L&H Missed questions
Which of the following statements best describes the intent of a Coinsurance clause in a Major Medical policy? discourages overutilization of the insurance coverage minimizes the need for deductibles discourages adverse selection minimizes the waiting period
minimizes the need for deductibles
What should an insured do if the insurer does not send claims forms within the time period set forth in a health policy's Claims Forms provision? file lawsuit submit the claim in any form wait for the claim form to arrive resubmit the request for the claim form
SUBMIT THE CLAIM IN ANY FORM+
A BLANK life policy combines investment choices with a form of Term coverage
Variable Universal
LTC policies will usually pay for eligiable benefits using which of the following methods delayed fee for service expense incurred respite
expense incurred
a disability income policy that only the policyowner can terminate and which the rates willl never go up is
noncancellable
A short term medical expense policy is
nonrenewable ++++++
M completes an application for life insurance but does not pay the initial premium. All of these actions must occur before M's policy goes into effect EXCEPT policy is delivered free look period has expired insurance company issues policy initial premium is collected
free look period has expired
All the following regarding Tax Sheltered Annuity (TSA) are true except: income derivied from the TSA is received income tax-free TSA's are available to public school employees contributions to the TSA are tax deductable interest earned by TSA is tax deferred
income derivied from the TSA is received income tax-free
S buys a $50,000 whole life policy with a $50,000 Accidental Death and Dismemberment rider. S dies 1 year later of natural causes. How much will the insurer pay the beneficiary?
$50,000
XYZ Company pays the entire premium for its group health plan. The MINIMUM percentage of eligible employees that must be covered is
100%
T calls to file a claim on his health insurance policy. Within how many days must the insurer provide T's proof of loss forms?
15
When an employee's coverage terminates under a group health policy, the employee must be offered continuation coverage for how many months
18
An insured must notify an insurer of a medical claim within how many days after an accident?
20
A potential client, age 40, would like to purchase a Whole Life policy that will accumulate cash value at a faster rate in the early years of the policy. Which of these statements made by the producer would be correct?
20 pay life accumulates faster than straight line
All are true statements regarding the underwriting process except: Signed consent from the applicant must be provided in order to test for AIDS and HIV AIDS and HIV virus exams can be conducted in a discriminatory fashion The cost of any examination is paid for by the insurer the og app is the primary source of info used in the underwriting process
AIDS and HIV virus exams can be conducted in a discriminatory fashion
Which premium schedule results in the lowest cost to the policyowner?
Annual
Who is NOT required to sign a life insurance app
Beneficiary
Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this? GUARENTEED INSURABILITY ADDITIONAL COVERAGE PAID-UP OPTION EXTENDED INSURABILITY
GUARENTEED INSURABILITY
Which of the following statements regarding the Notice Regarding Replacement of Life insurance is correct: It is presented to the applicant only on request It must be presented to the applicant after the policy is issued A copy of the notice must be signed by the applicant and submitted with the application A copy of the notice must be reviewed and signed by both the policy applicant and beneficiary
A copy of the notice must be signed by the applicant and submitted with the application
A BLANK term life policy is normally used when converting an insured;s mortage balance
Decreasing
C is trying to determine whether to convert her convertible term life policy to whole life insurance using her original age or attained age. What factor would affect her decision the most?
The cost
When does a Probationary Period provision become effective in a health insurance contract? at the policys inception 30 days after the policys inception when a claim is submitted when a covered loss occurs
at the policys inception
what is licensing not required for
selling prepaid legal services
In order for coverage on a non-medical insurance application to take effect the same day, the producer must collect a signed application and a medical info report the initial premium forward it immediately to the insuerer attending physiscian statement
the initial premium
A producer must remit premiums to the insuerer within how many days after receipt
45
Credit life insurance is typically issued with which of the following types of coverage?
Decreasing Term
addtional coverage can be added to a whole life policy by adding a payor rider accelerated benefit rider decreasing term rider automatic premium loan rider
decreasing term rider
After an insured gets notice of loss, what must they do if the insuerer does not furnish forms file a law suit contact the insuerer again reqesting the forms nothing file written proof of loss
file written proof of loss
What is being delivered during a policy delivery? a binding receipt to the proposed insured insurance contract to the proposed application and initial premium to the insuerer policy summerary sheet and disclosure materials
insurance contract to the proposed insured
primary difference btw the colorado partnership LTC and other partnership policies is
medicaid asset protection
A annuity pays benefits based on units rather than stated dollar amounts
variable
T files a claim on his Accident and Health policy after being treated for an illness. The insurance company believes that T misrepresented his actual health on the initial insurance application and is, therefore, disputing the claim's validity. The provision that limits the time period during which the company may dispute a claim's validity is called INSURING TIME LIMIT ON CERTAIN DEFENSES GRACE PERIOD FREE LOOK
TIME LIMIT ON CERTAIN DEFENSES
How many hours does renewing a producer's license require of continued education every 2 years
24
An insurer that terminates a producer's appointment must inform the Commissioner within how many days?
