Life and Health

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Once it has been reasonably proven that a person has knowingly violated the Insurance Code regarding unfair methods of competition, the Department may impose a civil penalty of

$5000 for each violation (not exceeding $50000 in a 6 month period)

An insured owns a $50,000 whole life policy. At age 47, the insured decides to cancel his policy and exercise the extended term option for the policy's cash value, which is currently $20,000. What would be the face amount of the new term policy?

$50000

individuals who itemize deductions can claim deductions for medical expenses not covered by healthy insurance that exceed what percent of their adjusted gross income?

10%

In a noncontributory health insurance plan, what percentage of eligible employees must participate must participate in the plan can be effective

100 percent

An insured was involved in an accident and could not perform her current job for 3 years. If the insured could reasonably perform another job utilizing similar skills after 1 month, for how long would she be receiving benefits under an "own occupation" disability plan?

2 years

If a viatical settlement provider transfers ownership of an insurance policy, how long does the insurer have to inform the insured of the change

20 days

Once a viatical settlement contract has been completed, how long does the viatical settlement provider have to notify the insurance company that it has been viaticated?

20 days

Which of the following must the patient pay under Medicare Plan B

20% of covered charges above the deductible

How long is open-enrollment period under an employer group health insurance plan?

30 days

In order to qualify for conversion from group life insurance to a individual policy of the same coverage, the person must be insured by the group policy for how many years?

5 Years

An insurer may provide commissions to an agent for the sale of long term care policy only if the first year commissions is NOT greater than what percentage of the first year premium?

50%

To attain currently insured status under Social Security, a worker must have earned at least how many credits during the last 13 quarters?

6 credits

For how long is an insurance company allowed to defer policy loan request?

6 months

What is the waiting period on a waiver of premium rider in life insurance policies?

6 months

A licensed producer moving to PA may become licensed as a resident if the producer submits a completed application within how many days of establishing residence in Pennsylvania with proof of licensing from their prior home state?

90 days

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

90 days

A hospital indemnity policy will pay...

A benefit for each day the insured is in a hospital.

In long-term care insurance what type of care is provided with intermediate care?

Occasional nursing or rehabilitative care

Medicare Part A services do not include which of the following?

Outpatient Hospital Treatment

An individual buys a flexible premium deferred life annuity with a 20 year period certain. What would his beneficiary receive if he died 5 years after beginning phase?

Payment for 15 years

The causes of loss insured against in an insurance policy are known as

Perils - causes of loss insured against an insurance policy.

Which of the following is the most common time for errors and omissions to occur on the part of an insurer?

Policy Delivery

Regarding the taxation of Business Overhead policies,

Premiums are deductible, and benefits are taxed

Which of the following is correct concerning the taxation of premiums in a key-person life insurance policy?

Premiums are not tax deductible as a business expense.

Which of the following are the main factors taken into account when calculating residual disability?

Present earnings and earnings prior to disability.

A Medicare SELECT policy does all the following Except

Prohibit payment for regularly covered services if provided by non-network providers

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.

Any inducement offered in the sale of insurance products that is not specified in the policy is

Rebating

The policyowner pays for her life insurance annually. Until now she has collected a nontaxable dividend check each year. She has decided that she would rather use the dividend each year. She decided that she would rather use the dividends to help pay for the next premium. What option would allow her to do this?

Reduction of Premium

Equity Indexed Annuities

Seek higher returns

Which of the following is an example of peril covered in an accident and health insurance policy?

Sickness

Upon policy delivery, the producer may be required to obtain any of the following EXCEPT

Signed waiver of premium

The paid-up addition option uses the dividend

To purchase a smaller amount of the same type of insurance as the original policy.

Should an insurance company deny a claim submitted by an insured without without providing to that insured a prompt and reasonable explanation of the claim denial, the insurer would be in violation of

Unfair claims methods and practice regulations

Which type of life insurance policy allows the policyowner to pay more or less than the planned premium?

Universal Life

Are insurance company underwriters allowed to discriminate?

Yes, but not unfairly

When an insurer offers services like preadmission testing, second opinions regarding surgery, and preventative care, which term would best apply?

case management provision

Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?

indemnity

An underwriter may obtain information on an applicant's hobbies, financial status, and habits by ordering a?

inspection report

Which of the following statements is NOT correct concerning the COBRA Act of 1985

it require all employees, regardless of the number or age of employees, to provide extended group health coverage.

Which of the following is incorrect connecting Medicaid?

it's strictly a federally administrated program

When calculating the amount a policy owner may borrow from a variable life policy, what must be subtracted from the policy's cash value?

outstanding loan and interest

When individuals is covered under the two health insurance policies that have a duplicate benefits which could make a claim benefits because of an injury or illness profitable is called

over insurance

Regarding Medicare SELECT policies, what are restricted network provisions?

they condition the payment of benefits

How soon after the due date should the insurer pay the agent appointment fees

within 30 days

Which of the following is TRUE about nonforfeiture values?

