Insurance

Written Instrument in which a contract is set forth

- Policy 58% :(

How many parts does Medicare have

4 A-D

Contracts prepared by one for a take-it-or-leave-it

CONTRACTS OF ADHESION

Moral

Conceal Health information on a contract

What groups make up MIB (medical information bureau) -

Insurers

Insurance Protects against

LOSS

Property being insured

Statement of insurable interest Etc

Organization company designed to return profits

Stock Company

In forming an insurance contract, when does an acceptance usually occur?

When the insurer approves a prepaid application

Pure Risk -

loss or stays the same

Adverse Selection

poor risks

Reciprocal -

when insurance is obtained through a reciprocal insurer, the insureds are sharing the risk of loss with other subscribers of that reciprocal

When does acceptance occur? -

when insurer's underwriter approves coverage

When must policy summary for a life insurancee o policy be be delivered

- at the time of policy delivery

What condition may a policy owner transfer their personal insurance policy to another

-written consent of the insurer -life you must provide notice of the transfer

3 Types of Hazards

1. Physical 2. Moral 3. And Morale

4 Elements of an Insruance Contract

1Agreement 2Consideration3Competent Parties 4Legal Purpose

What are the three Types Agent Authority

1Express 2Implied 3Apparent

Adverse Selection Prevention

1Restriction of Coverage 2Refusal to accept risk 3Accept risk at higher rate

First-year commission on a medicare supplement policy may not exceed

200% of the 2nd year commission on the same policy

Misrepresentation violation can include

25k, imprisonment in county jail for a pierod no longer than 1 year, or both, also suspension of license for 3 years

Elimination period -

30 days not eligible for benefits

Elimination period for SS -

5 months

An employee will be taxed on the cost of group life if exceeds

50k

How many spice rate requirements should an insurance policy have?

6

Affordable Care Act, specially enrollment period allows individual to enroll in qualified plan how man days

60

Graace period durrations

7 days if paid weekly, 10 days if monthly and 31 all other models

Accidental death ben if happens in -

90 days

OFFER IS USUALLY MADE WHEN

AN APPLICANT SUBMITS AN APPLICATION TO THE INSURER

Principal is represented by

Agent or Producer

Examples of risk retention are

Copayments Self-insurance Deductibles

NOT fundable by annuities

Death Ben

Moral Hazard -

Dishonesty

Five characteristics of an ideally insurable risk?

Due to chance Definite and measurable Statistically predictable Not Catastrophic Coverage cannot be mandatory

What kind of policy does not typically require proof of insurability?

Group Insurance,

Legal Hazard -

Individuals file lawsuit and claim tremendous amounts for alleged damages

Medicare Part A will pay for what type of services?

Inpatient hospital care, skilled ursing facility care, home health care and hospice

Pure Risk

Insurable

What two elements are necessary for a life insurance e contract to have a legal purpose

Insurance interest and consent

When is misrepresentation fraud

Intentional and material

Insurance company looking to return profits -

Mtual Company

Paid out one year and not the next, what type of company

Mutual

what part medicare will cover lab services

Part B

what part of midecare is medical insurance

Part B

Who is offered part B medicare

Part B is optional to everyone in part A

Profitable Distribuition of Exposures -

Poor risks are balanced with preferred risks, and average risks are in the middle

When does insurance policy go into effect

When teh policy is delivered and the premium is paid

In insurance when is the offer usually made on a contract?

When the insurnace application is submitted

An insurer is accepted an permitted to work -

admitted or authorized

no-loss/no-gain provision allowed and not allowed -

allowed; insurance with other insurers, payment of claims, free look/right of rescission. NOT ALLOWED; pre-existing conditions

Warrant -

an absolutely true statement upon which teh validity of the insurance contract is based

Employer contributions made to a qualified plan -

are subject to vesting requirements

How is the amount of SS disability benefits calculated

based upon the worker's Primary Insruance Amount (PIA), calculated from their Average Indexed Montly Earnings over their highest 35 years

PPACA metal levels of classification

bronze level benefit 60%, silver 70% gold 80% plat 90%

how is part B medicare funded

by monthly premiums and frm the general rev of the fed gov

Insured receives an annual life insurance dividend check, what term best describes this arrangement

cash option

Peril -

cause of loss insured against in an insurance policy, causing the loss ie tornado

Reduction -

change in lifestyle and habit would likely reduce the chances of helath problems

Hazard

conditions or situations that increase probability of an insured loss occurring

Hazards -

conditions such as lifestyle and existing health, activities such as scuba diving

A hospital indemnity policy will pay

confinement indemnity policies pay specific amounts that depend on the amount of time the insured is confined to the hospital

Aleatory contract -

contact which unequal amounts or value are exchanged

NOT legitimate use of annuities by business —

creating tax shelter

True about credit life insurance -

creditor is policyowner \

"First-dollar coverage" -

do not require the insured to pa a deductible

Certificate of Authority -

doc required for an insurance company to transact insurance?

Fact about Debtor

doesn't have insurable interest on the creditor

Double Indemnity

double the face amount of insurance policy due to death

Moral Hazard -

driving recklessly, arise from state of mind that causes indifference to loss, such as carelessness

What are the beenfits part C

expanded benefits for a fee through private insurnace programs such as HMO's or PPOs

Medicare supplement plan must have at least

guaranteed renewable

Skilled care -

in an institutional setting, under direction of physician

Policyowner must have an insurable interest

in the insured

If a Medicare insured uses a non-participating in Medicare physician, he or she may be asked to sign a private contract; these things will happen

insured will have to pay watever the provider charges for the services, medicare limiting charges will not apply, no claims submitted to medicare, and medicare will not pay if one is submitted

Back injury, disabled for a year, insurance carries diability income benefit rider, which of the following best fits will he receive -

monthly premium waiver and monthly income; Disability Income Benefit rider waives the policy premiums, just like the waiver of premium rider. Unlike the waiver of premium rider, it also allows the insured to receive a weekly or monthly income during the disability period

CONVERTIBILITY OPTION UNDER TERM LIFE INSURANCE POLICY -

most term policies contain a convertiblity option, upon conversion, the premium for the permanent policy will be based upon attained age, evidence of insurability is not required

Morale Hazard -

not locking doors

Business continuation plan -

one business partner becomes disabled or die, other purchase interst of deceased or disabled \

what is another name for meidcare advantage plan

part C

What do HMO's provide

pateint care, financing, services

Who must have insurable interest in the insured? -

policy Owner

Indemnity -

principle stipulates that the insured can only collect for the amount of the loss even if the policy is written with greater benefit limits Allow for greater compensation than the financial loss incurred

The price of insurance for each exposure unit is known as —

rate

What is not covered/insured

replacement

Variable annuities -

require SEC and securities license

In case of a loss, indemnity provision

restores an insured person to the same financial state as before the loss; indemnity aka reimbursement

Legal hazard -

set of legal or regulatory conditions that affect an insurere's ability to collect premiums commensurate with the level of risk incurred

Is considered risk

sharing arrangement

STOLI

stanger-originated life insurance, people who have no relationship with the insured with the intention of selling them for life settlements

When a client replaces an existing LTC or Medicare Supplement insurance policy wit another from the same company CA law requires that

the agent must advise the client about HICAP and its services

When must insurable interest exist in a life insurance policy?

time of app