ExamFX

Anyone who is willing to pay the premium

All of the following qualify for Medicare Part A EXCEPT

Always representing the insured

An agent is acting ethically in all of the following situations EXCEPT

Only to individuals

An agent license can be issued

Consideration Clause

An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the

5 years

An applicant whose license has lapsed during active military service will be granted a new license if an application is made within what time period after the lapse

$102

An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75, for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for COBRA coverage.

Workers Compensation

An employee is injured in a construction accident, rendering him unable to work for a year. Which of the following plans would provide him with medical expense coverage and income assistance

30 days

An insurance agent has received a request for a hearing from the commissioner. Within how many days must the hearing be held

Represent the client

An insurance agents responsibilities include all of the following EXCEPT

Conditional

An insurance contract requires that both the insured and the insurer meet certain conditions in order for the contract to be enforceable. What contract characteristic does this describe

committing insurance fraud

An insurance producer who knowingly and willfully solicits insurance contracts for an unauthorized insurer is

No coverage will apply, since the injury could have been foreseen

An insured is covered by a disability income policy that contains an accidental means clause. The insured exits a bus by jumping down the steps and breaks an ankle. What coverage will apply

$500

An insured is covered under 2 group health plans- under his own and his spouse's. He had suffered a loss of $2,000. After the insured paid the total of $500 in deductibles and coinsurance, the primary insurer covered $1,500 of medical expenses. What amount, if any, would be paid by the secondary insurer

Mutual

An insured purchased an insurance policy 5 years ago. Last year, the insured received a dividend check from the insurance company that was not taxable. This year, the insurer did not send a check. From what type of insurer did the insured purchase the policy

The insured was in compliance with the policy requirements regarding claims

An insured submitted a notice of claim to the insurer, but never received forms. He later submits proof of loss, and explains the nature and extent of loss in a hand written letter to the insurer. Which of the following would be true

$120 a day

An insured's long-term care policy is scheduled to pay 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

Consideration

An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principles has the insurer violated

Conditions

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

None

Bethany studies in England for a semester. While she is there, she is involved in a train accident that leaves her disabled. If Bethany owns a general disability policy, what will be the extent of benefits that she receives

Pay a special deductible on his major medical policy

Don has both a basic expense and a major medical policy. He is injured in an accident, which requires several major surgeries. This quickly exhausts Don's basic expense policy. What must Don do before his major medical policy can pick up where the basic expense policy left off

100

For how many days of skilled nursing care will Medicare pay benefits

31 Days

Group accident and sickness policies in Georgia have a grace period of

A member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area.

How is emergency care covered for a member of an HMO?

A notice regarding replacement

If an applicant intends to replace any existing accident and sickness policy with a Medicare supplement policy, what must the agent furnish to the applicant

An unfair trade practice.

If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered

during which illness-related disabilities are excluded from coverage

In a disability policy, the probationary period refers to the time

Company

In any case where there is a controversy or dispute between the insurance company and the insured, the soliciting agent is the agent of the

Broader in general

In comparison to a policy that uses the accidental means definition, a policy that uses the accidental bodily injury definition would provide a coverage that is

Elimination period

In disability income insurance, the time between the onset of an injury or sickness and when benefits begin is known as the

Unilateral

In insurance policies, the insured is not legally bound to any particular action in the insurance contract, but the insurer is legally obligated to pay losses covered by the policy. What contract element does this describe

Handling insurer funds in a trust capacity

In insurance transactions, fiduciary responsibility means

The insured must have been hospitalized for 3 consecutive Days

In order for an insured under Medicare Part A to receive benefits for care in a skilled nursing facility, which of the following conditions must be met

All providers will have the same coverage options and conditions for each plan.

In reference to the standard Medicare Supplement benefits plans, what does the term standard mean

Promising to pay in accordance with the contact terms

In respect to the consideration clause, which of the following is consideration on the part of the insurer

45 Days

In the event a policy lapses due to nonpayment of premium, within how many days would the policy be automatically reinstated once the outstanding premium is paid

$1,000

In this state, what is the maximum fine for transacting insurance without a license

In an institutional setting

In which of the following locations would skilled care most likely be provided?

The insured may carry over the amount of this years expenses to next year, which will help satisfy next year's deductible

Insured Z's health insurance policy year begins in January. His policy contains a carry-over provision. In November , he has a small claim which is less than his deductible. Which of the following is true

Rates by class

Insurers may change which of the following on a guaranteed renewable health insurance policy

A statement that the insured does not automatically qualify for Medicare Part A

Insurers or agents soliciting partnership policies must provide each prospective applicant with all of the following EXCEPT

Exclusions

Items stipulated in the contract that the insurer will not provide coverage for are found in the

Surgical expenses of persons eligible for Medicare

Medicare supplements specifically exclude all of the following EXCEPT

Control health insurance claims expenses

The purpose of managed care health insurance plans is to

$12,000 all of which is taxable

A noncontributory group disability income plan has a 30 day elimination period and offers benefits of $2,000 a month. If an employee is unable to work for 7 months due to a covered disability, the employee will receive

$10,000

The violation of a cease and desist order may result in a fine of

Disability buyout

This arrangement specifies who will purchase a disabled partners interest in the event he or she becomes disabled

Medicare Part A

To sign up for a Medicare prescription drug plan, individuals must first be enrolled in

A statement that is sufficiently clear to identify the insured and the nature of the claim

Under the mandatory uniform provision Notice of Claim, the First notice of injury of sickness covered under an accident and health policy must contain

Individual members of the group may select the level of benefits for their own coverage.

