Excel class
A policyholder has a major medical plan with a 80 % /20% coinsurance and a deductible of $75. If the insured has previously met her deductible and receives a bill for $175, how much will the insurer pay?
$140. Because the insured has previously met her deductible, the eligible expenses for a claim is the entire $175.
Kate has a Major Medical Plan with a 75/25 coinsurance and a deductible of $25. How much will she have to pay if she, not having met any of her deductible, visits the doctor and receives a bill for $125?
$50
An insurer will accept a premium from the insured and continue the coverage in full force as though it was NOT late during which time period?
(The grace period is the amount of time an insurer continues coverage in full force and will accept the premium from the insured as though it was NOT late.)
An individual life insurance policy becomes incontestable after it has been in force for
2 years
Employees are required to work at least ______ health plan hours per week to become eligible for a small employer
20 hours per week
An employer may qualify for health care tax credits through SHOP marketplace if that employer has fewer than how many employees?
25
As of January 1, 2014, an employer with up to 25 full time equivalent (FTE's) with average annual wages of less than $50,000 may be eligible for a tax credit of ___ of the premiums paid by the employer. 30% 40% 50% 60%
50%
Erica is 35 years old and owns an IRA. At what age can she begin to receive distributions without a tax penalty?
59 1/2
As classified by the Affordable Care Act (ACA), a Silver Plan offers
70% actuarial level of coverage provided
An agent who sells an individual life insurance policy in North Carolina MUST deliver to the policyowner
A Policy Summary and Buyer's Guide
How soon can the benefit payments begin with a deferred annuity?
A minimum of 12 months after date of purchase
An insurance company that has qualified and received a certificate of authority from the superintendent to sell insurance in this state is called a(n)
Admitted insurer
An insurance consultant is BEST defined as a(n)
Agent who charged fees for for advice
What is the nonforfeiture value of an annuity before annuitization?
All premiums paid, plus interest, minus any withdrawals and surrender charges
A life settlement intermediary is a(n)
Association which maintains a facility that displays offers and counteroffers for purchasers or sellers of life settlement contracts
When does a family health policy's coverage for a newborn child begin
At the moment of birth
With a scheduled dental policy, how are covered expenses paid?
Benefits are limited to a specific maximum dollar amount per procedure
What happens if the insurer discovers that the insureds age was accidentally mistakes on an application for an individual life insurance policy
Benefits will be calculated according to how much coverage the premium would have purchased for the correct age
How are health plans classified according to the Affordable Care Act?
Bronze, Silver, Gold, Platinum
What are the levels of coverage as defined by the affordable care act
Bronze, Silver, Gold, Platinum
Donald is the primary insured of a life insurance policy and adds a children's term rider. What is the advantage of adding this rider?
Can be converted to permanent coverage without evidence of insurability
Which of the following is required for an insurer to conduct business in this state
Certificate Authority
Which of the following is NOT an insurance contract?
Certificate of authority
Which of the following is a requirement for ANY change in an insurance application
Change must be initialed by the applicant
Which of the following is an example of an agents fiduciary duty
Collecting premiums and remitting them to the insurer
A health insurance policy where the insurer has the right to terminate the policy for reasons other than the insureds health is called
Conditionally renewable
Which type of clause describes the following statement: "We have issued the policy in consideration of the representations in your applications and payment of the first-term premium".
Consideration clause
Which of the following statements is not true regarding a critical illness plan
Coverage is limited to a single devastating disease
Julie has a $100,000 30-year mortgage on her new home. What type of life insurance could she purchase that is designed to pay off the loan balance if she dies within the 30-year period?
Decreasing term insurance
A form of medical health insurance covering the treatment and care of gum disease is called
Dental expense insurance
Lisa has recently bought a fixed annuity. Which of these is considered to be a disadvantage of owning this type of annuity?
During periods of inflation, annuitants will experience a decrease in purchasing power of their payments
The taxable portion of each annuity payment is calculated using which method?
Exclusion ratio
Which of the following is considered to be an act of of misrepresentation
Falsifying the terms, benefits, advantages, or conditions of an insurance policy
A spouse and child can be added to the primary insured's coverage as what kind of rider?
Family term
Which of these riders will pay a death benefit if the insured's spouse dies?
Family term insurance rider
How is Medicare Part B funded?
General tax revenue and user premiums
Janice forgot to make her insurance premium payment by the due date. The specified period after the due date where she can still make payment and avoid discontinuance of her coverage is called the - Incontestable period - Courtesy Period - Reinstatement period - Grace Period
Grace Period The grace period is the specified period when the insured may still make payment for the continuance of the policy after the premium payment due date.
In New York, a long-term care policy must be ____ renewable
Guaranteed
Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?
Guaranteed insurability rider
Which of the following is NOT information found in a life insurance buyers guide
How to take legal action against an insurance company
A life settlement broker is someone who is
Licensed to negotiate a life settlement contract
Someone needing custodial care at home would require which type of coverage?
Long-term care coverage
Life Settlement Broker are permitted to do all of the following except
Make the first transaction up to 30 days before approved for a license
According to the Affordable Care Act, any plan in existence prior to which date is considered a grandfathered plan?
March 23, 2010
Sonya applied for a health insurance policy on April 1. Her agent submitted the information to the insurance company on April 6. She paid the premium on May 15 with the policy indicating the effective date being May 30. On which date would Sonya have coverage?
