Q Bank Quiz 1 - the ones I got wrong
The minimum benefit period for a long-term care insurance policy is A)18 months B)24 months C)36 months D)12 months
12
in group accident and health policies, the policy must provide a grace period of how many days? A)30 B)15 C)10 D)31
31 days
what is the minimum number of home care visits that a health and accident policy in WI may cover in a 12 month period
40 home health care visits
Lee has a Social Security PIA of $800 at the time of his death. How much is payable to his surviving spouse, who is caring for an unmarried child under the age of 16? A)$640 B)$400 C)$160 D)$800
400
the soc. sec. spouse benefit for a spouse caring for an unmarried child under 16 or disables before age 22 is what percentage of the PIA
50%
an HSA or HRA is a tax-exempt trust or account that pays for qualified medical expenses.
HSA
Medicare—Part D Prescription Drug Coverage
a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries.
a _____ is a tax exempt trust or account in a financial institution in which one saves money to pay for qualified medical expenses
MSA
Direct-writing companies employ producers to sell the company's insurance products. These employees are paid a salary, commission, or both. The insurer owns the business that the producers write. T.F
T
If an employer offers an accidental death and dismemberment policy to employees and pays 100% of the premium, those premiums are deductible to the employer and are not taxable to the employee, and the employee receives the benefits tax-free T/F
T
Which of the following statements regarding the licensing examination process in Wisconsin is NOT correct? A)The applicant must send the examination results to the OCI. B)The criminal background check results are valid for 180 days C)Examination results are automatically sent to the OCI. D)After an applicant reserves an examination date, a crime check on the applicant will be conducted by the Department of Justice Crime Information Bureau.
The applicant must send the examination results to the OCI
Sajji has an accidental death and dismemberment policy through her company. What is the tax treatment on the expenses if her employer pays 100% of the premiums? A)Her employer may deduct the premiums and receive corporate benefits tax-free. B)She receives benefits tax-free and is taxed on the premium. C)The premiums are deductible for her employer and her benefits are tax-free. D)The premiums are not deductible for her employer and her benefits are taxed.
The premiums are deductible for her employer and her benefits are tax-free
An insured employee who resigns or is terminated has 31 days in which to take out a conversion policy without having to show evidence of insurability. The insurer has the right to adjust the premium rate for the new policy. The insurance continues in force for the individual while she is converting from the group plan to an individual policy. T/F
True
qualifying events under COBRA include medicare eligibility reduction in hours termination of a child's dependent status legal separation of a covered employee from the covered employees spouse T/F
True
thirty days is required for patients who enter a licensed skilled nursing center 24 hours after discharge from the hospital. T/F
True
Which of the following statements about a corporation licensed as an insurance agent is CORRECT? A)Any corporation not involved in soliciting insurance from the public may be licensed. B)All officers and directors of such a corporation must be individually licensed. C)If a corporation has at least 10 licensed agents in the field, no corporate officer need be personally licensed. D)Every officer, director, stockholder, or employee personally involved in soliciting insurance must be registered with the Commissioner and must qualify for an individual license.
Every officer, director, stockholder, or employee personally involved in soliciting insurance must be registered with the Commissioner and must qualify for an individual license.
HSA or HRA is what Rodney had through his employer that paid into an account for his medical expenses
HRA
Medicare C
Medicare Advantage Plan
exam results are valid for how many days
30
In Wisconsin, policies that cover hospital expenses must cover how much of the expenses of inpatient and outpatient treatment of kidney disease in a year? A)$50,000 B)$100,000 C)$5,000 D)$30,000
30,000
Which one of the following coverages is NOT a mandated coverage in both group and individual policies? A)90 days of skilled nursing B)Optometrists C)Kidney disease D)Diabetes
90 days of skilled nursing; 30 days is required
No bonus, cash award, or prize is to be used as a sales incentive in the state of Wisconsin as a result of a contest or competition amongst intermediaries. Merit awards may not exceed $150 and may not exceed 1.5% of the insurer's total first-year premium income. An intermediary may receive expense reimbursement for educational courses, conferences, meetings, or trainings. T/F
True
There is no limit on the number of corporate officers who must be licensed as agents. Anyone involved in a corporation, whether an employee or owner, who is involved in the actual transaction of insurance must be licensed. T/F
True
separate riders can be added to a medicare supplement policy if necessary. The insurer will issue a separate rider for each coverage and price them separately/ T/F
True
Which of the following scenarios is considered to be a sales incentive unfair trade practice? A)ABC Insurer pays for all continuing education for its agents. B)XYZ gives a $100 merit award to all intermediaries writing 20 or more life insurance applications in December. C)ABC Insurer pays a $1,000 bonus to the intermediary that writes the most new life insurance applications in a year. D)XYZ Insurer pays for all agents to attend a national sales conference if they meet a goal for first-year premiums.
