Series 17-55

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Maximum amount of coinsurance in New York

25%

What percentage of prescription drug cost is the insured responsible for paying in part D of Medicare

25%

Medicare supplement renewal commissions paid in the third year must be as high as a commission of which year

2nd

How long does a licensee have to notify the superintendent of a change of address?

30 days

How often does the code require examination of domestic life insurance?

5 years

How long can an agent backdate an application for?

6 months

How long is an open enrollment period for Medicare supplement policies?

6 months

Open enrollment. Period for Medicare supplement policies.

6 months

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

6 months

Under the affordable care act, a special enrollment period Allows an individual to enroll in a qualified health plan within how many days of a qualifying event.

60 days

Minimum percentage for medical care in an individual health plan

80%

How long after the date of issue may an insurer cancel an accident and health policy

90 days

What do Deferred annuities do

Accumulate retirement funds, accumulate funds in an IRA, and fund a child's college education

The amount of position or supplier bills for a particular service or supply

Actual charge

What can an independent adjuster include?

Affirm who acts on behalf of the insurer

Which documentation grants Xpress authority to an agent

Agent contract with the principal

How can a new physician be added to the PPOs approved list

Agree to follow the PPO standards and charge the appropriate fees.

Cash option

Allows an insurer to send the policyholder an annual non-taxable dividend check

Pure Life Annuity

Also known as life only or straight life, income payments sis at the Newton's death, and there are no refunds or payments to survivors

What is an independent adjuster?

Any person firm association of corporation who acts on behalf of an insurer in the work of investigating and adjusting claims

In order for a nonresident license, you to become a resident producer in New York, the licensee must

Apply within 90 days of becoming a resident

How long can an insurer contest of fraudulent statement in a health insurance application?

As long as policy is in force

When was Agents submit license renewal applications to the superintendent?

At least 60 days before the license expires

What type of benefit plan is in conjunction with the health benefit plan committee

Basic coverage benefit plan

Who receives the annuity benefits if an annuitant dies during the accumulation period?

Beneficiary

What do you need to legally transact insurance in New York?

Certificate of authority

How are all medical expense health insurance sold two individuals or small groups rated

Community rated

How much must all medical expense health insurance sold to individuals or small groups be rated

Community rated

Health insurance plan that covers all accidents and sicknesses that are not specifically excluded from the policy is referred to as

Comprehensive plan

The report that provides the underwriter with information about insurance applicant credit

Consumer report

What provision must be on the first page of Medicare supplement policy this also states the insurance right to change premium amounts

Continuation provision

When selling insurance policy to family, what kind of business is this?

Controlled

Specific, dollar amount that must be paid by an HMO member for a Service

Copayment

Embezzlement

Criminal act of taking money belonging to someone else

What's the most common policy used in credit life insurance?

Decreasing term

Needs approach method

Determined by predicted needs of the family after the premature death of the insured, which is assumed to happen immediately

What is one qualifying event under cobra?

Divorce

What do fixed annuities provide?

Equal monthly payments for life, minimum guaranteed rate of interest, and future income payments

Misrepresentation

False or misleading statements with intent to defraud another

Benefits for an individual disability plans are based on

Flat amount

When an HSA holder is 65 years old, uses money in the account for a non-health expense, what happens

Gets taxed

What two types of interest rates the universal life policy have

Guaranteed and current

Two types of flexible spending accounts

Health care accounts and dependent care accounts

To be eligible for a health savings account an individual must be covered by

High Deductible Health Plan

reimbursement

How benefits are provided when benefits are paid directly to the insured under a health insurance policy

The annual contribution limit of a dependent care flexible spending account is set by

IRS

What happens to the premium in long-term care policies one benefit Lengthens

Increases

What does the notice regarding replacement do?

Informs applicant of 30 day free look provision of the replacing policy

Who has authority to make changes to an insurance policy

Insurer's executive officer

What determines the interest rates paid to the owner of a fixed annuity?

