Life & Health exam MI
How is an individual disability income insurance benefits & premiums taxed?
Premiums are NOT tax deductible and benefits are not taxable
Dismemberment and total blindness will automatically qualify the insured for disability benefits. Which disability policy provision does this describe?
Presumptive disability
She must a LTC shoppers guide be presented
Prior to the time of application
prospective review
precertification
Benefits for a group disability plan are based on what?
% of income
What are the 3 basic goals of risk retention
1) reduce expenses and increase cash flow 2) to increase control of claim reserving and claim settlements 3) fund losses that can't be insured
If an insurer wishes to appoint a producer, it must file a notice within how many days of the date the co tract was issued?
15days
Every small carrier must actively offer to small employers at least how many benefit plans?
2
What is the max age for qualifying for a catastrophic plan
30
Employer health plans provide coverage to those with end-stage renal failure for how many months before Medicare becomes primary?
30 months
There is little or no medical information required regarding plan participants in group of?
50 or more
What is partial disability
50% of the total disability benefit & limited to a certain time period
Recent residences of MI who hold a license must apply within how many days of establishing legal residency?
90 days
Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within
90 days of a loss
Benefits for an individual disability plan is based on what?
A flat amount
Installments for a fixed amount option means what?
A specific amount of benefits are paid until funds are exhausted, whether or not annuitant is living.
What LTC benefit would provide coverage for functionally impaired adults on a less than 24-hour basis?
Adult day care
When is an "offer" made in insurance
Applicant submits application to insurer
What is the primary source of information used for insurance underwritting
Application
In a replacement situation what must be considered
Benefits, limitations & exclusions. NOT Assets
How is the guaranty association funded?
By its member- authorized users
What is an important feature of dental insurance that is not typically seen in a medical insurance plan?
Diagnostic and preventative care
What is not applied toward the deductible in a nonscheduled plan?
Diagnostic and preventative care
When a term nonforfeiture option is selected, the CV is used to purchase term insurance with what face amount?
Equal to the original policy for as long as the CV will purchase
Which rider, when attached to a permanent life insurance policy, provides an amount of insurance on every family member?
Family term rider
What allows periodic additions to the face amount at standard rates without proving insurability
Guaranteed insurability rider
Which type of policy pays a fixed amount each day the insured is in the hospital?
Indemnity
An underwriter may obtain information on an applicants hobbies, financial status and habits by ordering what?
Inspection report
The provision which prevents the insured from bringing any legal action to the company for at least 60 days is known as what?
Legal actions
Waiver of Cost of Insurance
Life insurance rider that allows a universal life policyowner who becomes disabled to waive the cost of death protection but does not waive the cost of premium required to build cash value.
What would provide the underwriter with information concerning an applicants health history?
Medical information bureau
Are short-term disability plans renewable?
No
Can a retired person age 50 qualify for Medicare?
No
Under HIPPA, if an individual was previously covered by group health insurance for 6 months will they meet the requirement for conversion to an individual policy
No, HIPPA requires have previous continuous creditable health coverage for at least 18 months.
Which organization contract on fee-for-fee service basis?
PPO
Apparent Authority is also called?
Perceived Authority
What is the Taft-Hartley Act?
Prohibits employers from making direct contributions to unions for employee benefits, but allows employee contributions to be paid to separate benefit trust managed by the union
The paid-up addition option uses the dividend to do what?
Purchase a smaller amount of the same time of insurance as the original policy
A firm with 2-50 employees is classified as what?
Small employer
If agent X tells a customer her new policy requires lower premiums, even though the premium amounts are the same. What happens to agent?
Suspension of license
Which act amended the National Labor Relations Act?
Taft-Hartley
How will the life insurance potion or death benefit payable on an AD&D policy be taxed
Tax free
Who does not regulate variable life policies?
The Guaranty Association
What is reciprocal
The insureds are sharing risk of loss with other subscribers that are reciprocal
what is a captive/exclusive agent
an individual who has agreed, by contract, to produce insurance business only for the insurer they are contracted with.
An adjustable life policyowner can change what about their policy
coverage period, increase or decrease of premiums, premium pay period, period protection or increasing or decreasing face amount
What are examples of risk retention?
deductibles, copayments, and self-insurance
Specified coverage
limit coverage to one illness or one limiting group of coverages. i.e. Cancer policies, heart disease, dental plans.
Concealment
withholding information that will influence the result of an underwritting decision