They are required by law to be included in the policy

An insured's disability income policy includes an additional monthly benefit rider. For how many years can the insured expect to receive payment from the insurer before Social Security benefits begin?

1 year

When the policy premium wasn't submitted with the application, what should the agent obtain from the insured upon policy delivery?

A statement of good health

Which of the following is another term for an authorized insurer

Admitted

When an insurer begins underwriting producers for an applicant, what will be the main source for its underwriting information?

Application

At what point must an Outline of Coverage be delivered?

At time of application or upon delivery of the policy

A producer who fails to separate premium monies from his own personal funds is guilty of?

Commingling

What is the contract provision that allows the insurer to nonrenew health coverage if certain events occur?

Conditionally renewable

Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following elements EXCEPT

Conditions

Under the Fair Credit Reporting Act, individuals rejected for insurance due to information contained in a consumer report

Must be informed of the source of the report

Which of the following is NOT a characteristic or service of an HMO plan?

Contracting with insurance companies

All of the following could be considered rebates if offered to an insured in sale of insurance EXCEPT

Dividends from a mutual insurer

Which of the following is considered a moral hazard?

Driving recklessly

Concerning group Medical and Dental insurance, which of the following statements is INCORRECT?

Employee benefits are tax deductible the year which they were received

When the insured selects the extended term nonforfeiture option, the cash value will be used to purchase term insurance with what face amount?

Equal to the original policy for as long as the the cash values will purchase

An agent selling variable annuities must be registered with

FINRA

What does "level" refer to in level term insurance?

Face Amount

Which of the following is an example of an unfair claims settlement practice?

Failure to properly settle a claim when liability has clearly been established

True or False: Are calls based from outside the United States considered an exception to the National Do Not Call List

False

True or False: Regarding installments for a fixed amount. "The payments will stop when the annuitant dies"

False

Circulating deceptive sales material to the public is what type of Unfair Trade Practice?

False advertising

Violation of unfair discrimination law may result in all of the following penalties EXCEPT

Fines up to a $1000 for each set

The automatic premium loan provision is activated at the end of the...

Grace Period

All of the following are licensing requirements for a business entity except?

Having all employees complete continuing education once every 2 years

An insured has a Modified Endowment Contract. He wants to withdraw some money in order to pay medical bills. Which is true?

He will have to pay a penalty if he is younger than 59.5

Which of the following health care plans would most likely provide the insured with comprehensive health care coverage?

Health Maintenance Organization (HMO) plan

A man purchased a $90,000 annuity with a single premium and began receiving payments 2 months after that. What type of annuity is it?

Immediate

The benefits received by the business in a disability Buy-Sell policy are

Income Tax-Free

Issue age policy premiums increase in response to which of the following factors?

Increased benefits

A Return of Premium term life policy is written as what type of coverage?

Increasing

The insured had his wife named as the beneficiary of his life insurance policy. To ensure that his wife had income for life after the insured's death. he chose the life income settlement option. The amount of payment will be determined by taking into account all of the following EXCEPT

Insured age at death

Which statement regarding insurable risk is NOT correct?

Insureds cannot be randomly selected

Which document is used to assess risk associated with an applicant's life style and character?

Investigative Consumer Report

Which of the following is true about the mandatory 10 day free look in a life insurance policy?

It commences when the policy is delivered

Which of the following is true regarding single life settlement option?

It provides income the beneficiary can not out live.

Which of the following best describes annually renewable insurance?

Its a level term insurance

Which of the following is true of a PPO?

Its goal is to channel patients to providers that discount services.

Which of the following settlement options in life insurance is known as Straight Life

Life income

If an annuitant selects the straight life annuity settlement option, in order to receive all of the money out of the contract, it would be necessary to

Live at least to his life expectancy

A producer is helping a married couple determine the financial needs of their children in the event one or both should die prematurely. This is a personal use of life insurance known as?

Survivor Protection

Which of the following would help prevent universal life policy lapsing?

Target premium

Which of the following may NOT be included in an insurance company advertisement?

That is policies are covered by state Guaranty Association.

Which of the following entities established the Do Not Call Registry

The Federal Trade Commission

which of the following is NOT covered under plan A in Medigap insurance

The Medicare Part A deductible

The annuity owner dies while the annuity is still in the accumulating stage, which is true?

The beneficiary receives benefits from the annuity; either the amount paid in the plan or the cash value, whichever is greater.

An insured who has Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?

The capital amount in a lump sum.

Which of the statements about group life is correct?

The cost of coverage is based on the ratio of men and women in the group

What is necessary in order to be eligible to receive benefits from a long term care policy?

The insured must be unable to perform some activities of daily living

an application is considered to be high-risk, but not so much that the insurer wants to deny coverage. Which of the following is NOT true?

The insurer will issue conditional coverage.

All of the following are true of key person EXCEPT

The plan is funded by permanent insurance only.

All of the following are characteristics of a group life insurance plan EXCEPT

There is a requirement to prove insurability on the part of the participants

Which of the following is true regarding METs?

They allow several small employers purchase less expensive insurance together.


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