30
An insured pays premiums on an annual basis for an individual health insurance policy. What is the MINIMUM number of days for the Grace Period provision?
31 days
P is an employee who quits her job and wants to convert her group health coverage to an individual policy. After the expiration of COBRA laws, which of the following statements is TRUE? She DOES need to provide evidence of insurability She does NOT need to provide evidence of insurability She will have up to 6 months to convert to an individual policy She will be paying exactly the same premium for the individual plan as she does for the group plan
She DOES need to provide evidence of insurability
all of these statements about equity indexed life insurance are correct except: Cash value has a min rate of accumulation If the gain on the index goes beyond the policy's min, rate of return the cash value will mirror that of the index The premiums can be lowered or raised based on investment performance Tied to equity index such as the S&P 500
The premiums can be lowered or raised based on investment performance
which of the following is the reimbusrment of benfits for the treament of a benficiary's injuries caused by a third party indemnity subrogation legal action consideration
subrogation
M's insurance company denied a reinstatement application for her lapsed health insurance policy. The company did not notify M of this denial. How many days from the reinstatement application date does the insurance company have to notify M of the denial before the policy will be automatically placed back in force?
45 days
A Disability income policyowner recently submitted a claim for a chronic neck problem that has resulted in total disability. the og neck injury occurred before the app was taken 5 years prior. The neck injury was never disclosed to the insuerer at the time of application. What wil happen
Claim will be paid and coverage will remain in force bc after a policy has been in force for 2 -3 years, it enters the incontestable period so the claim can;t be denied based on the info not disclosed
F needs life insurance that provides coverage for only a limited amount of time with a death benefit that changes regularly according to a schedule. What kind of policy is needed?
Decreasing Term Policy
An employee requested that the balance of her 401(k) account be sent directly to her in one lump sum. Upon receipt of the distribution, she immediately has the funds rolled over into an IRA. What is the tax consequence of the distribution sent to this employee? Distribution is subject to capital gains tax Distribution is subject to ordinary income tax Distribution is subject to tax penalty Distribution is subject to federal income tax withholding
Distribution is subject to federal income tax withholding
the federal income tax treatment of employer-provided group medical expense insurance can be described as Employees coverage paid for by the employer is considered taxable income to the employee Employees premiums paid by the employer is a tax deductible to the employer as a business expenditure Employer is given tax credits for contributions made to an employer provided group health plan Benefits are taxable to the employee
Employees premiums paid by the employer is a tax deductible to the employer as a business expenditure
T has Disability Income policy that pays a monthly benefit of $5000. If T becomes partially disabled, what can he likely expect?
Less than 5000 per month benefit regardless of the cause
T has an annuity that guarantees an income payment for the rest of his life. The contract also guarantees that if T dies before receiving payments for 20 years, the remaining payments will be paid to his son for the balance of the 20 years. What type of annuity is this?
Life Annuity with Period Certain
CHARACTERISTIC OF A CONDITIONALLY RENEWABLE HEALTH INSURANCE POLICY premiums may increase at time of renewal premiums may increase at any time policy may be renmed at the discretion of the insured policy may be amended by the insurer at any time
MAY INCREASE AT ANY TIME
According to the Time Payment of Claims provision, the insurer must pay Disability Income benefits no less frequently than which of the following options? anually semiannually quarterly monthly
MONTHLY
G is involved in an automobile accident as a result of driving while intoxicated and suffers numerous injuries. According to the Intoxicants and Narcotics exclusion in G's policy, who is responsible for paying the medical bills?
The insured
Which type of life policy contains a monthly mortality charge as well as self-directed investment choices?
