Life Insurance Exam

Who regards all examinations of companies?

the Commissioner must examine all allen companies

what happens if a non-member physician is utilized under the Point-Of-Service plan?

the attending physician will be paid a fee for service, but the member patient will have to pay a higher coinsurance amount.

An insured purchased a noncancelable health insurance policy 1 year ago. Which is the following circumstances would NOT be a reason for the insurance company to cancel the policy?

the insured is in an accident and incurs a large claim.

What is the most the insurance guaranty association will pay for net cash surrender values?

$100,000

Most policies will pay the accidental death benefits as long as the death is caused by the accident and occurs within

90 days

Felony

A person who knowingly and with intent to defraud an insurer files a statement of claim containing any false, incomplete, or misleading information can be found guilty of?

All of the following individuals may qualify for Medicare health insurance benefits EXCEPT

A retired person over 50.

Revocable

An insured want to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have herhusband named as what type of beneficiary?

Consideration

An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principles has the insurer violated?

First-dollar basis

Another term used to describe "no deductible" is...

Which hospice expenses would NOT be covered in a cost-containment setting?

Antibiotics

All admitted insurance companies in IN are subject to fiscal examinations by the Commissioner when?

At least every 5 years

This describes taxation of individual disability income insurance premiums and benefits?

Benefits are not taxable, and premiums are not tax deductible

.A policy that uses the accidental bodily injury definition will provide coverage that is _________ than a policy that uses the accidental means definition.

Broader in general

Health insurance policy lapses but is reinstated within a acceptable timeframe. How soon from the reinstatement date will coverage for accidents become effective?

Immediately

Loss of one eye

In a Disability Income policy, all of the following are considered presumptive disabilities EXCEPT

A type of dental plan which is incorporated into a major medical expense plan is a/an

Integrated dental plan

Skilled Care

Is one of the long-term care coverages that WILL NOT allow an insured to receive care at home. Skilled care is provided in a institutional setting.

A guaranteed renewable disability insurance policy

Is renewable at the insured's option to a specified age. Guaranteed renewable means that the insured has the right to keep the policy until a specific age; however, while the insurer cannot increase the rates on an individual basis, the insurer can increase the rates for all insureds by class.

Indiana Controlled Business

Limited to 25% of a producer's annual comission

Explain the CORRECT statement for the relationship between Medicare and HMOs.

Medicare Advantage is Medicare provided by an approved HMO only.

A long-term care insurance shopper's guide must be provided in the format developed by which of the following?

NAIC National Association of Insurance Commissioners

An insurer purchases an individual health policy, and another who purchased the same policy but did so by result of a direct response solicitation. Which of these have the longer free-look period?

The insurer who purchase through a direct response solicitation. By purchasing a policy as result of...this produces a longer free-look period of 30 days instead of the normal 10 day free-look period

Legal actions

The provision which prevents the insured from bringing any legal action against the company for at least 60 days after proof of loss is known as

what is the purpose of coinsurance provisions?

To help the insurance company to prevent overutilization of the policy

What is the reason for insurer limitations on coverage amounts?

To provide an incentive for the insured to return to work

What is not covered under a long-term care policy?

acute care in a hospital

In order to get a nonresident license in this state, procedures must

apply and pay a fee to a nonresident state that reciprocates

What doesn't cause an suspension or denial of an insurance license?

sharing commissions with another licensed producer.

Statement of good health

if a premium is not collected until the policy is delivered, than you as the agent must ask for this...it acknowledges the insured's health status has not changed.

Medicare Part B

it is a compulsory program. Part B is elective, when individuals become eligible for Part B at the same time they're eligible for Part A, however Part B requires that a monthly premium be paid.

What is covered by Part A of Medicare?

physician's and surgeon's services

Elimination periods, Cost of Coverage

the longer the elimination period, the lower the cost of coverage. is the period of days which must expire after the onset of an illness or occurrence of an accident before benefits will be payable.

What is necessary in order to be eligible to receive benefits from a long-term care policy?

to be eligible the insured must be unable to perform some activities of daily living (ADLs). ADLs include bathing, dressing, toileting, transferring, continence, and eating.