Life health
Under the affordable care act what percentage of preventative care must be covered without cost sharing
100%
What is a penalty tax for non qualified distributions from a health savings account
20%
What is the penalty tax for non qualified distributions from a medical savings account
20%
For how many days of skilled nursing facility care will Medicare pay benefits
100
A health insurance policy that pays lump sum if the insured suffers a heart attack or stroke is known as
Critical illness
Which of the following is not fundable by annuities
Death benefits
Which of the following levels of care in long term care policies specifically includes assistance with activities of daily living
personal care
What is a period of coverage for events such as death or divorce under cobra
36 months
How can a new physician be added to the PPO's approved list?
Agree to follow the PPO standards and charge the appropriate fees.
Assume that a policy allows the insurer to terminate coverage for a class of clients under stated circumstances which of the following classes would it be illegal for the insurer to terminate
All insureds with a sexual preference which increases the risk of hiv infection
Which concept is associated with exclusion ratio
Annuities payments
Employer contributions made to a qualified plan
Are subject to vesting requirements
A policyowner fails to pay the premium due on his whole life policy after the grace period passes, but the policy remains in force. This is due to what provision?
Automatic premium loan
Which of the following is true regarding inpatient hospital care for HMO members
Care can be provided outside of the service area
The types of perils which are usually excluded from coverage and which do not allow for an accurate pattern of predictability and will adversely slant the law of large numbers is known as
Catastrophic losses
Which of the following is not a characteristic or service of an hmo plan
Contracting with insurance companies
A rider that may be attached to a life insurance policy that will adjust the face amount based upon a specific index, such as the Consumer Price Index, is called
Cost of Living Rider
An individual has just borrowed 10,000 from his bank on a 5 year installment loan requiring monthly payments what type of insurance policy would be best suited for the situation
Decreasing term
Which of the following is true regarding taxation of benefits
Dividends are non taxable
Which of the following is true regarding taxation of dividends in participating policies
Dividends are not taxable.
Because of a history of cancer in her family what policy should you buy to treat cancer expenses
Dred disease policy
How many pints of blood will be paid for by medicare supplement core benefits
First 3 pints
Mortality, Interest, Expense
Gross premium
Who must pay for the cost of a medical examination required in the process of underwriting?
Insurer
The policy owner wants to make sure that upon his death the life policy will pay a portion of the proceeds annually to his spouse but that principal will be paid to their children when they reach a certain age which option
Interest only option
What is the main purpose of the seven pay test
It determines if the insurance policy is an MEC.
How is the amount of Social Security disability benefits calculated?
It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years.
What is franchise insurance
It is health coverage for small groups whose numbers are too small to qualify for true group insurance
When a reduced-paid up nonforfeiture option is chosen, what happens to the face amount of the policy?
It is reduced to the amount of what the cash value would buy as a single premium
In a group health policy a probationary period is intended for people who
Join the group after the effective date
A couple receives a set amount of income from their annuity. When the wife dies, the husband no longer receives annuity payments. What type of annuity did the couple buy?
Joint Life
Which of the following is not correct concerning a medical savings account (msa)
MSA are only available to groups with at least 100 employees
Which of the following would not be considered a primary risk factor in underwriting individual health insurance
Marital status
Which of the following information regarding an insured is not included in an investigative consumer report which is requested by an underwriter
Medical history
If a life insurance policy develops cash value faster than a seven-pay whole life contract, it is
Modified Endowment Contract
Which of the following terms most precisely fits the definition of the incidence of probability or sickness or accidents within a given group of people
Morbidity
Which of the following terms most precisely fits the definition of the incidence or probability of sickness or accidents within a given group of people
Morbidity
What do living benefit riders do
Pay part of the policy death benefit to insureds in order to help fund long term care or nursing home care
What do living benefit riders do
Pay part of the policy death benefit to insureds in order to help fund long term care or nursing home cares
Which of the following must be present in all medicare supplement plans
Plan A
All of the following are actual deductibles found in medical insurance policies except
Replacement
What part of the internal revenue code allows an owner or a life insurance policy or annuity to exchange or replace their current contract with another contrac with out creating adverse tax consequences
Section 1035 policy exchange
Restoration of benefits is most beneficial to the insured when they ?
Suffer a large loss
Which of the following is not covered under basic hospital expense coverages
Surgeon fees
Which of the following is not covered under basic hospital expense coverage
Surgeons fees
Which of the following is not covered under plan a in medigap insurance
The Medicare Part A deductible
When a client replaces an existing LTC or Medicare Supplement insurance policy with another from the same company, California law requires that
The agent must advise the client about HICAP and its services.
