Life and health insurance
To sell variable life insurance policies an agent must have what?
Agent selling variable life products must be registered with Tinerra, have a securities license, and must be licensed within the state to sell life insurance. SEC registration is for securities, not aegi agents
Business continuation arrangement
In a business continuation arrangement the partners of a business can buy shares belonging to recently deceased or disabled partner.
What type of policy contains a coverage that is only activated upon the insured's losses reaching a certain level?
Modified coverage In a partially funded plan, coverage is only activated upon the insured's losses reaching a certain level. It may take the form of a maximum aggregate limit payable or a maximum limit payable for any one event.
Which policy is referred to as the "second to die" policy
Survivorship
Our insurers allowed to reduce the premium is paid by employers for group insurance based on loss experience?
Yes insurers are permitted to lower the premiums of employers group insurance because of lost experience. This is called experience rating.
In which of the following locations would skilled care most likely be provided? A. An institutional setting B. At the patient's home C. In an outpatient setting D. At a physicians office
A. Skilled nursing care is performed under the direction of a physician, usually in an institutional setting
In reference to the standard Medicare supplement benefits plans, what does the term standard mean?
All providers will have the same coverage options and conditions for each plan
When are insurers required to file a statement with the superintendent?
Annually on or before March 1 Each entity must file a statement with the superintendent annually or on before March 1
Which type of Asian authority is also called perceived authority?
Apparent Apparent authority is the appearance or the assumption of authority based on the actions, words, or deeds of the principle or because of circumstances the principal created.
Which statement regarding insurable risk is not correct? A. An insurable risk must involve a loss that is definite as to cause, time, place and amount B. Insurance cannot be randomly selected C. Insurance cannot be mandatory D. The insurable risk needs to be statistically predictable
B. Granting insurance must not be mandatory selecting insured's randomly will help the ensure have a fair proportion of good risks support risks all other statements are true
All of the following statements are true regarding installments for a fixed period Annuity settlement option except A. The insured determines the amount for each payment B. It is a life contingency option. C. It will pay the benefit only for a designated period of time D. The payments are not guaranteed for life
B. Under the installments for a fixed period Annuity settlement option, the annuitant selects the time period for the benefits. The insured determines how much each payment will be. This option pays for a specific amount of time only, and there are no life contingencies
What insurance concept is associated with the names Waze and Fitch?
Guides describing company financial integrity Because an insurance company strength and stability are two very crucial factors and it's sustainability, independent reading services performed to publish regular updates on the financial integrity of different insurance companies. Waze and Fitch or two of these services, although there are more.
What are the two types of flexible spending accounts?
Healthcare accounts and dependent care accounts A healthcare account is for out of pocket health care expenses and a dependent care account helps pay for dependent care expenses which make it possible for an employee and his or her spouse if applicable to work
A rider attached to a life insurance policy that gives coverage on the insured's family members is called a...
Other insured rider
And insured states her age is 40 on the application when she dies the insurer discovers that she was actually only 37 at the time of application what will the insurance company do?
Pay the death benefit in the amount that the premium at the correct age would've been. If the applicant has missed stated his or her age on the application the insured in the event of a claim is allowed to adjust the benefits to an amount that the premium at the correct age would have otherwise purchased. If the insured has overstated his or her age, the insurer will pay the full death benefit and refund the excess premiums paid.
If an individual is covered by a policy that includes an accidental death and dismemberment rider what term describes the maximum benefits you will receive if he loses sight in both eyes as a result of a fire?
Principal some If the insured dies, the insurer pays the full amount, also known as the principal sum. Principal sum will most likely be paid out if the insured loses sight in both eyes or loses two limbs. If the insured lives but loses a hand or foot or the sight in one eye, the insured will be paid a percentage of the principal sum, called the capital sum.
Under which provision can a physician submit claim information prior to providing treatment?
Prospective review Under the perspective review or precertification provision, the physician can submit claim information prior to providing treatment to know in advance if the procedure is covered under the insurance plan and I would rate it will be paid
Regarding cost containment in medical plans what type of review process to employers and ensures used to evaluate the utilization review process and effectiveness of the professionals involved in large insurance claims?
Retrospective review
When a group disability insurance policy is paid entirely by the employer, benefits paid to disabled employees are....
Taxable income to the employee Disability benefit payments That are attributed to employee contributions are not taxable, but benefits payments that are attributed to employer contributions are taxable
What is business of life settlement?
The term business of life settlement refers to any activity relating to the solicitation and sale of an insurance policy to a third-party who has no insurable interest in the insured
According to the proof of loss provision, which of the following must be specified in the contract that provides disability benefits?
When and how and insured may prove a loss
An employee insured under a group health plan has been paying $25 monthly premium for his group health coverage. The employer has been contributing $75 for the total monthly cost of $100. If the employee leaves the company, what would be his maximum monthly premium for cobra coverage?
$102 The employer is permitted to collect a premium from the terminated employee at a rate of no more than 102% of the individuals group premium rate. In this scenario, 102% of $100 total premium is $102. The 2% charge is to cover the employers administrative costs.
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. It is an unfair trade practice to make any statement that an insurer's policies are guaranteed by the existence of the insurance guaranty Association. Though it is illegal to advertise, the statement is still true and would not be considered a misrepresentation.
Which policy has the least expensive first year premium?
Annually renewable term Annually renewable term is the purest form of term insurance. The death benefit remains level, but the premium increases each year with the insured's attained age. In decreasing policies, while the face amount increases, the premium remains constant throughout the life of the contracts. And level term and increasing term policies, the premium also remains level for the term of the policy. Therefore, in the other types of level policies, the first year premium would not be different from any other year.
