Must for exam! Part 1

Which of the following is not true about term health coverage A. The policy is issued only for a specified period of time only B. The policy could be written as accident only policy C. The policy ends at the end of the term D. The owner pay renew the policy for a specific term

D

Which of the following types of insurance policies would perform the function of cash accumulation A. Term life B. Increasing term life C. While life

C

Under the Affordable Care Act, what percentage of preventive care must be covered without cost sharing? a. 100% b. 70% c. 80

A

An Equity Indexed Annuity will grow based upon A. Performance of a recognized index

A

Which of the following individuals would be a likely candidate to purchase a deferred annuity? A. Someone who wants to grow retirement funds tax deferred B. Someone who cannot Afford life insurance

A

Statistical probabilities of loss for a particular class of insureds is best predicted when the insured group is A. Large B. Older C. Diverse

A- large

Who is the annuity owner? A. Person who received the benefit B. The insurer C. The person who purchased the annuity

B. Insurer

Which of the following is incorrect regarding the definition of total disability? A. Total disability is the inability to perform partial duties of any occupation for which a person is suited by reason of education, training or experience. B. Total disability can be the inability to perform duties of one's own occupation C. Disability can be defined differently under certain income policies

A

For which of the following reasons could an insurer terminate a long term care policy? A. Nonpayment of premium B. Deterioration in physical health of the insured

A- nonpayment of premium

How does a member of an HMO see a specialist? A The member is allowed to choose his or her own specialist. B The primary care physician refers the member. C The insurer chooses the specialist. D HMOs do not cover specialists.

B The primary care physician refers the member.

Policy loan request, except for loan request for payments due to premiums, may be up for a period up to? A. 30 days B. 6 months C. 9 months

B- 6 months

An insured bought an insurance policy that required him to pay $150 on the 15th of each month. He then takes an extended vacation and forgets to pay the premium. 10 day's later, his policy is still in effect and has not collapsed. Which policy provision allows this? A. Waiver of premium B. Incontestability C. Grace period

C- grace period

Which of the following is NOT provided by an HMO? A Services B Financing C Patient care D Reimbursement

D Reimbursement

In a variable life insurance policy, all of the following assets are held in the insurance company's general account except A. Face amount reserves B. Cash surrender values C. Mortality reserves

B

A dentist Is off work for 4 months due to a disability. His dental disability salary would be covered by? A. Disability income B. Business overhead insurance

B

after a year of receiving disability income benefits, the insured notices that her monthly benefit has increased slightly. what rider does the policy likely have that would cause this? a. cost of living adjustment rider(COLA) b. Guaranteed insurability

a. cost of living adjustment rider(COLA)

a woman obtains health coverage through the Marketplace on Oct1. Two weeks later she finds out that she is 3mon pregnant. Which of the following is true about the coverage for pregnancy? a. pregnancy may be covered with the insurer's special approval b. pregnancy will be covered immediately

b. pregnancy will be covered immediately

Considering the principals of liquidity, how would the policy owner of today's cash values in a life insurance policy? A. Use for emergency expenses B. Fund a retirement C. Make a down payment on a home in 5 years

A

Under HIPAA probability, which of the following are not protected under required benefits? A. Group of one or more B. Pregnant women C. Self- employed

A

What is the shortest possible elimination period for group short term disability benefits provided by an employer? a. 0 days b. 10 days c. 30 days

A

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? A. Paid-up additions B. Lump-sum

A

Which of the following is true regarding premium in a 10-year level premium policy A. Premium will remain level for 10 years B. The premium will remain level at renewal C. Premium will decrease at the end of the term

A

An insured bought a whole life policy 15 years ago and it has accumulated a cash value of several hundred dollars. She named her spouse as the owner at the time of purchase. Who has the right to change beneficiaries and access the cash value? A. Policy owner B. Insured C. Beneficiary

A- policy owner

All of the following are characteristics of group health insurance except? A. The parties that hold a group health insurance contract are the employees and the employer B. Employers may required employees to contribute to the premium payment C. Benefits under a group plan are more extensive then those under individual plans D. The cost of insuring an individual is less than what would be charged to comparable benefits under an individual plan

