Life
An insureds long-term care policy a fixed amount of coverage of $120 per day. The long-term care facility only charged $100 per day. How much will the insurance company pay?
$120 a day
Annually Renewable Term
-Renews each year without proof of insurability -Premiums increase due to attained age
What is the minimum length of benefit period that a long term care policy must provide?
12 months
the inflation protection feature in ltc policies issued in this state must provide protection for inflation at what percent annually?
5%
Under the NYS disability benefit law, for an employed individual, disability benefits will be payable after a waiting period of
7 days
What is not covered under a long term care policy?
Acute care in a hospital
What type of care would be provided at a community center?
Adult Day Care
Because an agent is using stationery with the logo of an insurance company, applicants for insurance assume that the agent is authorized to transact on behalf of that insurer. What type of authority does this describe?
Apparent
If an insurer meets the state's financial requirements and is approved to transact business in the state, it is considered to be
Authorized
How is the state trying to encourage its residents to purchase long-term care insurance policies?
By offering tax credits on LTC policy premiums
What provision gives an employee the right to exchange group insurance for an individual policy within 60 days from termination of employment?
Conversion
Examples of risk retention
Copayments, deductibles, self-insurance
Prior to issuance of a Long-Term Care policy to an applicant age 80 or older, the insurer must obtain all of the following except
Date of a previous doctor visit.
The benefit amount under a LTC policy is usually expressed as a fixed dollar amount per
Day
What is considered a qualifying event under COBRA?
Divorce
The authority granted to an agent through the agent's contract is referred to as
Express Authority
Which of the following acts provides an employee with 12 work weeks of leave to care for a child born to that employee?
Family Medical Leave Act
What type of Long term care is not provided in an institutional setting?
Home health care
What method of calculating the amount of life insurance needed takes into account the insured wages, years until retirement and inflation?
Human Life Value Approach
Which insurance principle states that if a policy allows for greater compensation than the financial loss incurred, the insured may only receive benefits for the amount lost?
Indemnity
whole life insurance
Insurance that is kept in force for a person's entire life, or until age 100 and pays a benefit upon the person's death, whichever comes first
Who makes up the Medical Information Bureau?
Insurers
What concept is the foundation of the statistical prediction of loss upon which rates for insurance are calculated?
Law of large numbers
Under workers compensation, which of the following benefits are NOT included?
Legal Benefits
Whole life key characteristics
Level Premium, Death Benefit guaranteed & remains level, cash value is accumulated, living benefits
In cases where a covered employee is eligible for Medicare benefits to treat end stage renal disease with dialysis for kidney transplant, how would each respond?
Medicare is the secondary payor during the first 30 months of treatment.
This type of insurance company issues participating policies
Mutual Insurer
Can a group that is formed for the sole purpose of obtaining group insurance qualify for group coverage?
No, the group must be formed for a purpose other than obtaining group insurance.
Implied
Not specifically stated in the contract, but is assumed necessary to conduct insurance business
Because an insurance policy is a legal contract, it must conform to the law governing contracts which require all of the following elements
Offer and acceptance, legal purpose, consideration
Express
Powers specifically stated in the contract
Which services are associated with Stand & Poor's and AM Best?
Rating the financial strength of insurance companies
term insurance/pure death protectionle
Temporary protection because it only provides coverage for a specific period of time.
Apparent
The appearance of a relationship between the agent and principal based on words or actions
Who guarantees a conventional fully-insured group plan?
The insurer
What are characteristics of an insurable risk?
The loss must be large, measurable, and due to chance.
What do long-term care policies offer to policyholders to account for inflation?
They offer the option to purchase coverage that raises benefit levels accordingly.
What is the purpose of key-person insurance?
To cover decreased business revenues as a result of the death of a key employee
If only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it?
Unilateral
What types of services will not be provided under the assisted living care of a LTC policy?
Visits by a registered nurse
Renewal Provision
allows the policyowner the right to renew the coverage at expiration date without evidence of insurability. New Premium will be based off insureds age
straight life insurance
also called ordinary life insurance and whole life insurance, requires the payment of premiums throughout the insured's life. cash value gets higher
Nonforfeiture Values
benefits in a life insurance policy that the policyowner cannot lose even if the policy is surrendered or lapses
buy sell funding
continuation of business
variable life insurance products
contracts in which the cash values accumulate based upon a specific portfolio of stocks without guarantees of performance
fixed life insurance products
contracts that offer guaranteed minimum or fixed benefits
Securities
financial instruments that may trade for value (ex: stocks bonds options)
Regarding long-term care coverage, as the elimination period gets shorter, the premium
gets higher
Events or conditions that increase the chances of an insured loss occurring are referred to as
hazards
What are the 2 types of flexible spending accounts?
health care accounts and dependent care accounts
Policy maturity
in life policies, the time when the face value is paid out
Limited Pay Whole Life (Life paid up at 65)
limited-pay whole life is designed so that the premiums for coverage will be completely paid up well before age 100.
When compared with the administrative cost found in individual coverage, the per capita administrative cost in group health insurance is
lower
single premium
paid in lump sum. generates immediate cash.
level term insurance
provides a level death benefit and a level premium during the policy
Converible provision
provides the policyowner with the right to convert the policy to a permanent insurance policy without evidence of insurability
endow
to have the cash value of a whole life policy face contractual face amount