Illinois Health Only
An individual whose license is denied or revoked will be ineligible to apply for a license for a period of
3 years
Ron's application to become an insurance provider has been denied. What is the soonest possible time that he can apply again?
3 years
The Director informs a producer that its license has been terminated and immediately receives a request for the charges to be reviewed in court. Within what maximum number of days must the hearing be held?
30
What is the maximum age for qualifying for a catastrophic plan?
30
An insured receives her Medicare Supplement policy and notices provisions that she does not like. She would rather return the policy than keep it. How many days does she have to return the policy for a full premium refund?
30 days
Illinois law requires that a licensed insurance producer notify the Director, in writing, of any change in their residential address within
30 days.
According to the Recurrent Disability Provision, disability coverages cannot be separated by more than
6 months
A hospital indemnity policy will pay
A benefit for each day the insured is in a hospital.
Which of the following situations would describe a proper handling of premiums by a producer in this state?
A producer who holds premiums for 15 days establishes a Premium Fund Trust Account.
All of the following are correct about the required provisions of a health insurance policy EXCEPT
A reinstated policy provides immediate coverage for an illness.
Under the mandatory uniform provision Notice of Claim, the first notice of injury or sickness covered under an accident and health policy must contain
A statement that is sufficiently clear to identify the insured and the nature of the claim.
Which of the following is NOT covered under a long-term care policy?
Acute care in a hospital
If an insurance company. makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered
An unfair trade practice.
Which statement accurately describes the Change of Beneficiary provision?
Any. policy that has a death benefit must also have a Change of Beneficiary provision.
Under a Key Person disability income policy, premium payments
Are made by the business and are not tax-deductible
In a replacement situation, all of the following must be considered EXCEPT
Assets
The premium charged for exercising the Guaranteed Insurability Rider is based upon the insured's
Attained age.
Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?
Attending physician
An insurance contract must contain all of the following to be considered legally binding EXCEPT
Beneficiary's_consent
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?
Conditional
Which of the following includes information regarding a person's credit, character, reputation, and habits?
Consumer Report
A small company offers group health insurance to its employees, but recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?
Convert to an individual health policy.
In a basic expense policy, after the limits of the basic policy are exhausted, the insured must pay what kind of deductible?
Corridor
Which of the following is NOT an exclusion in medical expense insurance policies?
Coverage for dependents
When a producer was reviewing a potential customer's insurance coverage that is written by another company, the producer made several oral statements that were maliciously critical of that other insurer. The producer could be found guilty of
Defamation
Concerning an HMO, with what must an enrollee be provided?
Description of services, directions as to how to secure services, and truthful advertising.
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?
Diagnostic and preventative care
Applications for policies advertised by what method must include a statement announcing that the policy excludes pre-existing conditions from coverage?
Direct response
Which of the following is considered a qualifying event under COBRA?
Divorce
The insurance policy, together with the policy application and any rides form what is known as
Entire contract.
How often is a resident insurance producer required to pay license fees?
Every 2 years
All policy applications must identify which of the following?
Producer who solicited the applicant's business
Any inducement offered to the insured in the sale of an insurance policy that is not specified in the policy is an unlawful practice known as
Rebating
When an insurer combines two periods of a disability into one, the insured must have suffered a
Recurrent disability.
An insured submitted a notice of claim to the insurer, but never received claims 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?
The insured was in compliance with the policy requirements regarding claims.
Which of the following is NOT a feature of a guaranteed renewable provision?
The insurer can increase the policy premium on an individual basis.
Producers who broker insurance must file a bond along with the application for license. The bond must be issued in favor of the people of Illinois, and must be on a continuous form for an amount equal to 5% of the premium brokered the previous year, NOT to exceed
$50,000
L has a major medical policy with a $500 deductible and 80/20 coinsurance. L is hospitalized and sustains a $2,500 loss. What is the maximum amount that L will have to pay?
$900 (deductible + 20% of the bill after the deductible [20% of $2,000])
Within how many days may a person who is being examined by the Director for non financial business practices request a hearing after receiving the examination report?
10 days
A client has a new individual disability income policy with a 20-day probationary period and a 30-day elimination period. Ten days later, the client breaks their leg and is off work for 45 days. How many days of disability benefits will the policy pay?
15 days
The Patient Protection and Affordable Care Act mandates that insurers provide coverage for adult children of the insured up to the age of
26
Ray has an individual major medical policy that requires a coinsurance payment. Ray very rarely visits his physician and would prefer to pay the lowest premium possible. Which coinsurance arrangement would be best for Ray?
50/50
For what time period after the effective date of the policy can coverage be excluded on permissible pre-existing conditions applicable to a Medicare Supplement insurance policy?
6 months
Each Medicare supplement policy must be
?? Guaranteed renewable
Disclosure requirements for Medicare Supplements include all of the following EXCEPT
?? The advertisement may apply affiliation with the Medicare program.
Insurance policies are not drawn up through negotiations, and an insured has little to say about its provisions. What contract characteristic does this describe?
Adhesion
When the insured purchased his health policy he was a window washer. He has since changed occupations and now manages a library. If the insurer is notified of the insured's change of occupation, the insurer should
Adjust the benefit in accordance with the decreased risk.
Assuming that all of the following people are covered by a High Deductible Health Plan and are not claimed as dependents on anyone's tax returns, which would NOT be eligible for a Health Savings Account?
Amanda is 67 and is covered by a basic medical expense policy
All of the following would be considered rebating EXCEPT
An agent misrepresents policy benefits to convince policyowner to replace policies.
Which of the following best describes the aleatory nature of an insurance contract?