A. The parties that hold a group health insurance contract are the employees and the employer

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. Limited benefit plan B. A gatekeeper HMO plan to control the cost

B

An illustration used in the sale of a life insurance policy must include a label stating A. Guarantee items B. Life insurance illustration C. Representation of insurance

B

Which of the following is not a standard exclusion in life insurance policies? A. Aviation B. War and military services C. Disability D. Hazardous occupations

C

Which of the following riders pays a beneficiary a death benefit that is double or triple the face amount if the insured's death was caused by an accident as defined in the policy? A. Accidental death rider B. Double indemnity rider C. Guaranteed insurability rider

C

Which of the following used to be called Medicare + choice plans? A. Medical insurance B. Original Medicare plan C. Medicare advantage plans

C

With a conditionally renewable policy, the premiums are more likely to be A. Flexible B. Increased C. Decreased

B

Group members that are covered by group life insurance policies will be issued which of the following? A. Master policy B. Certificate of insurance

B- certificate of insurnace

During the accumulation phase of a fixed annuity, the annuitants interest is based on a minimum rate as specified in the contract, or the current rate, which is A. Lower B. Higher C. Specified in the contract

B- higher

Which of the following would NOT be eligible for coverage under key person? A . The owner of the shop B. The manager

A

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? A. The primary beneficiary died before the insured

A . The primary beneficiary died before the insured

A person has a history of DUI's. To this insurer, this presents what type of hazards A. Morale B. Legal C. Physical D. Moral

A- morale

Medical claims covered by the program known as Medi-Cal in California are paid for by A. HMO's B. Worker's compensation insurance C. The state, mostly through federal reimbursements

C

Which of the following is the best definition of "indemnification" ? A. the act of one person who agrees to restore an injured person to the condition he/she enjoyed prior to the loss B. A contract whereby two parties involved agree to what things of value will be exchanged by the parties to the contract

A

Which of the following must indicate how much of the health coverage premium must go toward actual medical care? A. Medical loss ratio B. Minimum value calculator

A

In insurance, what is the term used for the cause of a loss? A. Hazard B. Peril

B

The provision that sets forth the basic agreement between the insurer and the insured and state the insurer's promise to pay the death is called the A. Consideration B. Insuring Clause C. Payment of claims

B

Under the Affordable Care Act, when would pregnancy be consider a pre-existing condition? A. Always B. Never C. If begins before the coverage takes place

B

Hazards are conditions or situations that; A. Guarantee that a loss will occur B. Increase the likelihood of a loss occurring C. Determine the likelihood of a loss occurring

B.

A guaranteed insurability rider allows the owner to purchase additional amounts of life insurance without proof is insurability at all of the following except? A. Birth of a child B. Marriage C. Purchase of new home D. Approximately every 3 years between the age of 25 and 40

C

A qualifying retiree has access to all parts of the social security Medicare plan. Which of these parts requires a monthly payment for the insured? A. Part A B. Medicaid C. Part B

C

An individual is applying for Heath insurance. His health history is nearly perfect, he had a healthy weight, and doesn't smoke. What risk classification would the applicant most likely receive? A. Standard B. Superior C. Preferred

C

Which method of dealing with risk is applied when insurance is purchased? A. Avoidance B. Reduction C. Transfer

C- transfer

On a disability income policy that contains the "own occupation" definition of total disability, the insured will be entitled to benefits if they cannot perform a. Their regular job. b. any job that they are suited for by prior education

a. Their regular job.

If an applicant submits the initial premium with the application, which action constitutes acceptance? A. The underwriter approves the application B. The producer delivers the policy C. The insurance company receives the application and initial premium

C

Which of the following meets the insureds personal needs and is provided my nonmedical personnel? A. Intermediate care B. Custodial care C. Skilled care D. Assisted living

Custodial care

Medicare Part B covers all of the following except: A. Doctor's service B. Home health visits C. Outpatient hospital services D. Long term care services

