance policies that will be replaced
When does Medicare cover nursing home care?
Only if it is part of treatment for a covered illness or injury
In what way can an agent demonstrate a high standard of ethics?
Putting the client's best interests before their own
Which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses?
Stop-loss limit
Who examines the books and records of insurance companies in Florida?
The Chief Financial Officer
Which of the following is NOT covered under Plan A in Medigap insurance?
The Medicare Part A deductible
If an agent is in the military, which of the following is true?
The agent cannot sell a policy to another active military person who is of a lower rank.
Who does the secondary addressee provision protect?
The insured over the age of 64
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to
The insured.
Which of the following is NOT a feature of a guaranteed renewable provision?
The insurer can increase the policy premium on an individual basis.
Which of the following definitions would make it easier to qualify for total disability benefits?
The more liberal "own occupation"
A policyowner names his five children as primary beneficiaries and his wife as a contingent beneficiary. If the policyowner and one of his children die, who would receive policy benefits?
The remaining 4 primary beneficiaries
Which provision states that the insurance company must pay Medical Expense claims immediately?
Time of Payment of Claims
Which of the following statements is CORRECT about Social Security?
To be eligible, one must meet certain requirements.
Long-term care policies require that in addition to the applicant at least one person must be designated in the policy. What is the role of that designated person?
To receive notice of policy lapse or termination
A policyowner has a health insurance policy with his wife listed as the primary beneficiary. He would like to change the primary beneficiary to his sister. Which of the following is true?
Unless the policy designated the current beneficiary as irrevocable, the policyowner can make the change at any time.
Workers compensation insurance covers a worker's medical expenses resulting from work related sickness or injuries and covers loss of income from
Work-related disabilities.
Which of the following is NOT a factor in determining qualifications for Social Security disability benefits?
Worker's occupation
Which of the following insurance products will be subject to the regulation on life insurance solicitation?
A term life policy
Licensed life insurance agents are expected to be familiar with which of the following laws?
All of the insurance laws and regulations
Which of the following is NOT an enrollment period for Medicare Part A applicants?
Automatic enrollment
How are state Insurance Guaranty Associations funded?
By their members - authorized insurers
What type of policy allows the insurance company to cancel a policy at any time?
Cancellable
Which of the following statements about occupational vs. nonoccupational coverage is TRUE?
Disability insurance can be written as occupational or nonoccupational.
Two individuals are in the same risk and age class; yet, they are charged different rates for their insurance policies due to an insignificant factor. What is this called?
Discrimination
Which types of insurance companies marketing long-term care insurance coverage must establish procedures to assure that any comparison of policies by its agents will be fair and accurate?
Every company is required to establish marketing procedures.
An individual did not enroll in Medicare Part B when first becoming eligible. Which of the following would allow the individual another opportunity to enroll?
General enrollment period
What kind of policy issues certificates of insurance to insureds?
Group insurance
Which of the following is INCORRECT concerning Medicaid?
It is solely a federally administered program.
Under workers compensation, which of the following benefits are NOT included?
Legal benefits
Which of the following premium modes would result in the highest annual cost for an insurance policy?
Monthly
Can a group that is formed for the sole purpose of obtaining group insurance qualify for group coverage?
No, the group must be formed for a purpose other than obtaining group insurance.
What is the major difference between a stock company and a mutual company?
Ownership
Certificates of coverage are issued to
Participants in a group plan.
A participating insurance policy may do which of the following?
Pay dividends to the policyowner
An insured pays her Major Medical Insurance premium annually on March 1. Last March she forgot to mail her premium to the company. On March 19, she had an accident and broke her leg. The insurance company would
Pay the claim.
With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance?
Payment of premium
Medicare Part D provides
Prescription drug benefit.
Which rule would apply if an agent knows an applicant is going to cash in an old policy and use the funds to purchase new insurance?
Replacement rule
Disability income policies can provide coverage for a loss of income when returning to work only part-time after recovering from total disability. What is the benefit that is based on the insured's loss of earnings after recovery from a disability?
Residual disability
Which of the following may NOT be included in an insurance company's advertisement?
That its policies are covered by a state Guaranty Association
How will a life insurance beneficiary designation naming a spouse be changed by divorce?
The beneficiary designation will be voided.
What type of information is NOT included in a certificate of insurance?
The cost the company is paying for monthly premiums
Which of the following dates must be contained in a policy summary?
The date the summary was prepared
An employee insured under a group health policy is injured in a car wreck while performing her duties for her employer. This results in a long hospitalization period. Which of the following is true?
The group plan will not pay because the employee was injured at work.
Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In November, he has a small claim which is less than his deductible. Which of the following is true?
The insured may carry over the amount of this year's expenses to next year, which will help satisfy next year's deductible.
Which of the following is true regarding Medicare supplement policies?
They must be guaranteed renewable.
When an HMO knowingly makes any misleading representations, incomplete or fraudulent comparisons for the purpose of inducing any person to lapse, forfeit, terminate, surrender or convert any insurance policy or contract with another insurance company or HMO, they are in violation of the unfair trade practice of
Twisting
Which characteristic does NOT describe managed care?
Unlimited access to providers
When are HMOs required to file a report of their activities with the Department of Financial Services?
Within 3 months of the end of each fiscal year
When can a Long-Term Care policy deny a claim for losses incurred because of a pre-existing condition?
Within 6 months of the effective date of coverage
An employee will be taxed on the cost of group life insurance paid by the employer if the amount of coverage exceeds
$50,000
An annuity contract is issued to a senior consumer over age 65. What is the maximum surrender charge for a withdrawal of money allowed on this annuity?
10%
The free-look provision allows for which of the following?
A right to return the policy for a full premium refund