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

Premiums always stay the same

Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT

7.5%

Unreimbursed medical expenses paid for the insured may be claimed as deductions if the expenses exceed what percentage of the adjusted gross income

No tax

in an individual long-term care insurance plan, the insured is able to deduct the premiums from taxes. What income taxation will be imposed on the benefits received

2 years

A person who is convicted of a felony related to insurance fraud may be imprisoned for what minimum term

Commingling

A producer who fails to separate premium monies from his own personal funds is guilty of

the insured who is 60 years old

A qualified long-term care insurance policy must provide compound annual inflation protection to which of the following insureds

Unearned premiums are retained by the insurance company

According to the rights of renewability rider for cancellable policies, all of the following are correct about the cancellation of an individual insurance policy EXCEPT

5 years

Agents, Subagents, and counselors are required to maintain records of all insurance transactions for what time period

It is a compulsory program

All of following statements about Medicare Part B are correct EXCEPT

Explaining to a client the advantages of permanent insurance over term and suggesting changing policies.

All of the following actions can be described as twisting EXCEPT

Both group and individual plans are renewable

All of the following apply to short-term disability plans EXCEPT

A reinstated policy provides immediate coverage for an illness

All of the following are correct about the required provisions of a health insurance policy EXCEPT

Individual insurance does not require medical examinations, while group insurance does require medical examination

All of the following are differences between individual and group health insurance EXCEPT

Coverage applies both on and off the job

All of the following are true about group disability income insurance EXCEPT

Premiums are deductible, and benefits are taxed

Regarding the taxation of Business Overhead polices

Disability expected to last for at least 6 months.

Social Security disability definition includes all of the following EXCEPT

Inviting prospective clients to the grand opening of the company's new office

State law specifically prohibits using illegal inducements in the marketing of insurance. All of the following would be considered illegal inducements EXCEPT

Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class.

A guaranteed renewable health insurance policy allows the

Promptly forwarding premiums to the insurance company

Pertaining to insurance, which of the following is an example of a producers fiduciary responsibility

Entire contract.

The insurance policy, together with the policy application and any added riders form what is known as a(n)

Individual tax deduction for premiums paid

The patient protection and affordable care act includes all of the following provisions EXCEPT

It allows guaranteed acceptance of all applicants.

What is NOT a benefit of a POS plan?

Probationary Period

What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered

Amounts payable under the policy will reflect the insured correct age

When an insured purchased her disability income policy, she misstated her age to the agent. If the policy contains the optional misstatement of age provision

Alien Insurer

When transacting business in this state an insurer formed under the laws of another country is known as a/an

Renewal Provision

Which health insurance provision describes the insured's right to cancel coverage

renewal provision

Which health insurance provision describes the insureds right to cancel coverage

Exchange of unequal values

Which of the following best describes the aleatory nature of an insurance contract

Aleatory

Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company

Premiums are not tax deductible, and benefits are not tax deductible

Which of the following describes taxation of individual disability income insurance premiums and benefits

Insurer

Which of the following entities can legally bind coverage

A person insured under a high-deductible health plan

Which of the following individuals is eligible for a Health Savings Account

Premiums are tax-deductible

Which of the following is CORRECT regarding Business Overhead Expense insurance

Underwriting the contract

Which of the following is NOT a responsibility of an insurance agent

The application given to a prospective insured

Which of the following is NOT the consideration in a policy

It is designed to pay on a first dollar of expense basis

Which of the following is NOT true of a major-medical health insurance policy

It is issued to group insurance participants.

Which of the following is NOT true regarding a Certificate of Authority

Fully Insured Status

Which of the following is an eligibility requirement for Social Security disability income benefits

Copayment

Which of the following is the term for the specific dollar amount that must be paid by an HMO member for a service

Its goal is to channel patients to providers that discount services

Which of the following is true of a PPO

A person who negotiates insurance contracts

Which of the following persons is required to hold a producer license

Physical examination and autopsy

Which of the following provisions is mandatory for health insurance policies

Individuals who has ALS automatically qualify for Medicare Part A, regardless of age

Which of the following statements pertaining to Medicare Part A is correct.

Benefits are usually limited to six months

Which of the following statements regarding Business Overhead Expense policies is NOT true

Surgeon's services

Which of the following would basic medical expense coverage NOT cover?

A salaried employee who advertises and solicits insurance

Which of the following would be required to be licensed as an insurance producer

the group is assessed individually for insurability

Which statement is NOT true regarding underwriting group health insurance

Long-Term care

Which type of care is NOT covered by Medicare

Gatekeeper

which of the following is another name for a primary care physician in an HMO