Texas life and health study questions

In HI, if a doctor charges $50 more than what the insurance company considers usual, customary and reasonable, the extra cost

Is not covered

A guaranteed renewable disability insurance policy

Is renewable at the insureds option to a specified age

Underwriting a group health insurance plan that is paid for by the employer required all of the following EXCEPT

Individual members of the group may select the level of benefits for their own coverage (Not true, all ind. are covered under the master policy for the same coverages.

An employee quits her job where she has a balance of $10,000 in her qualified plan. If she decides to do a direct transfer from her plan to a Traditional IRA, how much will be transferred from one plan administrator to the other and what is the tax consequence of a direct transfer?

$10,000, no tax consequence

Which statement accurately describes the Change of Beneficiary provision?

Any policy that has a death benefit must also have a Change of Beneficiary provision.

Which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium?

Automatic premium loan (not required, but added to contracts with CV at no additional charge)

The provision that provides for the sharing of expenses between the insured and the insurance company is

Coinsurance

If more than one family member covered under the same major medical policy is injured in the same accident, the family only has to pay one deductible. This is due to the

Common accident provision

A HI policy that pays a lump sum if the insured suffers a heart attack or stroke is known as

Critical Illness

The provision in a health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the

Entire contract clause

Which of the following statements is correct concerning the relationship between Medicare & HMOs?

HMOs may pay for services not covered by Medicare.

Which of the following types of LTC is NOT provided in an institutional setting?

Home health care

Annually renewable term policies provide a level death benefit for a premium that

Increases annually

All of the following are differences between group health insurance EXCEPT

Individual insurance does not require medical examinations, while group insurance does. (Not true)

The Medical Information Bureau (MIB) was created to protect

Insurance companies from adverse selection by high risk persons

Who makes up the MIB?

Insurers

If the policy owner, the insured, and the beneficiary under a life insurance policy are three different people, who has the ownership rights?

Policy owner

Which of the following has the right to convert the existing term coverage to permanent insurance?

Policyowner

True statements about annuitants

Receives the annuity benefits, must be a natural person, life expectancy is taken into consideration

When an insured under a life insurance policy died, the designated beneficiary received the Face amount of the policy, as well as a refund of all the premiums paid. Which rider is attached to the policy?

Return of premium

A domestic insurer issuing variable contracts must establish one or more

Separate accounts

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

Signed waiver of premium

What is the best way to change on application?

Start over with a fresh application

Your client is planning to retire. She has accumulated $100,000 in a retirement annuity, and now wants to select the benefit option that will pay the largest monthly amount for as long as she lives. As her agent, you should recommend

Straight life (provides the highest monthly benefits for an individual annuitant)

Which of the following statements about HRAs is TRUE?

The account allows roll-over of unused balances at the end of the year at the employer's discretion

Upon the death of the insured, the primary beneficiary discovers that the insured chose the interest only settlement option. What does this mean?

The beneficiary will only receive payments of the interest earned on the death benefit.

All of the following must be included in the evidence of coverage for an HMO plan EXCEPT

The insurance agent;s bane and license number

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

Universal Life

The proposed insured makes the premium payment on a new insurance policy. If the insured should die, the insurer will pay the death benefit to the beneficiary if the policy is approved. This is an example of what kind of contract?

conditional

Who can provide skilled nursing care?

doctor

The elimination period is

time immediately following the start of a disability when benefits are not payable.

What is the maximum penalty for habitual willful noncompliance with the Fair Credit Reporting Act

$2,500

In response to an alleged fraud violation, an insurer must respond to the Department's request for relevant information to an investigation within

15 days

Following hospitalization because of an accident, Bill was confined in a SNF. Medicare will pay full benefits in this facility for how many days?

20

Concerning Medicare Part B, which statement is INCORRECT?

It is fully funded by Social Security taxes (FICA) (not true, funded by monthly prem. & gov.)

If an insured surrenders his life insurance policy, which statement is true regarding the cash value of the policy?

It is only taxable if the cash value exceeds the amount paid for premiums.

A woman's health insurance policy dictates which doctors she is allowed to see. Her health providers share an assumed risk for their patients and encourage preventive care. What best describes the health system that the woman is using?

Managed care

An applicant for a health insurance policy returns a completed application to her agent, along with a check for the first premium. She receives a conditional receipt two weeks later. Which of the following has the insurer done by this point?

Neither approved the application nor issued the policy