Life, Health, and Variable Annuities

a waiver

A voluntary surrender of a known right, claim, or privilege is known as:

Major Medical Policy

Coordination of benefits is permitted

Industrial

Debit life insurance is classified as which of the following?

the policyholder or the individual insureds

Premiums may be paid by ___________

Children's Rider (Health)

covers a newborn at moment of birth

Home health care

is medically driven, may include several different health care professionals, and the goal is to avoid unnecessary hospitalization.

$10,000

penalty if an insurer used a Medicare supplement policy advertisement that violated an unfair trade practice

Grandfathered Health Plan

provided coverage after March 23, 2010

Intermediate Care

provides assistance with activities of daily living and some health services and nursing supervision

Autism spectrum disorder

required as optional coverage for individual and group health insurance.

Part III of the application

the agent's confidential report and is not photocopied or communicated to client, or included in the entire contract.

Conversion of Group Health Insurance

A group policy must provide conversion rights, without evidence of insurability, to an employee or member whose coverage under the group policy has been terminated.

three basic high deductible plan options

Basic Limited Mandate Health Benefit Plan, Basic HSA Health Benefit Plan, and Basic HSA Limited Mandate Health Benefit Plan

Annuity units

Before VA benefits can be paid, they must be converted into

advantages, disadvantages

Before the replacement of an annuity contract, the agent must provide a written explanation of the _________ and ________ of the purchase or exchange to the consumer.

fees, charges

Before the replacement of an annuity contract, the agent must provide comparison of the ____ and ____

Universal Life Policy

Which of the following pays a current interest rate and also guarantees a minimum interest rate that will be credited to the cash values of the life insurance policy?

Coordination of Benefits

provision to eliminate over insurance and establish a prompt and orderly claims payment system when a person is covered by more than one group insurance and/or group service plan.

Medicare Open Enrollment Period (turning 65)

6-month open enrollment for a person turning 65 starts the first day of the birthday month as long as the person has purchased Medicare Part B.

6 months

A Medicare supplement policy must not exclude benefits based on a preexisting condition if the insured had creditable coverage for at least _____ ____from the date of the application.

Facultative

A ____________ agreement is a reinsurance agreement that allows the reinsurance company an opportunity to reject coverage for individual risks, or price them higher due to their substandard (higher risk) nature.

NAIC

A buyer's guide is a generic brochure developed by the ______ to assist prospective buyers of life insurance, which includes descriptions of all the basic types of life insurance, as well as comparative costs of each type of plan.

not an eligible group

A group eligible for group auto insurance, is ________ for health insurance

Medicare Supplement Policy

A person can suspend the ________ up to 2 years if entitled for Medicaid

LTC Policy

A policy issued to an individual must not contain renewal provisions other than 'guaranteed renewable' or 'noncancellable.'

the beneficiary

All of the following are parties to a life insurance contract, except:

Defamation

An agent is guilty of ______ when he / she makes a false or malicious statement about a competing insurer's financial condition.

tax

An agent must also disclose to the consumer that the purchase or exchange may have ______ consequences and that a tax advisor should be consulted prior to purchasing or exchanging an annuity contract.

Long-Term Care Shopper's Guide

An agent must deliver ______ prior to the presentation of an application or enrollment form, and in the case of direct response solicitations, must be presented in conjunction with any application or enrollment form.

life insurance agent

An agent must inform the prospective purchaser, prior to a life insurance sales presentation, that he/ she is acting as a _________

Signed replacement notice, Copy of each sales proposal, Signed statement as to whether a policy is being replaced

An agent replacing a life policy or annuity must give the applicant and the insurer all of the following:

Advertising of Health Insurance

An insurer may immediately begin using advertising upon filing, subject to subsequent disapproval by the office.

an insurance policy or annuity contract

An insurer must clearly identify its life insurance and annuity contract as ________ in its advertisements.

Replacement

Any transaction in which new life insurance or an annuity is to be purchased, and it is known, or should be known to the agent, that existing life insurance or an annuity will be amended to reduce benefits or coverage is covered under which regulation?

Eligible Group

Association members must be engaged in a particular profession and the association must have been in existence for at least 2 years and holds regular meetings not less than annually.

existing, recommended

Before the replacement of an annuity contract, the agent must provide information to the consumer the terms of the_______ annuity and ____ annuity

Medicare

Duplication of ______ coverage is prohibited - Medicare Supplement Policy

health

Eligibility for participation in the group is not based on _____

optional

Employer life insurance includes that _____ insurance must be elected

living benefit

Employer life insurance offers ____________.

accidental death and dismemberment

Employer life insurance offers _____________ benefits

minimum

In health insurance, limited benefit insurance, disability income protection insurance and major medical expense insurance are all __________ standards of benefits.

4 years

Insurers must keep every advertisement on file for at least ________ or until the filing of the next regular report on its examination of the insurer, whichever is longer

Medicare Outline of Coverage

Must be delivered to the applicant at the time application is made, however, if the policy is direct response, acknowledgment of receipt or certification of delivery of the outline of coverage must be provided to the insurer.

three health policies offered to small employers

Standard health benefit plan, Limited benefit plan, Basic health benefit plan

Medicare marketing standards

The agent must inquire and make every reasonable effort to identify whether a prospective applicant or enrollee for Medicare supplement insurance already has accident and sickness insurance and the types and amounts of any such insurance, but the applicant cannot be forced to prove it. Every insurer must establish an audit program to verify compliance. It is unacceptable to mislead a person into taking out a policy with another insurer. It is an unfair trade practice to frighten a person into buying Medicare supplement policies.

