Life and Health part 2.
An insured decided to surrender his Whole Life insurance policy. The cash value at surrender is higher than the premiums paid into the policy, due to interest. What part of the surrender value would be income taxable?
The difference between the premiums paid and the cash value
All of the following are features of a health insurance plan purchased on the health insurance marketplace EXCEPT
Dollar limits on essential benefits
Which of the following could reduce the amount of the death benefit?
Failure to repay a policy loan
All of the following statements are true regarding an Ordinary (Straight) Life policy EXCEPT
It does not have a guaranteed death benefit
All of the following are true of the Survivorship Life policy EXCEPT
The premium is based on the age of each insured
Who determines if a particular group of employees can be excluded from group health coverage?
The employer
Which of the following statements in INCORRECT?
Medicare and Medigap policies provide coverage for long-term custodial or nursing home care
All of the following are true of credit life EXCEPT
The insured names the beneficiary
To qualify for disability income benefits under Social Security, an individual's disability must be expected to result in death or last for at least
12 months
An agent's first-year commission CANNOT exceed what percentage of the renewal commission for servicing a Medicare Supplement policy in its second year?
200%
All of the following are benefits that must be provided by core policies issued by the New York Partnership for Long-Term Care EXCEPT
Inflation protection option of 10% compounded annually
What does the Guaranty Association guard against?
Insurer insolvency
Which of the following is permissible reason for an insurance company to contest payment of a claim based on statements in the applicantion?
The application contains material misstatements
Which of the following is true regarding pure life annuity settlement option?
It provides the highest monthly benefit
The Omnibus Budget Reconciliation Act of 1990 requires
Larger group health plans must provide primary coverage for disabled individuals under age 65 who are not retired
All of the following could qualify as a group for the purpose of purchasing group health insurance EXCEPT
An association of 35 people
An elimination (waiting) period may NOT have to be satisfied for a disability in which of the following?
An insured suffers a relapse of a prior disability within 6-months of the initial covered disability
Regarding the consideration clause, which of the following is NOT correct?
Consideration of the insurer and insured must be equal
What is the purpose of the gatekeeper in HMO?
Controlling costs
Darryl is involved in an automobile accident with another motorist. Darryl was at fault. Darryl was injured and hospitalized for 2 months. The other motorist suffered $15,000 of medical expenses as a result of the accident. Darryl's disability income policy will pay
Darryl's loss of income
Which of the following is NOT correct concerning taxation of disability income benefits?
If paid by the individual, the premiums are tax deductible
Which of the following is TRUE of level term insurance?
It is temporary protection
Which of the following best describes pure life annuity?
It provides the highest monthly benefits
Medicare Part B covers all of the following EXCEPT
Long-term care services
An insured falls down a flight of stairs and sustains a neck injury that renders him severely disabled. The insured owns a Whole Life policy. Is it possible for the policy to include a Wavier of Cost of Insurance rider, and if so, what insurance costs would be wavied?
No; it is not possible for this waiver to be included in a whole life policy
Dividends received on participating life insurance policies are
Not taxable because they are a return of unused premiums
When the owner of a participating whole life policy uses the dividend to provide more life insurance coverage, which of the following dividend options is being used?
Paid-up additions
Which of the following is NOT a characteristic of Managed Care Plan?
Risk retention
With respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy
Only the executive officer of the company
What is the cost of coverage based on for group life insurance?
The average age and the ration of men to women
In a life insurance application, all of the following signatures will be required EXCEPT
The home office underwriter
Underwritters use all of these methods to protect the insurer against adverse selection EXCEPT
Only accepting a small number of applicants
A stock insurer is defined as an insurer
Owned be its stockholders
Which of the following would NOT be eligible for coverage under key person?
The owner of a shop
A life settlement broker represents
The policyower
An insured driver is involved in an accident in which he is disabled and his passenger and the other driver are injured. Which of the following will be covered by his disability income policy?
His lost income
When a whole life policy is surrendered for its nonforfeiture value, what is the automatic option?
Extended term
If a person, firm, association or corporation conducts insurance business in New York without a certificate of authority the penalty for the first violation is
$1,000
In the state of New York, how is "Outline of Coverage" referred to?
Disclosure Form
A married couple wants to include the entire family in their whole life policy under one rider. Which of the following riders will help them achieve that goal
Family term
All of the following are features of catastrophic plans EXCEPT
High premiums
In group insurance, the primary purpose of the Coordination of Benefits provision is to
Prevent overinsurance
An individual was denied coverage under Social Security because his disability did not meet the strict definition of total disability used by Social Security. Which of the following would provide disability income coverage?
SIS rider
According to the "Common Disaster" clause, if the insured and primary beneficiary are killed in the same accident and it cannot be determined who died first, which of the following will be assumed?
