final
how long would the grace period be under a policy if the insured pays a monthly health insurance premium
10 days
in a noncontributory group policy
100% of eligible employees have to participate
temporary license texas is valid for
180 days
according to the limit on certain defenses provision ,statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been effective for a minimum of how many years
2 years
a coffee shop owner is under a business overhead expense policy that pays a maximum month benefit of 2,500$ her actual monthly expenses are 3,000$ if the owner becomes disabled the monthly benefit payable under her policy will be
2,500$
resident agent must complete how many house of contributing education every 2 years
24
newborn is covered by parents for how many days
31
under the HMO child immunization cost cannot be charged for children under
6
policy loan request expect loan request for payment of past due premium can be deferred for a period of up to
6 month
Death proceeds from a life insurance policy must be paid to the claimant with receiving proof of insurance death
60 days
texas employer to obtain group health coverage for small employers what percent must be covered
75%
under the mandatory uniform provision of proof of loss the claimant is required to submit proof of loss within what period after the loss
90 days
the corridor deductible applies between
Basic and major medical coverage
an adjustable life policy can assume the form of
Either term insurance or permanent insurance
which fed act defines rules regarding protected health insurance
HIPPA
which act was introduced to lower the cost of healthcare by utilizing preventive care
HMO act of 1973
variable insurance and variable annuities are regulated by
SEC, FINRA, and departments of insurance
what is the purpose to buy sell agreement
To allow the business buyout in case of the owner's death
what guarantees that the information explained in the insurance contract is true
a warranty
which term is used to define the period during annuitant makes payments into an annuity
accumulation period
best describes rebate
agent returning paty of her commissions on her clint as an inducemnt to buy
an insurance provider who conducts instance in texas but whose articles of incorporation are registered on canadas is considered what type
alien
which of the following statements is not true regarding health insurance policy provision
all additional provisions written by insurance providers are cataloged by their respective status
all could qualify as a group to obtain group health insurance except
an association of 35 people
which of the following premium modes would result in lowest overall premium
annual
which of the following signifies the individual upon whose life teh annuity income account is calculated
annulint
an insurer is trying to determine an applicants insurability and decides to obtain medical information from several different sources which has to be notified of the investigation
applicant
which of the following is an acceptable reason for an insurance company to contest the payment of a claim based on statements in the application
application contains material misstatements
an underwriter is reviewing an applicant with the extensive medical history which would provide underwriter a better understanding of the applicants treatment for various illnesses
attending physician's statement
which provision can be added to a permanent life insurance policy at no cost to ensure that the policy will not lapse if there is cash value
automatic premium loan option
which is not a trigger of the payment of accelerated death benefits
being permanently disabled
answers to question in an insurance application are called representations and as such they are
believed to be true to the best of the applicant's knowledge
true regarding drug and alcohol addiction treatment coverage in group health insurance in texas
benefits provided must be the same as benefits for any other physical illness
a dentist has been off work for 4 months because of disability his dental assistant salary would be paid by
business overhead insurance
which is not an indicator of a competent party
business profession
insurance providers cannot conduct insurance business in texas without
certificate of authority
An insured and his spouse recently had a child. Which of the following riders would allow the couple to insure the child for a limited period of time at a specified amount?
children term rider
HMO members pay a small fee when they see their primary care physician the fee is called
co pay
which is not usually an executed clause of disability is an individual disability income policy
complications from pregnancy
an applicant gives his agent a completed applicant and initial premium what can the agent issue him that acknowledges the initial premium payment
conditional receipt
which of following is not correct concerning an insurance policy's consideration clause
considering must be equal on the part of the both the insurance provider and the insured
which of the following distinguished characteristic if the interest adjusted net cost method
considering time value of money in comparing life insurance cost
when the whole life policy is surrendering for reduced paid-up policy the new policy's cash value will
continue to increase
Network Model HMO
contracts independent group physicians provide medical services to subscribers
in an HMO what is the purpose of the gatekeeper
controlling cost
which is true policy conversion from group to individual coverage
conversion need to occur within 31 days
insurance policy is required to have all of the following valid except
countersignature
when filling out and application the applicant makes a mistake what can the applicant do to correct the error if a new application is unavailable
cross out the incorrect answer , write the correct one beside it and initial the new answer
which of the following best describes a major medical expense policy
delivers catastrophic medical coverage beyond basic benefits on a usual customary and reasonable
a major medical expense policy would exclude coverage for all treatments except
drug addiction
HMOs attempt to identify medical problems
early detection through regular check ups
the uniform provision law that prevents an insurance provider from altering oits agreement with a policyholder by referring in the policy is called
