Exam

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Which of the following indicates how much of the health coverage premium must go toward actual Medical care

Medical loss ratio indicates how much of the health coverage premium mother go toward actual Medical care as opposed to administrative costs and profits

Which of the following used to be called Medicare plus choice plans

Medicare advantage plan

What does basic medical expense cover

Non-surgical services a position provides

There is a 10% penalty on the taxable portion of a deferred annuity when it is surrender prior to what age

59 1/2. Went to deferred annuity is surrender prior to 59 1/2 there is a 10% penalty on the taxable portion penalty free withdrawal is are permitted in distribution is from a qualified plan. Immediate annuity or structured settlement employer purchased a new woody periodic payments if taken in a series of equal payments for disability disability or death

All of the following are pictures of my health insurance plan purchased on the health insurance marketplace except

Dollar limit on essential benefits. Health plans are restricted from applying a dollar limit on essential benefits nor Can they establish a dollar limit on the amount benefits paid during the course of an insurance lifetime

Which of the following employee benefits a sensually provide the employee with the wage increase and directs that wage increase to be spent on the life insurance policy

Executive bonus

California's insurance code requires all ensures to have a department does sole purpose of which is to investigate possible

Fraudulent claims from insureds

Medicare part a services do not include which of the following

Private duty nursing. Private duty nursing is not covered under Medicare part A

What is the minimum number of members required for group life insurance in the

10

Jay is receiving fixed amount benefit payments from his late wife's insurance policy. He was told that if he dies before all of the benefits are paid, the remaining amount will go to the contingent beneficiary. Which settlement option did Jay choose?

Fixed amount. The fix amount option pays a fixed specified amount installment until the proceeds principal and interest are exhausted. If the beneficiary dies before the proceeds are exhausted installments will continue to be paid to a contingent beneficiary until all proceeds have been paid out

Which of the following policies can be described as a flexible premium adjustable life policy

Universal life is known by the generic name of flexible premium adjustable life. The policy owner has the flexibility to increase the amount of premium going into the policy and to later decrease it again

An employee that become ineligible for group coverage because of termination of employment or change in status must exercise extension of benefits under COBRA

Within the 60 days

Which rider when added to a disability policy pays income during the six month waiting period before Social Security benefits can begin

Additional monthly benefit

All of the following are features of catastrophic plan except

Hi premiums. Catastrophic plan usually have a lower monthly premium and high deductible

All of the following are true of credit life including the death benefit cannot exceed the amount of the loan, the premium payment is included in the loan payment, the creditor is the policy owner.

The insured names the beneficiary. With credit line the lending institution is the owner and name as the beneficiary.

A Medicare supplement policy must have a free look period for at leasr

30 days

Which of the following is not a type of hazard

Exposure. Physical hazards are those arising from the material structural or operational features of the wrist apart from the persons owning or managing it. Moral hazard refer to those applicants that may lie on an application for insurance or in the past have submitted fraudulent claims against an insurer. Morel hazards referred to an increase in the hazard presented Buy a risk, arising from the insurance in difference so lost because of the existence of insurance

In some cases in order for an insured so legally disclose privileged information to appropriate sources the insured must sign off the rise form what is the maximum amount of time that can legally pass between the completion of the form and the disclosure of information

One frikin year

Which statement best describes agreement as it relates to insurance contracts

One party except the exact terms of the other parties offer.

Underwriters use all of these methods to protect the insured against adverse selection except

Only accepting a small percentage of applicants.

They guaranteed insurability rider allows the owner to purchase additional amount of life insurance without proof of insurability at all of the following except

Purchasing of a new home. They guaranteed insurability rider allows the owner to purchase additional amounts of insurance without proof of insurability add marriage birth of a child and or every three years or so between the ages of 25 and 40

According to the life insurance replacement regulations which of the following would be an example of policy replacement

The policy is re-issued with the reduction in cash value

In the Social Security blackout. The surviving spouse will not receive benefits until the age

60

If the insured purchases an insurance policy with a large deductible, what risk management they need is insured exercising?

Retention. Because they receive a lower premium rate they also get to retain a larger amount of the loss.