Insurer's guaranteed minimum rate of interest

What kind of insurance is annually Renewable term insurance

Level term insurance

cease and desist order

Licensee must stop the violation he or she is suspected of doing

Why would an agent backdate an application

Lower the premium

When do insurance licenses expire?

On the birthday of every odd number year

Which option for universal life allows the beneficiary to collect both of death benefit in cash value upon the death of the insured

Option B

Rider attached to a life insurance policy that provides coverage on the insurance family members

Other insured rider

Joint life policy

Pays death benefit upon death of the first insured

indemnity

Pays fixed amount each day The insured is hospitalized.

What does the employee retirement income security act monitor?

Pension, profit-sharing stock, bonuses, and most welfare benefit plans

Share care long-term care policies

Pockets to split the total benefits of two policies

Who receives dividends from mutual insurer

Policyholders

In long-term care policies, when benefit period lengthens

Premium increases

What are required provisions of a health insurance policy?

Proof of loss forms must be settled in 15 days, 31 day, grace, period, the entire contract clause

What does health insurance do?

Provide payments for loss of income

Omnibus Budget Reconciliation Act (OBRA)

Provide primary coverage for disabled individuals under age 65 who are not retired

Who Represents the insured in the investigating of a claim

Public Adjuster

What does the ownership provision do?

Receive a policy loan, sign a policy, designate a beneficiary

Standard Risk

Represents majority of people in their age with similar lifestyles

Reinstatement provision

Requires policy owner to pay all overdue premiums with interest before the policy is reinstated

What do annuities fund?

Retirement plans

Which type of retirement account does not require the owner to start taking distributions at age 73

Roth IRA

Examples of risk retention

Self insurance, deductibles, copayment

How can annuities be funded?

Single payments or periodic payments

Fixed amount

The annuitant selects the amount of each payment, and the insurance determines how long will pay benefits

What happens if a nonmember physician is utilized under the point of service plan?

The attending physician will be paid a fee for service, but the member patient will have to pay a higher coinsurance amount.

What happens when a policy has an irrevocable beneficiary designation?

The beneficiary can only be changed with written permission of the beneficiary

What happens when an annuitant dies when the annuity is in the accumulation Stage

The beneficiary receive the greater of the money paid into the annuity or the cash value

When can a temporary license be issued?

The death of an agent, an agent, disability, and agents time in the military service

Who can revoke a producers license?

The department of financial services

What happens during an IRA direct transfer

The full amount gets reinvested from one plant to another

In a group policy, who is issued a certificate of insurance

The individual insured

If an insurer over, pays on a claim, who can't recover the excess

The insurance guaranty association

What isn't considered when underwriting group insurance?

The insured's medical history

Who guarantees a conventional fully insured group plan

The insurer

In the return of premium option for long-term care policies what happens to the premium if the policy lapses

The insurer will return the percentage of the premiums paid

An insurer over paid on a claim, the insurer may recover the excess from

The other insure, another organization involved in the claim, the person on the benefit has been paid

Who is the owner of a life settlement contract

The seller of the contract

What is true regarding optional benefits with long-term care policies?

They are available for an additional premium

Another name for administrative services only arrangement

Third-party administrator

What's the best reason to purchase life insurance rather than annuity?

To create an estate

When can a temporary license be issued?

To service the existing business

What does a policy assignment do

Transfer right of ownership from the owner to another person

Interest sensitive life insurance policy

Universal life

How are death benefits paid enjoying life policies

Upon the first death only

Health insurance grace period durations based upon premiums

Weekly = 7 days, monthly = 10 days, all others = 31 days

open panel

When a medical caregiver contracts with the health organization, to provide services to its members or subscribers, but we change the rate to treat patients who are not members for subscribers

The difference between the Medicare approved amount for a service or supply and the actual charge

excess charge

Who bears all of the investment risk in a fixed annuity?

insurance company

All advertisements are the responsibility of the

insurer

What is the shortest? Possible elimination period for a group short term disability benefits provided by an employer.

0 days


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