Legal Actions provision

The insured must wait at least 60 days following the filing of a proof of loss before pursuing any legal action against the insurer.

policy owner

The person who generally has the rights in the insurance policy is known as the ____________.

Compensation paid to an agent

can vary because of health status, claims experience, industry, occupation, or geographic area of the small employer if the percentage of premium does not vary due to those factors.

Qualifying Event

death of covered employee, divorce/legal separation, eligible for Medicare

Non-Grandfathered Policy

does not provide Medicare supplement, dental, vision, long-term care, disability, accident only, specified disease policies, or other supplemental limited-benefit plans (provided coverage before March 23, 2010)

Deferred Variable Annuity

future payments

Group Blanket Health Insurance

health insurance that covers special groups of individuals.

advertised, solicited, issued

if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare, then it may not be ______, ______ or ________ as a Medicare supplement policy

Immediate Variable Annuity

immediate payments

The dread disease policy

is a limited benefit policy for which benefits are paid as expense incurred, per diem, or a principle sum, and services incurred as a result of human and/or non-human organ transplant are provided.

Home care

is not medical-driven and instead focused on helping the senior with daily activity and feeling safe and independent at home.

Standard Health Plan

low deductible health plan

Defamation

making false oral or written statements that are critical or derogatory of an insurer's financial condition and is intended to cause injury to someone in the insurance business.

LTC insurance policy

may not be issued if the premiums to be charged are calculated to increase based solely on the age of the insured.

The Outline of Coverage

must be provided at the time of sale or delivery.

HMOs, PPOs

pay benefits to the provider(s) of health care services rather than to the subscribers.

Certificate of Coverage

provided to the policyholder for delivery to each member of the insured group. Evidence of coverage for each individual insured, but it is not the actual policy.

Certificate of Coverage

sent to members containing the group number and the essential features of the insurance coverage, and if dependents are included in the coverage, only one certificate is issued for each family unit.

acceptable reasons to deny coverage

small employers who are not physically in their service area, or to employees who do not live or work in the service area, or the carrier cannot deliver proper service in the area.

conditional contract

A ________________ ____________ states that both parties must perform certain duties and follow rules of conduct to make the contract enforceable.

Yes, only during the accumulation period.

Can you add a waiver of premium to a variable annuity contract?

other

Coordination of Benefits: if the policies do not agree on the order of benefits, the provisions of the _______ policy determine the order of benefits.

earlier

Coordination of Benefits: when there is a dependent child and the parents are not separated or divorced, the plan of the parent with the _________ birthday is primary

Medicare Open Enrollment Period (under 65)

For a person under age 65 who has been on Social Security disability for 2 years, the 6-month enrollment begins at the beginning of the 25th month.

the individual states

For the most part, the highest authority for insurance regulation is:

30 days

Free Look Period (Medicare Supplements Policy)

marketing health insurance

Health status, claims experience, industry, occupation, or geographical locations cannot be used to avoid ___________.

free

Insurers are not required, to pay benefits covered under Workers' Compensation or Veterans Administration benefits since these are usually _____.

absolute assignment

If no money is involved when the ownership of a policy changes, this is referred to specifically as a(n) __________ ________________.

180, 5

If the carrier stops selling all plans, ___ days' notice is required, and the carrier may not re-enter the Florida market for ____ years.

90

If the carrier stops selling an insurance form, the carrier must provide ____ days' notice

option

Individual health insurance is renewable at the insured's _______.

automatic premium loan

Some traditional whole life policies offer a(n) __________ feature to keep the policy in force if there are sufficient cash values to do so. The __________ ___________ ________ provision is available on cash value policies only and does not require an additional premium.

name of the insurer

The _______ must appear on all advertisements

purpose of obtaining insurance

The group may not have been formed for the

policyowner

The insured and the ______________ are usually the same, but not necessarily

on the first page of the policy

The insuring clause is found:

Capitation

This is the fixed amount paid by the HMO to a health care physician or provider in exchange for medical services rendered by that provider.

the insurer

Ultimately, who determines if a life insurance policy with an owner other than the insured will be issued?

terms of units

Variable Annuities are paid in

The two types of assignment are Collateral (temporary), and Absolute (permanent).

What are the two types of life insurance assignments?

Good faith

When forming and entering a contract, both parties act in:

aleatory

When the exchange of value is unequal, the contract is considered:

C) Based on a percentage of the increase in a stipulated stock index

With equity-indexed life, the interest credited to the policy is:

63 days

Within how many days must the first premium be paid for the converted policy after the group policy was terminated?

Partial surrenders

__________ _______________ are typically available only on universal life insurance types of policies.

Participating

____________ policies are the only policies that may pay dividends to policyowners.

5 people covered at all times

a life insurance group must have _______

Health Maintenance Organization (HMO)

a medical group plan that provides physician, hospital, and clinical services to participating members in exchange for a periodic flat fee.

The Medicare Part C - Advantage plan

a private fee-for-service plan

Reinstated A&H Policy

accidents are covered immediately, and sickness after 10 days. This prevents insureds from reinstating a policy when they are already sick.

Upon annuitization

accumulation units are converted to annuity units, and the income is paid on the value of the annuity units

Children's Rider (Life)

covers a newborn at 14 days of age

election of continuation

written notice a qualified beneficiary gives within 63 days of a qualifying event. entitled to continuation without evidence of insurability.