entire contract provision
the stop loss feature on a major medical policy intent to
establish a maximum out of pocket cost that an insured will have to pay for medical ecpemedews in a calendar year
what is the automatic option when a whole life policy is surrendered for its nonforfeiture value
extended term
a husband and wife both incur cost attributed deducible in their policy which type of deductible do they have
family
an annuity owner received the same guaranteed payment each month what type of annuity is it
fixed
at what point is an automatic premium loan generated
following the grace period
insurer that opportates 1 or more charitable, religious, education, social oe been left proposed for benefit of its members
fraternal insurer
guaranteed purchase option is also known as
future increase option
what provision helps ensure that the insured is protected in the event of an unintentional lapse on the policy
grace period
long term care policies issued in texas must be
guaranteed renewable
medicare supplement plan must have at leats 1 renewable provisions
guaranteed renewable
an insured was diagnosed 2 years ago with kidney cancer he was treated w surgeries and chemotremony and is now in remission he also has a 30 year smoking history the insured is now healthy enough to work and has recently secured a full time job what best describes the health insurance that he will most likely receive
he would be covered under his employer's group health insurance plan without higher premium
when an insured reinstated their major medical policy they were involved in an accident that required hospitalization upon reinstatement of the policy when would this accident be covered
immediately
when an agent suspects a fraudulent insurance act has been committed in texas whom must the agent in from first
in insurance fraud unit of the texas department of insurance
what type of health insurance plan offers board medical expense coverage without requiring an insurance to study a deductible
indemnity
which is true in ACA health care tax credit
individual receiving medicare are not eligible
medicare is a health insurance program for all except
individuals with low assets and low income
to buy insurance policy owner must face prospect of losing money or something of value in the event of loss what is concept called
insurable intrest
which is the primary source of information that an insurance provider uses to evaluate an insured risk for her life insurance
insurance application
all required to sign an application for health insurance except
insurer
which is not true concerning a noncancelable policy
insurer can increase premium above what is stated in policy if claims experience is greater than expected
jacki reviews an agreement on the first page of her policy which contains a list of losses that her insurance provider will cover what is the name of agreement?
insuring claus e
which entity is considered principle
issuing policy
when the policy is issued what happens to the copy of the applicant for health insurance
it becomes part of the entire contract
regarding an ordinary (straight) life policy all of the statement true expcet
it does not have a guaranteed death benefit
regarding an agent report during the policy application process which is true
it provides the agent observations about the proposed insured
which of the following is general enrollment period for medicare part B
jan 1 through march 31 every year
which condition is true when comparing a joint life policy to 2 individual life policies of the same amount on the same insurers
joint life has a lower premium than the total of the two individual policies
if a business wants to ensure it can cover losses due to the disability of its top employee the business should get which type of insurance
key person disability income
For a contract to be enforceable by law, the purpose of the contract must be
legal and not against public policy
an illustration used during the sale of life insurance policy has to include a label stating
life insurance illustration
which of the following statement about medical information bureau correct
med information bureau assist underwriters in evaluating and classifying risk
in an individual health insurance policy all are excluded from coverage except
mental illness
insurance company owned by the policyowners called
mutual insurer
in the event an annuitant dies during the accumulating period and there is a beneficiary names in the annuity the insurer would pay annuity benefits to the
named beneficiary
in a whole life policy cash value guarantees are
nonforfeiture values
texas resident agent looking to sell insurance to clients in another state needs
nonresident license in that state
dividends received on participating life insurance policy are
not taxable because they are a return of unused premiums
which of the best describes unfair trade practice of rebating
offering an inducement of something of value not states in policy
when can HIV related test results be provided to the MIB
only if the person is not identified
what does it mean when insurance contracts are unilateral
only one party makes a promise
sharing of commissions is legal if
other oaty is license for the same lines of insurance as agent
which of the following dividend options is being used when the owner of a participating whole life policy uses the dividend to provide more life insurance coverage
paid-up additions
which of the following is the consideration on the part of an insurance provider
paying a claim
a vertical settlement is a transaction outside the life insurance provider where the owner sells the life insurance policy for which of the following
percentage of policy face amount
an equity indexed annuity will grow based upon
performance of a recognized index
ellen is covered under a health plan provided by her employer she was told that her insurance would pay most of the covered expenses if she chose to see a provider on her plans lst if ellen's chose to be treated by a provider that is not on the list her portion of the bill would be greater ellen is covered under
prefered provider plan
the amount and the frequency of the premium payment are known as
premium mode
the manner and frequency that the policy owner pays the premium is known as
premium mode
what is the difference between a 20 pay whole life policy and a straight life policy
