Final Insurance Exam Missed Questions
Which of the following would be covered by contract law?
And insured suing the insured for failure to provide promised benefits Contract law applies to voluntarily undertaken written agreements between parties.
Which of the following statements is incorrect concerning modified endowment contract
Ann MEC must always pass the 7 pay test
Occasional visits by which of the following medical professionals will not be covered under LTC's home health care
Attended physician
When long-term care insurance covers care in a persons home warranty skilled a residential facility the policy may be labeled
Comprehensive
And insured owns a $50,000 whole life policy. At 8:47 the insured decides to cancel his policy and exercise the extended term option for the policies cash value, which is currently $20,000. What would be the face amount of the new term policy?
$50,000 The face of the term policy would be the same as a face-amount provided under the whole life policy
In some cases in order for an insurer to legally disclose privilege information to appropriate sources, the insured must sign an authorization form. What is the maximum amount of time that can legally pass between the completion of the form and the disclosure of information
1 year
How many tears must be included in each treatment category of a Medicare prescription drug plan formulary?
2
Which of the following is not covered under a long-term care policy?
Acute care in a hospital
Which of the following types of care could be provided at the community center
Adult daycare
Which of the following is not an example of valid insurable interest
Debtor in the life of the creditor The three recognize areas in which insurable interest exist are a policy ensuring their own life, the life of a family member, or the life of a business partner, key employer, or someone who has a financial obligation to the policy owner
Under HIP AAA portability, which of the following are not protected under required benefits
Groups of one or more
All of the following are features of catastrophic plans except
High premiums
If the request for payment of due premiums are the policy How soon must the insurer issue a loan
Immediately
A return of premium term life policy is written as what type of coverage?
Increasing Return of premium life insurance is an increasing term insurance policy that pays an additional death benefit to the beneficiary equal to the amount of premiums paid
Which of the following does not describe hospice care?
It provides care to people with life expectancies of 1 to 2 years
Which of the following statements is incorrect
Medicare and Medigap policies provide coverage for long-term going to studio or nursing home care
Which of the following is guaranteed under variable whole life insurance policy
Minimum death benefit
A person has a history of the wise. To his ensure, this presents what type of hazard
Morale
Gross premium for a life insurance policy is determined by adding which two components
Net premium and expenses
How are policy loans calculated
Policies cash value minus unpaid loans in accrued interest
Events in which a person has both a chance of winning or losing are classified as
Speculative risk
Which of the following would basic medical expense coverage not cover
Surgeon services
Which of the following is the best definition of idemnification?
The act of one person who agrees to restore an injured person to the condition he or she enjoyed prior to the loss
An application completed application for disability policy if he's initial premium. The producer gives applicant a conditional receipt. Insurance coverage for the applicant will become effective when
The insurance company except the risk
Which of the following is correct regarding selecting a primary care physician in a PPO plan?
The insured may choose medical providers not found on the preferred list
All of the following are true regarding the waiver of cost insurance rider except
The rider expires when the insured reaches age 60
What is it called when a doctor accepts Medicare approved amount
assignment
Health insurance rates may be based upon all of the following except
religion
How long is a grace period for an individual life insurance policy in California
60 days
To purchase insurance, the policy owner must face the possibility of losing money or something a value in the event of loss what is this concept called
Insurable interest
And health insurance the length of the grace period varies according to the
Mode of premium payment
Which statement best describes agreement as it relates to insurance contracts
One party accepts the exact terms of the other party's offer
What is the advantage of reinstating a policy instead of applying for a new one?
The original age is used for premium determination The reinstatement provision allows a policy owner an opportunity to put a lapsed policy back in force, subject approving continued insured ability. I have the policy owner Alex to reinstate the policy, as opposed to purchasing a new policy, the reinstated policies restored to its original status
Which of the following is not a goal of risk retention?
To minimize the insured's level of liability in the event of loss Retention usually results from three basic desires the insured call in to reduce expenses and improve cash flow, to increase control claim a serving and Claims settlements, and to fund losses that can't be insured.
What is the purpose of a benefit schedule
To state what and how much is covered in the plan
The renewable provision allows a policy owner to renew the coverage at the expiration date
Without evidence of insurability
Policy loan request except for the loan request for payments of two premiums may be deferred for up to
60 days
How is emergency care covered for a member of an HMO?
A member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area
Any person to whom the commissioner has issued a seizure order and he refuses to deliver any books records or is assets of an insurer face of the following penalties
A misdemeanor punishable by a fine of up to $1000, a year in jail or both
Which of the following would automatically qualify for medical benefits?