What is the purpose of the gatekeeper in an HMO

Controlling costs

An employee dies having 6/4 of coverage during the previous 13 quarter period. What status of coverage does the employee have under Social Security

Currently insured. Before becoming fully insured, workers me a cheap the status of currently insured or partially insured and by that qualify for certain benefits an individual is considered partially insured if he or she had earned six credits or quarters of coverage during the 13/4. Ending with a quarter in which the insured dies or becomes disabled

Which of the following statements is incorrect

Medicare and Medicare policies provide coverage for long term custodial or nursing home care. Medicare and Medicare policies do not provide coverage for long-term custodial or nursing home care Medicare will cover nursing home care if it is part of the treatment for cupboard injury or illness Medicare and Medicare supplement pay for skilled nursing care but the coverage is limited Medicaid does does pay for nursing home care but he provides coverage only for those that qualify with low income and low assets

Which dividend option will increase the death benefit

Paid up additions. Paid up additions option uses the dividend to purchase small amounts of the same type of insurance as the original policy the additional insurance is paid up by the dividend

Accord Medicare supplement policy plan hey will cover all of the following expenses except

Part eight adoptable. Plan a is the cord benefits only and does not include coverage for part a deductible

An annuity would normally be purchased by an individual who wants to

Provide income for retirement

An agent delivers a policy to an applicant, who pays the initial premium but refuses to submit a statement of good health which of the following items best describes what the applicant has violated

Consideration

In order for an alumni Association to be eligible to purchase group health insurance for its members all of these statements must be true except when the association

Has been active for five years minimum. To be eligible to purchase group health insurance on association must be organize for reasons other than buying insurance must have a least 100 members have a Constitution bylaws and must hold at least annual meetings on Association group must have been active for at least two years

A health care plan that is a hybrid of health maintenance organization and preferred provider organization that provides subscribers with freedom of choice of healthcare providers other than a health maintenance organization are called

Point of service plans are a hybrid arrangement that combines aspects of a traditional medical expense plan with an HMO or a PPO out. Point of service plans however exert more control over costs then PPOs

Medicare part B covers all of the following except

Long-term care services

Medicare is a health insurance program for all of the following individuals except

Those with low income and low assets. Medicare is a federal program for those over 65 those who have been on Social Security for two years and those with permanently kidney failure assets and income have nothing to do with Medicare eligibility

Which of the following statements is incorrect concerning modified endowment contract and MEC's

An MEC must always pass the seven Pay test. Life insurance contract must pass the seven pay test, otherwise they become classified as modified endowment contract and policy loans or withdrawals will be subject to taxation as provided by the regulation. If investment funds are withdrawn or borrowed prior to age 59 1/2 they will also be subject to a 10% penalty.

Under Hyppa portability, which of the following are not protected under required benefits

Groups of one or more

An insured falls down a flight of stairs and sustains a neck injury that renders him severely disabled. The insured owns a whole life policy. Is it possible for the policy to include a waiver of cost of insurance rider and if so what insurance cost would be waived

No. It is not possible for this waiver to be included in a hole like policy. The waiver of cost of insurance rider is found in universal life policy

Cash value guarantees in a whole life policy or called

Non-forfeiture values.

An equity indexed annuity will grow based upon

Performance of a recognized index.

All of the following are advantages of a qualified retirement plan except

The income at retirement is tax-free. In a qualified plan any amounts not previously taxed will be taxed when the funds are received.

The notice about policy cancellation delivered to senior consumers must provide all of the following information except

Explanation of where the premiums have been invested

When long-term care insurance covers care in a person's home or in a skilled or residential facility the policy may be labeled

Comprehensive. LTC insurance may be described and labeled as comprehensive only when it provides benefits in an institutional setting as well as in a residential or community-based setting.

Which type of authority is found in the agents contract

Express. The agents contract give the agent express authority

Slippery floors reckless driving or providing false information are examples of

Hazards. A hazard is any factor that increases the likelihood is that a loss may occur

What is the purpose of a benefit schedule

To state what and how much is covered in the plan

Which of the following describes the relationship between a capital some and the principal some

Capital sums are percentages of principal sums

Under what circumstances will the contingent beneficiary received the death benefit

If the primary beneficiary dies before the insured

What is it called when a doctor accepts the Medicare approved amount

Assignment is one the doctor agrees to accept the Medicare approved amount

A subscriber has been treated for medical condition by his primary care physician for three months with experimental remedies without a significant health improvement before being referred to a specialist which of the following types of plans does the subscriber have

I gatekeeper HMO plan to control the costs. Subscribers are participants in an HMO. And some HMOs the primary care position incurs a cost to refer patients to a more expensive specialist and therefore may try alternative treatments before referring a patient

Gross premium for a life insurance policy is determined by adding which two components

Net premium and expenses. The premium without operating costs factored in is the net premium net premium plus expenses or loading add up to gross premium.

Tom purchased a health insurance policy with a renewability clause that states the policy is guaranteed renewable. This means that as long as Tom pay the required minimum is the policy will continue until Tom

Reaches age 65 if he paid the premiums.

Which of the following would be true of both the fix. And fixed amount settlement options

Both guaranteed that the principal and interest will be fully paid

All of the following could qualify as a group for the purpose of purchasing group health insurance except

An association of 35 people. Group insurance may be issued to employer employee or other groups that are together for a purpose other than purchasing insurance

Which of the following statements is not true regarding H I C a P?

It exists to assist seniors who are not qualified to receive Social Security or Medicare


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