premium payment period
which is not included on 1 page of medicare supplement policy
premium rates
what is the primary purpose of the coordination of benefits provision in group insurance
prevent over insurance
medicare part A services do NOT include which
private duty nursing
jake retirement plans meets all fed requirements and entitles him to certain tax benefits as the plan owner what term best describes jakes retirement plan
qualified
a person buys a life insurance policy and list his parents as the beneficiaries he can change beneficiaries at any time the policy has what type of beneficiary designation
revocable
an agent delivers a life policy she explains a policy change and ask the applicant to sign a statement acknowledging that she explained the changed the agent sasy the premium has not been paid and needs to be paid before the policy goes into effect she collects a statement of good health , relinquishes the policy and leaves what did she do wrong
she left the policy with the insured without collecting the premium
an insured has an individual disability income policy with a 30 day elimination period she becomes disabled on june 1 for 15 days when will she collect on her disability income payments
she won't collect anything
what is the meaning behind a contract of adhesion
since insured does not take part in preparing the contract any ambiguities would be resolved in the insured's favor
a whole life policy that will generate immediate cash value is a
single premium policy
which of the following forms of care are daily nursing and rehabilitation catre that can only be delivered by medical personnel under the direction of a physician
skilled care
which of the following statements is right
socialisation of insurance cannot be associated with the fed gov
when differentiating mutual insurance from stock insures true
stock insures non participating policies own by shareholders
under a major medical policy , policy owners have the right to do which if they have NOT received the necessary claim forms within 15 days of their open works on a plan sheet of paper
submit the description in their own words on a plain sheet of paper
Upon payment of a loss, the insured is obligated to surrender to the insurer the right to sue a negligent party. This is called?
subrogation
if the benefits of a basic medical insurance plans are exhausted what type of plan will begin covering those losses
supplementary major medical
a life insurance policy can provide which
survivor protection
Which is incorrect?
testimonials used in advancement may or may not apply to the advertised policy
who is obligated to ensure that every question is answered and all necessary signatures are collected on the application
the agent
whose responsibility is it to ensure that the application for health insurance is accurate and complete
the agent
life insurance creates an immediate estate which best explains
the face value of the policy is payable to the beneficiary upon the insured's death
in a health insurance policy which entity has to option of including optional provision
the insurance provider
which is incorrect
the insurance provider does not have the right to conduct an autopsy
Under the Payment of Claims provision, to whom will the insured's benefits be paid if the insured is deceased?
the insured's primary beneficiary
the reduction of premium option uses the dividend to reduce
the next year premium
as it pertains to life settlements the term owner means
the owner of the original life policy
regarding the premium in a 10 year level premium policy which is true
the premium will remain level for 10 years
According to the Common Disaster clause, if the insured and primary beneficiary are killed in the same accident and it cannot be determined who died first, which of the following will be assumed?
the primary beneficiary died before the insure
the guaranteed insurability rider allows the owner to buy additional amounts of life insurance without proof of insurability at all of the following except
the purchase of a new home
what is accurate of dividends from a life insurance policy
they are not taxable and are not guaranteed
what is the purpose of key person insurance
to cover decreasing business revenues as a result of a key employees death
in a health insurance policy what is the purpose of the impairment rider
to exclude coverage for a specific impairment
in the application process what is the purpose of the agent's report
to give additional information about the applicant to the underwriters
what is purpose of a policy's benefit schedule
to state what and how much is covered in the plan
regarding the definition of total disability which is incorrect
total disability is the inability to perform practical duties of any occupation for which an individual's is suited because of education
2 individuals of the same age , health statue , and life expectancy apply for individual insurance coverages when the same insurer issues the coverage premium rates are different based on insured's race what practice is this
unfair discrimination
which of these can be described as a flexible premium adjustable life policy
universal life
which service is not provided by an HMO
unlimited coverage for drug rehabilitation treatment
due to an injury an insured has been unable to work for 8 months when her life insurance premium came due she could not pay yet the policy remained in force this policy includes
waiver of premium rider
when an insured's membership in a group is terminate the insured can convert to
whole life without proof of insurability
if an insured is not entirely satisfied with an issued policy the insured may return it to the insurance company and receive a refund of their entire premium paid at which of the time
within 10 day of when the policy was delivered
under the mandatory uniform notice of claim provision policy owners must submit written notice of a cami to the insurance providers within what time
within 20 days
an employee that becomes ineligible for group coverage due ti termination of employment or a change in status must exercise an extension of benefits under COBRA
within 60 day
the commissioner can issue a temporary agents license to an applicant who is under consideration for appointment as an agent by another agent an insurance company or a health maintenance organization (HMO)
without a written examination