Which of the following is not the consideration in a policy
The application given to a prospective insured
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 following is an example of liquidity in a life insurance contract
The cash value available to the policyowner
In a case where the primary beneficiary predeceases the insured in the event of the insureds death the death benefit proceeds will be paid to
The contingent beneficiary
The importance of miss representing is determined by
The materiality of rehabilitate care
Which of the following best describes what annuity period is
The period of time during which accumulated money is converted into income payments
All of the following are true of key person insurance except
The plan is funded by permanent insurance only
Under an extended term nonforfeiture option, the policy cash value is converted to
The same face amount as in the whole life policy
If a deferred annuity is surrendered prematurely, a surrender charge is imposed. How is the surrender charge determined?
The surrender charge is a percentage of the cash value and decreases over time.
Which of the following is true regarding commissions for medicare supplements policies
They are permitted up to a certain amount for each policy
An insured makes regular contributions to his Health Savings Account. How are those contributions treated in regards to taxation?
They are tax deductible
Which of the following statements regarding deferred compensation funds is incorrect
They are usually qualified plans.
Which or the following is true about about labor unions fraternals and co ops
They may opt for a self insured medical and disability plan
HICAP counselors are primarily
Trained and registered volunteers.
The waiver of cost of insurance rider is found in what types of insurance
Universal life
Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?
attending physician
If an insured changes his payment plan from monthly to annually, what happens to the total premium?
decreases
A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT
income
Which of the following is true regarding a single life settlement option
it provides income the beneficiary cannot outlive
In health underwriting it would be inappropriate to decline a risk using any of the following factors EXCEPT
mental illness
All of the following are beneficiariey designations EXCEPT
specified
First year commission on a Medicare supplement policy may not exceed
200% of the second year commission on the same policy.
An employee group with which the following number of employees would qualify for a medical savings account
23 employees (anything under 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
An employer offers its employees a group non occupational disability insurance policy that provides 60% of their pre tax wage in the event of total disability. Because the employer pays the full cost of the policy
Any benefits received will be taxes as ordinary income
In insured is involved in a car accident in addition to general less serious injuries he permanently loses the use of his leg and is blind the blindness improves a month later to what extent will he receive presumptive disability benefits
No benefits
Which of the following is NOT correct regarding false statements by a person engaged in the business of insurance
Oral statements cannot be considered fraud
If a health care plan has characteristic of an HMO and PPO what type of plan is it
POS ( point of service plans are combination of hmos and ppos
All of the following are true regarding a key person disability income insurance except
Premiums are tax deductible as a business expense
When a whole life policy lapses or is surrendered prior to maturity, the cash value can be used to
Purchase a single premium policy for a reduced face amount
Which of the following is not a feature of non cancellable policy
The insurer may terminate the contract only at renewal for certain conditions
Which of the following describes what the annuity period is
The period of time during which accumulated money is converted into income payments
All of thr following are general requirements of a qualified plan except
The plan must provide an offset for social security benefits
How does a member of an hmo see a specialist
The primary care physician refers the member
What do living benefit riders do
They pay part of the policy death benefit to insureds in order to help them fund long-term care or nursing home care
The purpose of having ab elimination period in a policy is to accomplish which of the following
To allow client some flexibility in determining their own premium
Jason is insured under his employer's group health insurance. He splits the cost of the premiums with his employer. This is an example of
contributory plan
According to the PPACA rules, what percentage of health care costs will be covered under a bronze plan?
60%
According to thr medical loss ratio MLR what is the minimum percentage of health coverage premium that must be applied to actual medical care in an individual health plan
80%
As it pertains to health insurance cobra stipulates that
A group coverage must be extended for terminated employees up to a certain period of time at the former employers expense
An investor buys a life policy on an elderly person in order to sell it for a life settlement this is an example of
A stoli policy (stranger originated life insurance
Which of the following is not an allowable 1035 exchange
A whole life policy is exchanged for a term insurance policy
Which renewal must be included in a long term care policy issued to an individual
Noncancellable and guaranteed renewable
Qualified medical expenses paid for participants in a medical savings account MSA are ?
Not taxable
When is the annual open enrollment for state insured exchanges
November 1st through December 31st
Which renewal option does NOT guarantee renewal and allows the insurance company to refuse renewal of a policy at any premium due date?
Optionally renewable
Medicare SELECT policy does all of the following except
Prohibit payment for regularly covered services if provided by non-network providers
One of hmos distinguishing features is that it
Provides for both medical services and the method of financing of medical services.
A formal arrangement of providing health care benefits without providing any financial protection to the principal is called what
Self insurance
When an employee covered under a health reimbursement account changes employers the HRA
Stays with the employer.
What happens in a non member physician is utilized under the point of service plan
The attending physician will be paid a fee of service but the member patient will have to pay a higher coinsurance amount
If a life insurance policy has an irrevocable beneficiary designation,
The beneficiary can only be changed with written permission of the beneficiary
Which of the following statements concerning group health insurance is correct
The employer is the policy holder
Which statement accurately describes group disability income insurance
The extent of benefits offered is determined by the insured's income.
The sole beneficiary of a life insurance policy dies before the insured. If the policyowner does not change the beneficiary designation, what will happen to the policy's death benefit?
The insureds estate