D

if an agent has an administrative action taken against him or her in another jurisdiction, how many days does the agent have to report this to the superintendent after the final disposition? a. 30 days b. 20 days

a- 30 days

According to the Medical Loss Ratio(MLR), what is the minimum percentage of health coverage premium that must be applied to actual medical care in an individual health plan? a. 80% b. 70% c. 60%

a. 80%

An individual works for a manufacturing company. If he decides to fund a retirement plan for himself, for which of the following plans could he qualify? a. 403(b) TSA b. Individual retirement account c. Simplified Employee Pension Plan

b. Individual retirement account

Dividends received on participating life insurance policies are A. Not taxable because they are return on your investment B. Taxable C. Not taxable because they are a return of unused premiums

C

Under a disability income policy, the insurer pays a monthly benefit that is less than the insured's income. What is the reason for that? To prevent over utilization and malingering

To prevent over utilization and malingering

all of the following would be different between qualified and nonqualified retirement plans EXCEPT 1. taxation on accumulation 2. taxation of withdrawals 3. taxations of contributions 4. IRS approval requirements

1. taxation on accumulation

A comprehensive Medical expense insurance policy combines which of the following coverages in a single contract ? A. Basic hospital and surgical coverage with major medical B. Disability income and accidental death

A

Under the Affordable Care Act, a special enrollment period allows an individual to enroll in a qualified health plan within how many days of a qualifying event? A 10 days B 30 days C . 60 days D 90 days

C

What happens to the application for health insurance once the policy is issued? A. It's discarded B. Filed with department of insurance C. Becomes part of the entire contract

C

Which of the following statements is INCORRECT concerning Modified Endowment Contracts (MECS)? A) A primary purpose of the regulations governing MEC's was to reduce incentives for the use of life insurance as a short-term investment vehicle. B) A distribution from an MEC may be subject to a 10% penalty if withdrawn prior to 59.5 C) An MEC must always pass the 7-pay test D) A life insurance policy failing the 7-pay test is classified as an MEC

C

What policy component decreases in decreasing term insurance? a. face amount b. cash value c. dividend

a- face amount

Which of the following statements is incorrect? A. Medicare and medigap policies do not provide coverage for long term custodial or nursing home care B. Medicaid does not pay for nursing home care in any case C. Medicare and MediGap policies provide coverage for long-term custodial or nursing home care D. Medicare and Medicare supplements does not cover skilled nursing home care

C

What is the purpose of the Agent's report in the application process? A. To give disclosure to the applicant B. To provide additional information of the applicant to the underwriters C. To provide medical information of the applicants to the underwriter

B

Under the family medical leave Act, what happens to an employee's insurance benefits while he/she is on leave? A. The benefits are canceled B. The benefits are cut during the employees leave C. The benefits earned remain in effect for the duration of the employee's leave.

C

Which of the following becomes part of the contract, is guaranteed to be true, and if untrue, may be grounds for rescinding the policy? A. Consideration B. Contract of adhesion C. Warranty

C

Which of the following permissible reasons for an insurance company to contest payment of a claim based on statements on the application? A. The application contains material misstatements B. The application contains a correction

A

All of the following are features of catastrophic plans except: A. High premiums B. Out of pocket cost C. High deductibles D. Essential benefits

A. High premiums

Because of an injury, an insured has been unable to work for 7 months. He wasn't able to pay his life insurance policy premium, yet the policy remained in force. The policy includes A. Nonforfeiture options B. Waiver of premium rider

B

Which of the following is NOT a crucial factor in health insurance underwritting? A. Health B. Income

B

Which of the following is an example of physical hazard? A. Bankruptcy B. Diabetes C. Carelessness D. Lying

B

Under the Affordable Care Act, which classification applies to health plans based on the amount of covered costs? a. Metal level classifications b. Metal variable level

a. Metal level classifications

According to the PPACA metal levels classification, if a health plan is expected to cover 90% of the cost for an average population, and the participants would cover the remaining 10%, what type of plan is that? a. Platinum b. silver c. gold

a. Platinum

Under an extended term nonforfeiture option, the policy cash value is converted to a. The same face amount as in the whole life policy b. the face amount equal to the cash value c. a higher face amount than the whole life policy

a. The same face amount as in the whole life policy

which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium? a. automatic premium loan. b. Reinstatement c. reduced-paid up option

a. automatic premium loan.