A person receiving supplementary security income assistance
According to the life insurance replacement regulations, which of the following would be an example of policy replacement?
A policy is reissued with a reduction in cash value
A small hardware store owner is involved in a car accident that renters him totally disabled for half a year. Which type of insurance would help him pay for expenses of the company during the time of his disability?
Business overhead expense policy Under the business overhead expense insurance small business owners can use it for rent utilities and employee salaries
Contracts that are prepared by one party and submit it to the other party on a take it or leave it bases are classified as
Contracts of adhesion Insurance policies are written by the insurer and submitted to the insured on a ticket or leave it bases. The insure does not have any input into the contract, but simply adheres to the contract.
Who would be the insured in business disability insurance
Key employees
Profitable distribution of exposures serves the purpose of
Protecting the insurer against adverse selection A profitable distribution of exposures exist when poor risk are balanced with preferred risk, with the standard risks in the "middle ". The purpose behind distributing risks in this manner is to protect the insure from adversal election
According to California insurance code which of the following can be classified as an insurable event?
Pure risks Speculative risks are uninsurable
All of the following are characteristics of group health insurance except
The party's I hold a group health insurance contractor they employees in the employer
And insured is involved in an accident that renders him permanently death, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive presumptive disability benefits?
Full benefits Presumptive disability plan offers full benefits for specified conditions. These policies typically require the loss of at least two limbs, total improvement blindness, or loss of speech or hearing. Benefits are paid, even if the insurance is able to work
And employee has a flexible spending account with a $5000 annual benefit. This year the employee used 3000. What would be the amount of the benefit available to play next year
5000 Use or lose rule
An employee that becomes ineligible for group coverage because of termination of employment or change the status, must exercise extension of benefits under cobra within
60 days
Under HIP AAA, which of the following is incorrect regarding eligibility requirements for conversion to an individual policy?
An individual who was previously covered by group health insurance for six months is eligible. All of these eligibility requirements are correct, except an individual who was previously covered for at least six months. HIPAA requires that the individual have a previous continuous creditable health coverage or at least 18 months
Every insure issuing long-term care contract in California must
Establish standards of agent conduct to prevent misleading comparisons of LTC policies, be certain that excessive replacements or transactions are not being made, and notify insured's of the HICAP program and the right to seek services through HICAP free of charge.
Which of the following is true regarding pure life annuity settlement option?
It provides the highest monthly benefit
Identify this off work at four months to do a disability. His dental assistant salary would be covered by
Business overhead insurance
Which of the following best describes the difference between joint life and joy and survivor annuity payment options
Enjoy in life option the benefit stop after the first death
Medicare part a services do not include which of the following
Private duty nursing
What is the application of the contract of adhesion mean
Since the insured does not participate in preparing the contract, any ambiguities would be resolved in favor of the insured
All of the following are true of a multiple employer trust except
The employee has a rate of conversion upon leaving the group coverage (they do NOT)
Which of the following insurance have a right to cancel an individual life policy for a full refund within 30 days of policy delivery?
Ensure to our 60 years of age you're older
What are the continuing education requirements for agency market long-term care insurance policies
Eight hours of long-term care specific education included in the regular CE requirements
Which of the following used to be called Medicare plus choice plans
Medicare advantage plans
When may HIV related test results be provided to the MIB
Only if the individual is not identified
Can an individual who belongs to a POS plan to use an out of network physician?
Yes, and they may use any preferred physician, even if not part of the HMO
And 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 charges $100 per day. How much will the insurance company pay?
120 a day Most LTC policies will pay the benefit amount in a specified dollar amount per day regardless of the actual cost of care
An insurer may discriminate against a person through underwriting if that person has
A physical handicap they could result in an actuarily predictable loss Physical or mental impairments may not be used to discriminate against a person in underwriting assurance unless it can be shown actuarially or on the basis of "actual and reasonably anticipated experience" that such persons represent extraordinary risk to the insurer
All of the following individuals may qualify for Medicare health insurance benefits except
A retired person age 50
An underwriter is reviewing an application with an extensive medical history. Which of the following would give the underwriter a better understanding of how the applicant has been treated for various illnesses
Attending physician statement
Which of the following is not true regarding basic surgical expense coverage?