May 30
Which type of plan would be most appropriate for an individual on Medicare and is concerned that Medicare will NOT pay for charges exceeding the approved amount
Medicare supplement Plan F
How does one become eligible for part D: prescription drug coverage
Must have Medicare coverage
All of these are considered sources of information that can assist an underwriter in determining whether or not to accept a risk EXCEPT
National Association of Insurance Underwriters
When an agent is replacing an existing ordinary life insurance policy, the agent must take all of the following actions except
Obtain the beneficiary's signature.
Chris is an insured bricklayer who severed his left hand in an automobile accident. Although his primary duty cannot be performed, Chris is also a substitute high school teacher. He collects a full disability income check every month. How does his policy define total disability?
Own occupation
Which clause defines total disability as being unable to perform the major duties of the insured's regular occupation?
Own occupation clause
Which type of rider will waive the premium on a child's life insurance policy if the parent paying the premium dies?
Payor benefit
Replacement regulation is designed to protect the interests of
Policyowners
Claims payable to a Disability Income insured, even when the insured can continue to work, are the result of a
Presumptive Disability-A presumptive disability provision specifies certain conditions that automatically qualify the insured for the full benefit because the severity of the conditions presumes the insured is totally disabled, even if the insured is able to work.
What is considered to be the primary reason for buying life insurance
Provide death benefits
Premiums paid that exceed 7 1/2% of an insured's Adjusted Gross Income (AGI) are tax-deductible when paid for which of the following plans?
Qualified Long-Term Care plan
An annuitant dies during the distribution period. What kind of annuity will return to a beneficiary the difference between the annuity value and the income payments already made?
Refund annuity
Which of these individuals would require continuing education
Resident agent
Which market index is normally associated with an indexed annuity's rate of return?
S&P 500
Long term care policies sold in New York may NOT exclude coverage for
Senile dementia
According to the affordable care act, what metal tier is required to have an actual value of 70% with covered individuals paying 30% through deductibles, co-pays and others cost sharing features
Silver plan
Generally speaking, which three levels of care are long-term care policies provided with
Skilled nursing, intermediate, and custodial care
What does "SHOP" stand for in SHOP exchange
Small business health options program
All of the following are exempt from the 10% tax penalty for early qualified plan withdrawals except
Stock purchase
Which of the following would be be a valid reason why a policy premium would be higher then the standard premium
The insured doesn't meet the established underwriting requirements
What is the elimination period of an individual disability policy?
Time period a disabled person must wait before benefits are paid
What is the purpose of the medical information bureau (MIB)
To help underwriters evaluate risk
The ___ is responsible for determining the appropriateness of a Medicare supplement policy for an applicant
agent
Fixed period settlement options are considered to be a form of a(n)
annuity
Maria would like an annuity that provides a guaranteed accumulation or payout. The type of annuity she is seeking is called
annuity certain
Which of these factors is NOT taken into account when determining an applicant's life insurance needs?
automobile
Which of these factors would an insurer consider when determining whether to accept a group life plan
average age
Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), a terminated employee's benefits must
be the same and the premium cannot exceed 102%
Preferred risk policies with reduced premiums are issued by insurance companies because the insured has
better than average mortality or morbidity experience
Coverage for newborns under an accident and health plan MUST include coverage for
birth abnormalities
An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before
bringing legal action against the insurer
Under a group life policy, the insurer will issue an individual _____ to the policyowner for delivery to each person insured.
certificate
What is issued to each employee of an employer health plan?
certificate
All of the following are elements of an insurance policy except
claim forms
Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)
conversion
All of the following are examples of business continuation plan EXCEPT
deferred compensation
Matt is applying for life insurance and requests a double indemnity rider. A double indemnity benefit will be payable to Matt's beneficiary if Matt
dies instantly from a car accident
A pharmacy benefit covers prescription drugs derived from a list called a(n)
drug formulary
Under group health insurance, a certificate of coverage is issued to the
employee
In New York, a Medicare supplement policy must be ___ renewable
guaranteed
Which of the following is considered to be an event or condition that increases the probability of an insureds loss
hazard
The amount received for a life insurance policy in a life settlement is _______ than the death benefit
less
Insurance premium is determined by each of the following factors EXCEPT
liquidity
A whole life policy option where extended term insurance is selected is called a(n)
nonforfeiture option
A provision in a whole life policy that allows a policyowner to terminate the policy in return for a reduced paid-up policy of the same type is called a(n)
nonforfeiture provision
A beneficiary change can occur
normally at any time during the policy term
Shirley has a $500,000 10-year non-renewable level term life policy. If she dies 15 years after the policy's inception date, how much will her beneficiary receive?
nothing
Which of the following does Medicare part D cover ?
prescription drugs
An insurance producer is often responsible for field underwriting during the application process. All of these are possible field underwriting roles except
providing commission information to the applicant
An example of endodontic treatment is a
root canal
Term insurance is appropriate for someone who
seeks temporary protection and lower premiums
Typically, Long-Term Disability benefits are coordinated with which benefit plan?
social security
Respite care is able to provide
temporary relief to the patient's primary caregiver
Pre-death distributions from a modified endowment contract (MEC) receive different tax treatment than other life insurance policies because
the MEC tends to be an investment vehicle
If an insured dies during the grace period with no premiums paid
the policy would be payable, minus the premium amount