Variable universal life
The provision in a Group Health policy that allows the insurer to postpone coverage for a covered illness 30 days after the policy's effective date is referred to as the
Waiting period
A reimbursement policy pays what amount of covered LTC expenses all expenses regardless of policy limits actual covered expenses up to the daily max a daily dollar amount regardless of the actual incurred expenses the usual, customary, and resonable expenses regardless of the policy limits
actual covered expenses up to the daily max
in health insurance policies a wavier of premium provision keeps the coverage in force without premium payments whenever an insured is unable to work during the time an insured is confinded in a hospital following an accidental injury, bur not during sickness after an insured has become totally disabled as defined in the policy
after an insured has become totally disabled as defined in the policy
Which of the following is NOT required to be disclosed to an applicant for health insurance standard compensation schedule for the product being sold any change to the standard compensation any contingient compensation received the insurance producer will receive a commission from the carrier
any contingient compensation received
When does a Guaranteed Insurability Rider allow the insured to buy additional coverage? 10 year increments at future dates specified in the contract with proof of insurability required at future dates specified in the contract with no evidence of insurability required at any time when the policy is active
at future dates specified in the contract with no evidence of insurability required
all of the following statements about major medical benefits are true EXCEPT the deductible can be expressed as a fixed dollar amount the benefit period begins only after a specified amount of expenses have accrued benefits are generally expressed as a percentage of eligible expenses benefits have no maximum limit
benefits have no maximum limit
M applies for health insurance policy and pays the inital premium. When the agent completes the app, a conditional receipt is left with the applicant. The insurance company's underwriting department requests M's medical records and determines that M has had asthma for many years. What is not a probable underwriting outcome deny coverage approve with higher premium changing the policy's provisions attach a rider exlcuding specified coverages
changing the policy's provisions
The situation which a group of physicians are salared employees and conduct business in an HMO facility is called closed panel open panel co-op panel capitation panel
closed panel
Which of the following policy provisions prohibits an insurance company from incorporating external documents into an insurance policy waiver exceptions and reductions incontestable entire contract
entire contract
Which is not included in the policy face free look provision name of the insured name of the insurer exclusions
exclusions
Taking receipt of premiums and holding them for the insurance company is an example of
fiduciary responsibility
a life insurance arangement which circumvents insurable interest statues is called a contract of adhesion a indemnity contract key person insurance investor-orginated life insurance
investor-orginated life insurance
When does coverage begin if a producer completes an insurance application, collects the initial premium, and issues the appropriate receipt
it's contingent upon the insuerer's underwriting policies
In Major Medical Expense policies what is the objective of a stop loss provision
limits an insuered out of pocket medical expenses
Which of these is an element of a single premium annuity: deferred payment lump-sum payment fixed income tax-deductible
lump-sum payment
WHich of these statements concerning an individual disability income policy is true : premiums are normally tax-deductible age of the insured determines the amount of the benefits normally includes an elimination period benefits are normally taxable
normally includes an elimination period
Which of the following coverage exclusions or limitations is permitted under a LTC policy issued in colorado preexisting conditions alzheimiers senile dementia parkinsons
preexisting conditions
Which of the following statements about guarenteed renewable health insurance policy is CORRECT premiums normally decrease at time of renewal premiums normally increase at time of renewal policy can renewed at any time by the company policy can be cancelled at any time by the company
premiums normally increase at time of renewal
which of the following best describes how pre admin certs are used assist in underwriting prevent nonessential medical costs min hospital lawsuits help process claims
prevent nonessential medical costs
Which of the following is required for a life insurance lapse notice noticed mailed to policyowner within 10 days notice mailed to policyowner within 30 days automatic premium loan explanation reason stated why the policy will lapse
reason stated why the policy will lapse
J let her life insurance policy lapse 8 months ago due to nonpayment. She can reestablish coverage under which of the following provisions? Payor clause automatic premium loan provision reinstatement provision waiver of premium
reinstatement provision
Which provision allows a portion of any used medical benefits to be restored following a particular amount of benefit has been used, or after the policy has been in effect for a particular period of time reimbursement benefit restoration of unused benefit restoration of used benefit medical offset benefit
restoration of used benefit
J, an Accidental Death and Dismemberment (AD&D) policy holder, dies after injuries sustained in an accident. J's age as stated on the application five years ago was found to be understated by ten years. Which of the following actions will the insurance company take? the insurer will pay the og benefit stated in the policy the insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age the insurer will pay the Og face amount minus any premium deficencies owed the insurer will deny the claim and refund the premiums paid
the insurer will adjust the benefit to what the premiums paid would have purchased at the insured's actual age
A license is deemed to be used for a controlled business if, during any 12 month period
the license's total premiums on controlled business exceeded the total premiums on all other business
the policy provision that entitles the insuerer to establish conditions the insured must meet while a claim is pending is grace period physical exam entire contract time limit on certain defenses
time limit on certain defenses
Which of these types of life insurance allows the policyowner to have level premiums and to also choose from a selection of investment options? Modified Whole life Variable life universal life adjustable life
variable life
Upon request, in how many business days must the Colorado Supplement to the Summary of Benefits and Coverage form be provided
within 7 business days