Coverage is unlimited Basic surgical expense coverage is commonly written in conduction with hospital expense policies. These policies pay for the cost of surgeon services, whether the surgery is performed in or out of the hospital. Coverage includes surgeons fees, anesthesiologist, and the operating room what is not covered as a miscellaneous medical item. As with the other types of basic medical expense coverage, there is no deductible, but the coverage is limited
Which of the following is not a legitimate use of annuities by businesses
Creating a tax shelter Annuities are most often used by businesses to fund employee retirement plans, to provide deferred compensation for employees or as an investment vehicle.
Which of the following is not a term for the period of time during which the annuitant or beneficiary receives income
Depreciation period The "annuitization. "Is the time during which accummated money is converted into an income stream. It is also referred to as than you would he, liquidation or payout period
Your client wants to provide a retirement income for elderly parents in case something happens to him. He wants to make sure that both beneficiaries are guaranteed income for life. Which settlement option shit this policy owner select
Joint and survivor
The growing tendency of individuals to file lawsuits and claim tremendous amounts for alleged damages is known as
Legal hazard Legal hazards arise from court actions which increase the likelihood of or size of a loss
A woman obtains health coverage through the marketplace on October 1 two weeks later she finds out that she's three months pregnant. Which of the following is true about coverage for pregnancy?
Pregnancy will be covered immediately
And insured purchased a health insurance policy with a renewability clause that states the policy is guaranteed renewable. This means that as long as the required premiums are paid, the policy will continue until the insured
Reaches age 65
Installing deadbolt locks on the doors of the home is an example of which kind of handling risk?
Reduction
A husband and wife are insured under a group health insurance plans at their own places of employment, and as dependents under their spouses coverage. If one of them and Cruz hospital Spences, how will the expenses likely be had paid?
The benefits will be coordinated
The policy owner of an adjustable life policy wants to increase the death benefit. Which of the following statements is correct regarding his coverage
The death benefit can be increased by providing evidence of insurability
And employee is insured under her employers group life plan. If she terminator group coverage, which of the following statements is incorrect?
The insured may choose to convert to term or permanent individual coverage When group coverage is converted to an individual policy the insured will determine the type of coverage, usually permanent insurance.
The insured had his wife's name as a beneficiary of his life insurance policy. To ensure that his wife had income for the life after the insured's death, he chose the life income settlement option. The amount of payments will be determined by taking into account all of the following except
The insured's age at death
All of the following are true regarding the accumulation at interest option except
The interest is not taxable since it remains inside the insurance policy The interest is credited at a rate specified by the policy, the policy owner has the right to withdraw the cumulations at any time, and the annual dividend is retained by the company
All of the following statements concerning the use of life insurance as an executive bonus are correct except
The policy is owned by the company
Which of the following describes a tax advantage of a qualified retirement plan?
Their earnings in the plan accumulate tax deferred
All of the following are true regarding the guaranteed insurability rider except
This rider is available to all insureds with no additional premium The insured may purchase additional insurance up to the amount specified in the base policy, it allows the insured to purchase additional amounts of insurance without proving insurability only on specified dates or events, and the insured may purchase additional coverage at the attained age
Which of the following is not the purpose of Hyppa
To provide immediate coverage to new employees who have been previously covered for 18 months HIP AAA does not prohibit employers or providers from establishing waiting periods or pre-existing conditions exclusions in which the case the coverage to new employees would not be immediate
An agent is a legal person who acts on behalf of
principal (insurer)
Health insurance rates may be based upon all the following except
religion
Doug decided to retire at age 62. When he applied for Social Security retirement benefits he discovered
Medicare coverage was not available until the month of his 65th birthday Those who qualify for Medicare through Social Security are not eligible until 865 unless they are totally disabled or suffer from kidney failure
Qualified long-term care policies covering home care must provide benefits that the insurance impaired in at least two of the six activities of daily living. The term "impaired "means
Need substantial hands-on or standby assistance with ADLs
A formal arrangement approving healthcare benefits without providing any financial protection to the principal is referred to as what type of plan?
Self insurance Self insurance, although not really insurance at all, is used to describe a formal plan of risk retention whereby the self ensure provides the funds necessary to pay the claims, defined in the arrangement as covered losses, without the use of an insurance company
The purpose of the California insurance guaranty association is to protect the entrance of policyholders in claimants against losses resulting from the inability of insolvent insurers to meet their contractual obligations. All of the following are covered under the association except
The insurance within the last 10 years healthy license in the states in which the person's reside
Which of the following statements is incorrect regarding the definition of total disability
Total disability is the inability to perform partial duties of any occupation for which a person is suited by reason of education, training or experience.