A 70-year-old individual who bought a part B Medicare policy two months ago just begin kidney dialysis treatment this week. The individual is now applying for a Medicare supplement policy, which would begin in eight months. Which of the following to the insurer do to avoid paying for the dialysis? A. Deny the supplement policy B. Charge a higher premium C. Declare a pre-existing condition D. Permanently exclude coverage for dialysis
C. If an applicant is age 65 or greater and apply for Medicare supplement coverage while covered under part B Medicare insurance, and ensure cannot alter the price of coverage based on prior claims experience or health status, provided that the application was made during the first six months of part B coverage. The insurer may, however, exclude benefits during the first six months based upon a pre-existing condition for which the policyholder received treatment during the six months before it became effective
And insured has medical insurance coverage through two different providers, both covering the same expenses on an expense incurred basis. Neither company knows in advance that the insured has coverage through any other insurers. The insured submit a claim to both insurers. How should the claim be handled?
Each insurance should pay a proportionate share of the claim (In the event that an insured is covered on an expense incurred basis for the same expenses under multiple insurers and the insurers are not informed about the other sources of coverage before the loss, proportionate shares of the claims should be paid)
True or false the convertibility option under a term life insurance policy allows the death benefit of the permanent policy to be reduced by 50% upon conversion
Falls Convertible term insurance is convertible without proof of insurability up to the full-term death benefit. However, upon conversion, the premium for the permanent policy will be based on the insured's attained age.
True or false money borrowed from the cash value of the policy is taxable
False Money borrowed from the cash value is not taxable. Policy loans can be repaid at any time including surrender death. And insured can charge interest on outstanding policy loans
To be eligible under HIPAA regulations for how long should it individual converting to an individual health plan I've been covered under the previous group plan?
18 months. Under HIPAA regulations, to be eligible to convert health insurance coverage from a group plan to an individual policy the insured must have 18 months of continuous creditable health coverage
What is the penalty tax for non-qualified distributions from a health savings account?
20% and HSAuser who uses the money for a non-health expenditure pays tax on it plus a 20% penalty
How long does a licensee have to notify the superintendent of a change of address?
30 days
Which of the following does not have to be disclosed on a long-term care policy? A. The aggregate amount of premiums due B. The meaning of terms reasonable and customary C. Any limitations or conditions of eligibility for LTC benefits D. Any riders or endorsements
A All LTC policies must disclose and explain the renewability provisions. with regard to life insurance policies that provide an accelerated benefit for long-term care, the policy must include a statement to the effect that receipt of the accelerated benefits may be taxable, and the insured should seek assistance from a personal tax advisor.
A hospital indemnity policy will pay...
A benefit for each day the insured is in a hospital. Hospital confinement indemnity policies pay specific amounts that depend on the amount of time insured is confined to the hospital
What is the benefit of choosing extended term as a nonforfeiture option?
It has the highest amount of insurance protection Under this option the insurer uses the policy cash value to convert to term insurance for the same face amount as the former permanent policy. The duration of the new term coverage lasts for as lob's as a period as the amount of cash value will purchase
An individual applied for an insurance policy and pay the initial premium. The insurer issued a conditional receipt. Five days later the applicant had to submit to a medical exam. If the policy is issued, what would be the policies effective date?
The date of medical exam If the company acknowledges receipt of the premium with a conditional receipt, the policy is in effect on the date of the application or the date of the medical exam which ever is later, provided that the applicant is found insurable at the rate applied for.
True or false when talking about group disability income insurance coverage applies both on and off the job
Falls Employees were injured on the job or covered by workers compensation insurance. Good disability income insurance is designed to cover employees only while they are off the job, so the coverage is considered to be non-occupational in nature.
All of the following our business uses of life insurance except A. Funding business continuation agreements B. Funding against companies general financial loss C. Compensating executives D. Funding against financial loss caused by the death of a key employee
B. Both life and health insurance can be used for a variety of purposes in a business setting, including the funding of business continuation agreements, compensating Executives, and protecting the firm against financial loss resulting from the death or disability of key employees.
True or false when determining the value of an individual's life need is predicted using the number of years until the insured's retirement
False In the needs approach method, need is determined by the predicted needs of the family after the premature death of the insured, which must be assumed will happen immediately. The policy allows for benefits to be collected upon the insured's death.
What policy allows the insured to relieve A minor insured from premium payments if the minors parents have died or become disabled?
Payor benefit If the payor becomes disabled for at least six months or dies, the insurer will waive the premiums until the minor reaches a certain age, such as 21
Who is eligible for coverage on the health insurance marketplace?
To be eligible for health coverage on the market please the individual must be a US citizen or national or be lawfully present in the United States, must live in the United States, and cannot be currently incarcerated. Medicare recipients are not eligible for coverage in the marketplace.
What is the purpose of a managed care health insurance plan?
To control health insurance claims expenses Managed-care is a system of delivering healthcare and healthcare services, characterized by arrangements with selected providers, programs of ongoing quality control and utilization review and financial incentives for members to use providers and procedures covered by the plan
Which type of life insurance policy allows the policy owner to pay more or less than the plan premium?
Universal life (The policy owner has the flexibility to increase the amount of premium going into the policy and to later decrease it again. In fact, the policy owner may even skip paying a premium and the policy will not lapse as long as there's sufficient cash value at the time to compensate for the nonpayment of premium)
When applying for an individual life insurance policy, an applicant states that he went to the doctor for nausea but fails to mention that he was also having severe chest pains this is an example of....
Concealment. Concealment occurs when a person withholds a material fact that is crucial to making a decision. In insurance, this involves withholding information that would be crucial to underwriting decisions.