The primary beneficiary died before the insured
If any authorized entity fails to file an annual financial solvency statement, or does not reply to a written inquiry within 30 days, they are subject to a penalty of up to
$250 per day of delay, not to exceed an aggregate of $25,000 for each failure
A whole life policy is surrendered for a reduced-paid up policy. The cash value in the new policy will
Continue to increase
Which of the following is NOT true regarding a deferred annuity?
Income payments begin within 1 year from the date of purchase
Regarding the PPACA health care tax credit, which of the following is true?
Persons receiving Medicaid are not eligible
As required by the Affordable Care Act, employers must provide minimum value plan that covers what minimum percentage of the participant's expected health care costs?
60%
How much of a business must an employee own at any time in the year to be considered a "highly-compensated employee"?
5%
If a person qualifies for Social Security disability benefits after the 5 month elimination period, when will benefits begin?
Benefits begin at the beginning of the 6th month and are not retroactive to the beginning of the disability
In a deferred annuity, the difference between the accumulation value and the surrender value is the
Surrender charge
What is the exclusion ration used to determine?
The annuity benefit to be excluded from taxes
In group health insurance, what is experience rating?
When an insurer uses the experience of the group as a whole to determine the premiums
Which of the following is NOT a crucial factor in health insurance underwritting?
Income
If an agent follows the rules and terms of his agent contract, he is exercising his
Express authority
What is another term for health insurance policy subscriber?
Participant
A life producer applying for a life settlement broker license may be exempt from the prelicensing education and examination requirement if the producer has held an active life license for at least how many years?
1 year
Which of the following is NOT a format for marketing Long-Term Care insurance?
Associations formed for the purpose of purchasing LTC insurance
Which of the following would NOT trigger the payment of Accelerated Death Benefits?
Being permanently disabled
Regarding major medical plans
Higher stop-loss means lower premium
Under the New York State Partnership for Long-term Care, there are restrictions for applying for New York State Medicaid benefits. Which of the following statements is correct?
If you buy a long-term care insurance policy under the Partnership program, and you use 3 years of nursing home care, or 6 years of home care.
Which of the following is NOT a Medicaid qualifier?
Insurability
Which statement is required to be printed on the first page of a health insurance policy, which signals to the insured that the policy's benefits are limited?
Limited Policy Notice
A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT
Part A deductible
An Equity Indexed Annuity will grow based upon
Performance of a recognized index
What is the difference between a straight life policy and a 20-pay whole life policy?
Premium payment period
What must states do after the death of a person who received Medicaid benefits, according to the Medicaid Estate Recovery Act?
Seek repayment of funds that were paid
In Credit Life Insurance, who is responsible for paying the policy premiums?
Borrower only
The needs approach to calculating the amount of life insurance needed is based on
Predicted needs of a family after the premature death of the insured
An insurer must notify the consumer in writing that an investigative consumer report has been requested, within how many days of the initial request?
3 days
Which of the following is required in order for a plan to be qualified
The plan must be formally written and communicated to the employees
Under the Affordable Care Act, when would pregnancy be considered a pre-existing condition?
Never
If an individual willfully violates provisions of the Fair Credit Reporting Act, what is the maximum civil penalty?
$2,500
An employee dies having 6 quarters of coverage during the previous 13-quarter period. What status of coverage does the employee have under Social Security?
Currently insured
An insurer wants to create a brochure to advertise its company, so a professional advertiser is hired to create and print the material. Several months after the publication of the brochure, a client threatens to sue the insurer for false advertising because of misleading information included in the brochure. Who is legally responsible for the false material?
The insurer
Whenever the Superintendent has reason to believe that a person has violated or is about to violate any unfair method of competition or an unfair claim practice, he or she may serve a statement of the charges and a notice of a hearing. What is the timeframe for the hearing after the notice is served?
10 days
According to the Time Limit on Certain Defense provision, statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been in force for a minimum of how many years?
2 years
The Omnibus Budget Reconciliation Act of 1990 requires that large group health plans (100 employees or more) must provide primary coverage for nonretired, disabled individuals under age
65
A subscriber has been treated for a medical condition by his primary care physician for 3 months with experimental remedies without a significant health improvement before being referred to a specialist. Which of the following types of plans does the subscriber have?
A gatekeeper HMO plan to control the costs
Which of the following is provided by skilled medical personnel to those who need occasional medical assistance or rehabilitative care?
Intermediate care
An insured recently received his major medical insurance policy. Only 20 days after the policy issue, while recreational rock climbing, the insured suffered a fall that required hospitalization, surgery and physical therapy to repair his broken leg. Which of the following is true?
Both a deductible and coinsurance payments will be required
Which of the following is NOT true regarding insurance consultants?
They may own shares in the insurers they represent
What is the purpose of a benefit schedule?
To state what and how much is covered in the plan