Life

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An insureds long-term care policy a fixed amount of coverage of $120 per day. The long-term care facility only charged $100 per day. How much will the insurance company pay?

$120 a day

Annually Renewable Term

-Renews each year without proof of insurability -Premiums increase due to attained age

What is the minimum length of benefit period that a long term care policy must provide?

12 months

the inflation protection feature in ltc policies issued in this state must provide protection for inflation at what percent annually?

5%

Under the NYS disability benefit law, for an employed individual, disability benefits will be payable after a waiting period of

7 days

What is not covered under a long term care policy?

Acute care in a hospital

What type of care would be provided at a community center?

Adult Day Care

Because an agent is using stationery with the logo of an insurance company, applicants for insurance assume that the agent is authorized to transact on behalf of that insurer. What type of authority does this describe?

Apparent

If an insurer meets the state's financial requirements and is approved to transact business in the state, it is considered to be

Authorized

How is the state trying to encourage its residents to purchase long-term care insurance policies?

By offering tax credits on LTC policy premiums

What provision gives an employee the right to exchange group insurance for an individual policy within 60 days from termination of employment?

Conversion

Examples of risk retention

Copayments, deductibles, self-insurance

Prior to issuance of a Long-Term Care policy to an applicant age 80 or older, the insurer must obtain all of the following except

Date of a previous doctor visit.

The benefit amount under a LTC policy is usually expressed as a fixed dollar amount per

Day

What is considered a qualifying event under COBRA?

Divorce

The authority granted to an agent through the agent's contract is referred to as

Express Authority

Which of the following acts provides an employee with 12 work weeks of leave to care for a child born to that employee?

Family Medical Leave Act

What type of Long term care is not provided in an institutional setting?

Home health care

What method of calculating the amount of life insurance needed takes into account the insured wages, years until retirement and inflation?

Human Life Value Approach

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

whole life insurance

Insurance that is kept in force for a person's entire life, or until age 100 and pays a benefit upon the person's death, whichever comes first

Who makes up the Medical Information Bureau?

Insurers

What concept is the foundation of the statistical prediction of loss upon which rates for insurance are calculated?

Law of large numbers

Under workers compensation, which of the following benefits are NOT included?

Legal Benefits

Whole life key characteristics

Level Premium, Death Benefit guaranteed & remains level, cash value is accumulated, living benefits

In cases where a covered employee is eligible for Medicare benefits to treat end stage renal disease with dialysis for kidney transplant, how would each respond?

Medicare is the secondary payor during the first 30 months of treatment.

This type of insurance company issues participating policies

Mutual Insurer

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.

Implied

Not specifically stated in the contract, but is assumed necessary to conduct insurance business

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

Offer and acceptance, legal purpose, consideration

Express

Powers specifically stated in the contract

Which services are associated with Stand & Poor's and AM Best?

Rating the financial strength of insurance companies

term insurance/pure death protectionle

Temporary protection because it only provides coverage for a specific period of time.

Apparent

The appearance of a relationship between the agent and principal based on words or actions

Who guarantees a conventional fully-insured group plan?

The insurer

What are characteristics of an insurable risk?

The loss must be large, measurable, and due to chance.

What do long-term care policies offer to policyholders to account for inflation?

They offer the option to purchase coverage that raises benefit levels accordingly.

What is the purpose of key-person insurance?

To cover decreased business revenues as a result of the death of a key employee

If only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it?

Unilateral

What types of services will not be provided under the assisted living care of a LTC policy?

Visits by a registered nurse

Renewal Provision

allows the policyowner the right to renew the coverage at expiration date without evidence of insurability. New Premium will be based off insureds age

straight life insurance

also called ordinary life insurance and whole life insurance, requires the payment of premiums throughout the insured's life. cash value gets higher

Nonforfeiture Values

benefits in a life insurance policy that the policyowner cannot lose even if the policy is surrendered or lapses

buy sell funding

continuation of business

variable life insurance products

contracts in which the cash values accumulate based upon a specific portfolio of stocks without guarantees of performance

fixed life insurance products

contracts that offer guaranteed minimum or fixed benefits

Securities

financial instruments that may trade for value (ex: stocks bonds options)

Regarding long-term care coverage, as the elimination period gets shorter, the premium

gets higher

Events or conditions that increase the chances of an insured loss occurring are referred to as

hazards

What are the 2 types of flexible spending accounts?

health care accounts and dependent care accounts

Policy maturity

in life policies, the time when the face value is paid out

Limited Pay Whole Life (Life paid up at 65)

limited-pay whole life is designed so that the premiums for coverage will be completely paid up well before age 100.

When compared with the administrative cost found in individual coverage, the per capita administrative cost in group health insurance is

lower

single premium

paid in lump sum. generates immediate cash.

level term insurance

provides a level death benefit and a level premium during the policy

Converible provision

provides the policyowner with the right to convert the policy to a permanent insurance policy without evidence of insurability

endow

to have the cash value of a whole life policy face contractual face amount


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