Exchange of unequal values
The requirement that producers must account for all insurance funds collected, and without the expressed consent of the insurance company are not permitted to commingle those funds with their own funds, is known as
Fiduciary responsibility.
How many pints of blood will be paid for by Medicare Supplement core benefits?
First 3
Which of the following criminal activities would warrant rejection, revocation, or suspension of an insurance producer's license?
Forgery
Which of the following is another name for a primary care physician in an HMO?
Gatekeeper
A new employee who meets HIPAA eligibility requirements must be issued health coverage on what basis?
Guaranteed
Most LTC plans have which of the following features?
Guaranteed renewability
An insurance company that routinely ignores all letters and phone calls from insureds that have filed claims is
Guilty of unfair claim settlement practice.
Which of the following statements is CORRECT concerning the relationship between Medicare and HMOs?
HMOs may pay for services not covered by Medicare
An insured becomes disabled at age 22 and can no longer work. She meets the definition of total disability under Social Security. What other requirement must the insured have met to receive Social Security disability benefits?
Have accumulated 6 work credits in the past 3 years
Before an agent delivers a policy, the insurer makes a last-minute change to the policy. The agent informs the insured of this change, and he accepts it. In response, the agent must
Have the insured sign a statement acknowledging that he is aware of the change.
A Health insurance policy lapses but is reinstated within an acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?
Immediately
Under the Accidental Death and Dismemberment (AD&D) coverage, what type of benefit will be paid to the beneficiary in the event of the insured's accidental death?
Income
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital?
Indemnity
The Patient Protection and Affordable Care Act includes all of the following provisions EXCEPT
Individual tax deduction for premiums paid.
Which of the following defines the term controlled business?
Insurance written on the interests of the producer who solicits a policy
Who is responsible for making sure that duplicate Medicare coverage is not being issued?
Insurer
This type of dental plan which is incorporated into a major medical expense plan is a/an
Integrated dental plan.
The mode of premium payment
Is defined as the frequency and the amount of the premium payment.
Which of the following statements is NOT true concerning Medicaid?
It consists of 3 parts: Part A: hospitalization, Part B: doctor's services, Part C: disability income.
Which of the following best describes the MIB?
It's a nonprofit organization that maintains underwriting information on applicants for life and health insurance.
What type of health insurance policy provides an employer with funds to train a replacement if a valued employee becomes disabled?
Key Person Disability
In a Disability Income policy, all of the following are considered presumptive disabilities EXCEPT
Loss of one eye.
Which of the following is NOT considered a misrepresentation as it pertains to unfair trade practices? - Stating that the insurance policy is a share of stock - Exaggerating the benefits provided in the policy - Stating that the competitors will arbitrarily increase their premiums each year - Making comparisons between different policies
Making comparisons between different policies
A nonresident licensed producer moves to Illinois and wants to obtain a license in this state. Which of the following is true regarding the licensing examination?
No examination will be required.
The Director suspends a producer's license. Which of the following occupations could the producer serve during the suspension?
None of the above
Which of the following would be an allowable reason for an insurer to cancel or non-renew a Medicare Supplement policy?
Nonpayment of the premium
Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss?
Notice of Claim
Long-term care partnership policies concern which of the following issues?
Nursing home expense payment
In long-term care insurance, what type of care is provided with intermediate care?
Occasional nursing or rehabilitative care
Which of the following applies to partial disability benefits?
Payment is limited to a certain period of time.
With respect to the Consideration Clause, which of the following would be considered consideration on the part of the applicant for insurance?
Payment of premium
According to the PPACA metal levels classification, if a health plan is expected to cover 90% of the cost of an average population, and the participants would cover the remaining 10%, what type of plan is that?
Platinum
A guaranteed renewable health insurance policy allows the
Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class.
Under standard circumstances, if a change occurs to a Medicare Supplement policy that reduces benefits, which of the following must occur?
Signature of the policyholder
In the event a licensed producer dies, a temporary license may be issued to the deceased producer's representative. This temporary license will allow the licensee to do all of the following EXCEPT
Solicit insurance.
Which of the following terms describes the specified dollar amount beyond which the insured no longer participates in the sharing of expenses?
Stop-loss limit
In order for a firm to maintain its registration as a legal insurance company, what must it do?
Submit a biennial fee to the Director
If the Director deems it so, why may an enrollee's HMO be cancelled?
The Director can cancel or nonrenew an HMO for any rules he/she establishes.
Which of the following protects consumers against the circulation of inaccurate or obsolete personal or financial information?
The Fair Credit Reporting Act
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?
The insured may carry over the amount of this year's expenses to next year, which will help satisfy next year's deductible.
Which of the following is NOT a feature of a noncancellable policy?
The insurer may terminate the contract only at renewal for certain conditions.
Which of the following is true regarding elimination periods and the cost of coverage?
The longer the elimination period, the lower the cost of coverage.
Which of the following will vary the length of the grace period in health insurance policies?
The mode of the premium payment
A group insurance policy was solicited by a limited insurance representative. Which of the following is true according to the disclosure regulation?
The representative's name and signature must appear on the master policy.
What is the purpose of coinsurance provisions?
To help the insurance company to prevent overutilization of the policy
Which of the following is NOT the purpose of HIPAA?
To provide immediate coverage to new employees who had been previously covered for 18 months
When an insurer issues an individual health insurance policy that is guaranteed renewable, the insurer agrees
To renew the policy until the insured has reached age 65.
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
Unearned premiums are retained by insurance company.
Manny has been injured in an accident. Although she is still receiving benefits from her policy, she does not have to pay premiums. Her policy includes
Waiver of Premium rider.
Which of the following determines whether disability insurance benefits are taxed?
Whether the premiums were tax deductible
