Final Exam
For individual health insurance, coverage for pre existing conditions may be excluded for up to _ months after the issuance of the policy
12
An insurance must furnish to a claimant forms for filling proof of loss with in __ days upon receiving a notice of claim
15
To be classified as a small employer in MI, an employer must employ
2-50 employees
A producer has allowed his/her license to lapse by failing to complete the requires continuing education credits. The license may be reinstated by completing the requirement within _ days of the renewal date
90
All of these are valid options for an Adjustable Life Policy EXCEPT
A nonforfeiture option can be used to increase the death benefit
Which of the following nursing home options would best suit an individual who needs some nursing care and supervision but NOT full time care
ASSISTED living facility
Which dividend option would an insurer invest the policyowner's money and add any interest earnings as the dividends accrue?
Accumulation at intrest option
Which of the following does coordination of benefits allow
Allows the secondary payor to reduce their benefits payments so no more than 100% of the claim is paid
Which of these is NOT considered to be a purpose of an annuity
Annuities are intended to create an estate
With a scheduled dental policy, how are covered expenses paid?
Benefits are limited to a specific maximum dollar amount per procedure
What is issued to each employee of an employer health plan?
Certificate
The policyholder for a group health benefit plan is considered to be the
Employer
All of the following are qualifications for establishing a HSA EXCEPT
Enrolled in a health plan with a prescription drug benefit
Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose?
Guaranteed lifetime withdrawal benefit
Tyler purchased a disability policy with a waiver of premium rider on April 1. He is disabled on May 1. On June 1, he receives proof of permanent and total disability, and submits a claim. He begins receiving benefits on June 15. When are his premiums waived?
May 1- beginning at the date of disability
Disability income plans which require that the insurer can NEVER change or alter premium rate are usually considered
Noncancellable
How are contributions made to a Roth IRA handled for tax purposes?
Not tax deductible
Under a Modified Endowment Contract, what are the likely tax consequences?
Pre-death distributions will become taxable
Claims payable to a Disability Income insured, even when the insured can continue to work, are the result of a
Presumptive Disability-A presumptive disability provision specifies certain conditions that automatically qualify the insured for the full benefit because the severity of the conditions presumes the insured is totally disabled, even if the insured is able to work.
which of the following actions is required by a producer who is replacing an existing life insurance policy
Submit to the replacing insurer a list of all Life Insurance policies or annuity contracts proposed to be replaced
A producers license is required for all of these activities EXCEPT
Underwriting
David submits a $500 claim for medical expenses. There is a past-due amount owed for insurance premiums of $200. As a result, the insurer only pays $300 for the claim. This deduction came as a result of which provision?
Unpaid provision
A long term care policy typically provides all the of the following levels of care except
acute care
In the Michigan insurance code, chapter 45, insurance fraud defines financial loss as all of the following EXCEPT
additional premiums
Medical expense insurance would cover
an injury occurring at the insured's residence
According to life insurance contract law, insurable interest exists
at the time of application
The period in which there are no social security benefits for the surviving spouse is called the
blackout period
Any changes of address by a licensee requires notice within 30 days to which of the following
commissioner
A waiver of premium rider allows an insured to waive premium payments if the insured is
completely and permanently disabled
Nate's dependent son is physically handicapped, but not eligible for medicare. How long may the son remain on natters health coverage after the age of 26
coverage remains with written proof of disability and dependency
An example of a presumptive disability would be
deafness
Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)
deductible
Fraternal Benefit Society has each of the following characteristics except
exist for profit
An applicant intentionally lying to an insurance company on an application in order to obtain a cheaper premium is an example of
fraud
Index whole life insurance contains a securities component that acts as a(n)
hedge against inflation
which of the following is not included under a health benefit plan
hospital indemnity plan
The conversion privilege under a group life plan allows an employee to convert to a
individual plan upon employment termination
An example of a primary care physician would be a
internist
An insurer would be committing unfair discrimination is coverage was denied based upon
marital status
All of these are considered key factors in underwriting life insurance except
martial status
What is the contract called that is issued to an employer for a group medical insurance plan
master policy
Richard owns an insurance policy that is renewable only at the option of the insurance company. His policy is considered to be:
optionally renewable
What is an insurer required to do when faced with an error made under the misstatement of age provision
pay age corrected benefits
what is an insurance poles grace period
period of time AFTER the premium is due but the policy remains in force
Which of the following would evidence ownership in a participating health insurance contract
policy ownership
A person who is a non smoker, a average weight, & in excellent health would most likely be in which risk classification
preferred
A health insurance policy will typically cover
preventative health services
An indemnity plan
provides the insured a specific dollar amount for services
Which of these is the best example of misrepresentation
providing incorrect, misleading, incomplete, or materially untrue information in a license application
Which of the following is an example of a producers fiduciary duty
recording receipt and remittance of the premiums due to the insurance company
A life insurance application may be backdated to
save on premiums
A _ company is owned exclusively by shareholders
stock
In a long term care policy, activities of daily living (ADL's) can be each of the follow EXCEPT
talking
Which of the following does not build cash value
term
maximum benefits refers to the
upper limit of the total lifetime benefits the insurance company will pay
An example of intimidation is
using threat or force to restrict fair trade in the transaction of insurance
When can a group health policy renewal be denied according to the Health Insurance Portability and Accountability Act (HIPAA)?
when contribution or participation rules have been violated
A universal life policy owner must receive a notice of cash surrender value at least every
year
Fixed Period Settlement Options are considered to be a form of a
Annuity
Insurable interest does not occur in which relationship
Business owner and business client
In which oft the following relationships would there NOT be an insurable intrest
Business owner to business customer
A health insurance policy where the insurer has the right to terminate the policy for reasons other than an insured health is called
Conditionally RENEWABLE
Which of the following is NOT true regarding a critical illness plan
Coverage is limited to a single devastating disease
All of the following are exampled of business continuation plan EXCEPT
Deferred compensation
A common exclusion of limitation on a dental policy is
Endodontic
Low frequency diseases can be exclusively covered by what kind of health insurance policies
Limited policies
A single premium cash value can be described as
a policy that is paid up after only one payment
An example of unfair claims settlement practice is
failing to promptly provide a reasonable explanation for the denial of claims
which of these would not be considered a presumptive disability
loss of leg OR arm
According to HIPPA, when can a group health policy renewal be denied
participation or contribution rules have been violated
How is a health provider reimbursed if they do NOT have an agreement in place with the insurance company?
with a usual, customary, and reasonable fee
Major medical expense plans provide coverage for each of the following except
work related injuries
Loans obtained by a policyowner against the cash value of a life insurance policy
would not be treated as taxable income
Michigan requires that a licensee complete _ hours of continuing education on the subject of ethics every reporting period
3
In determining whether a pre-existing condition applies, the enrollee cannot have more than how many days, gap in health insurance
63
Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ___ day gap without previous health insurance.
63
A annuitant is guaranteed to NOT outlive their benefits with a
Guaranteed lifetime withdrawal benefit
All of the following plans allow for employee contributions to be taken on a pre tax basis except
Health Reimbursement Arrangement Plan
HMO plans are required to provide
Home health care
In an insurance contract, the element that shows each part is giving something of value is called
consideration
A spouse and child can be added to the primarys insureds coverage as what kind of rider
family term
Simon has purchased a fixed immediate annuity. His payment amount will be dependent upon principal, interest, and the contract's
income period
a foreign insurance company doing business in MI
is a company domiciled under the laws of another state
The election of COBRA for continuation of health coverage will
maintain the same coverage & INCREASE premium
Which requirement must be met by associations that seek group health coverage for its members?
must have been formed for a legitimate purpose other than obtaining insurance
which of the following is not covered under worker compensation
pain and suffering
Joe is a Medicare participant who receives his benefits through a Managed Health Care Plan. Which Medicare plan does he have?
part C
Which policy feature makes a universal life policy different from a whole life policy?
a flexible premium schedule
An insurance producer license is required for which of the following
a business entity soliciting insurance
Tonya has replaced her whole life policy with an annuity without incurring a tax penalty. This transaction is called a(n)
1035 exchange
An individual applying for a MI resident producer license must have complete the required pre- licensing education within _ months of license application
12
A life insurance policy sold in MI may be contested by the insurer only during the first __ years of the contract
2
What will the beneficiary receive if an annuitant dies during the accumulation period?
The GREATER of the accumulated cash value or the total premium paid
Which of the following is INELIGIBLE to participate in a Section 125 Plan?
An S-Corp owner w/a greater than 2% share
Which type of life insurance policy pays the face amount at the end of the specified period if the insured is still alive
Endowment policy
Dana is an employee who deposits a percentage of her income into her individual annuity. Her company also contributes a percentage into a separate company pension plan. What kind of annuity is this
Qualified retirement annuity
Which of these is NOT a characteristic of the accelerated health benefit option
The benefit can be offered as a rider at a specific extra cost or may be at no cost
Under which circumstance may a minor receive proceeds from a death benefit
The minor must have an appointed gaurdian
Who were Keogh plans designed to provide pension benefits for?
The self- employed
When are group disability benefits considered to be tax-free to the insured?
When the RECIPIENT pays the premiums