ABC Insurer pays a $1,000 bonus to the intermediary that writes the most new life insurance applications in a year
medicare part ____ helps cover the cost of prescription drugs. it is available to anyone enrolled in medicare part A or benefits are available through private prescription drugs plans or medicare advantage plans. all plans must offer basic drug coverage
D
with employer paid group health insurance premiums are A)taxable for employees B)not taxable for employers C)not deductible for employers D)not taxable for employees
not taxable for employers
Employer paid group long term care insurance is/isn't taxable to the employee
not taxable to the employee and benefits are tax-free to the employee up to certain specified limits
When an employer renews the group coverage with the same insurer year-to-year, this is known as A)administrative capability B)persistency C)composition D)plan design
persistency
To be considered qualified, a long-term care insurance policy must conform to requirements concerning all of the following EXCEPT A)marketing standards B)policy replacement C)policy conversion D)premium charges
premium charges
For group health insurance, employees may be classified by all of the following EXCEPT A)duties B)length of service C)age D)type of payroll
age
the cost for a physician's services even in the case of surgery is covered under which one: basic hospital expense or basic surgical expense (basic physician's (non surgical) expense policy
basic surgical expense (basic physician's (non surgical) expense policy
Agnes purchases a round-trip travel accident policy at the airport before leaving on a business trip. Her policy would be which type of insurance? A)Business overhead expense B)Industrial health C)Limited risk D)Credit accident and health
credit accident and health
the premiums and benefits in a business overhead expense plan are
deductible and taxable
a wavier of premium provision does not apply to group or individual insurance
group
applicants for _____ _____ _____ insurance may NOT be required to take a test or disclose whether or not they have received the results of a test.
group accident and health
Medicare Part B does NOT cover
hospital charges
Which of the following statements regarding direct-writing companies is NOT true? A)The producer owns the book of business. B)The insurer owns all of the business that is produced. C)Producers are considered employees. D)Employees are paid a salary, commission, or both to sell the company's insurance products
the producer owns the book of business
how can an underwriter deal with HIV tests or HIV related claims
they can't require a person to reveal the result of an HIV test or attempt to learn if a person has been tested for HIV
Which of the following was the primary purpose of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)? A)To require employers to provide medical coverage for all employees B)To provide government subsidies for indigents' insurance C)To expand coverage eligibility to many people that are uninsured D)To establish government benefits for otherwise uninsurable individual
to expand coverage eligibility to many people that are uninsured
an applicant determined by underwriting to be declined would be
uninsurable at any price
after a hearing what is the maximum court ordered fine a licensee will pay for failing to comply with the commissioner's order to continue to violate wi. insurance law within 2 weeks of its issuance
up to $5,000 a day each day the violation continues beyond the 2 week period
To provide compensation to individuals who have sustained job-related injuries is the primary purpose of A)medical expense insurance B)disability income insurance C)OSHA D)workers' compensation insurance
worker's compensation insurance
are the exam results automatically sent to the OCI after your exam
yes
Which of the following descriptions characterizes a health reimbursement account (HRA)? A)An employer-funded account that pays employees for qualified medical expenses they incur B)A tax-exempt trust or account in a financial institution in which the account holder saves money for qualified medical expenses C)A tax-exempt trust or account designed to pay for qualified medical expenses of the account holder D)A cafeteria plan with several components
An employer-funded account that pays employees for qualified medical expenses they incur
Medicare Part B
The part of the Medicare program that pays for physician services, outpatient hospital services, durable medical equipment, and other services and supplies.
Which of the following statements regarding HIV and AIDS testing is NOT true? A)Any person who has tested positive for HIV is automatically eligible for coverage under the Health Insurance Risk Sharing Plan (HIRSP). B)Applicants for individual accident and health insurance may be required to take a test or disclose if they have received the results of a test. C)Insurers may disclose the results of the test to the Medical Information Bureau (MIB) only if they have received consent from the applicant. D)Applicants for group accident and health insurance may be required to take a test or disclose whether or not they have received the results of a test
applicants for group accident and health insurance may be required to take a test or disclose whether or not they have received the results of a test
Medicare Part A (Hospital Insurance)
covers Medicare inpatient care, including care received while in a hospital, a skilled nursing facility, and, in limited circumstances, at home.
An agent may do all of the following to comply with disclosure notification rules EXCEPT A)provide a copy of the information disclosure procedures form to the state Department of Insurance B)notify the applicant of the insurer's information disclosure procedures with a written form C)obtain the applicant's signature on the disclosure form authorizing the insurer to gather and disseminate information D)answer any questions the applicant may have regarding the insurer's information gathering and dissemination practices
)provide a copy of the information disclosure procedures form to the state Department of Insurance
All licensed producers, public adjusters, and consultants must complete 24 hours of approved continuing education courses every 2 years. How many of those ethics must be an approved ethics course? A)5 B)3 C)6 D)2
3
newborns are covered on group health insurance policies from birth. how long after birth does the insured have to notify the insurer of the child's birth and pay the first premium A)45 days B)60 days C)30 days D)10 day
60 days
the commissioner must inform the applicant for an insurance agent's license whether the application has been approved within how many days after receiving the appropriate fee, application and certificte
60 days
Medicare Part C (Medicare Advantage Plans)
A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide the person with all Part A and Part B benefits. Medicare Advantage Plans include HMOs, PPOs, Private Fee for Service Plans, Special Needs Plans and Medicare Medical Savings Account Plans. If enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren't paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
A ____ is an cafeteria plan with 3 components; health insurance premiums, qualified medical expenses and dependent care expnese
FSA
what is a compulsive forfeiture
a court ordered fine
An individual who recruits agents to sell insurance within a certain geographical area is A)a broker B)a special agent C)a general agent D)a career agent
a general agent
Which of the following statements about Medicare Part D is CORRECT? A)It is available to anyone enrolled in Medicare Part A or B)It helps cover the costs of hospitalization. C)Some plans offer basic drug coverage. D)Benefits are available only through Medicare Advantage plans.
it is available to anyone enrolled in medicare part A or
Basic hospital expense insurance provides coverage for all of the following EXCEPT A)drugs and x-rays B)physician services C)hospital room and board D)anesthesia and use of the operating room and supplies
physician services
what does PIA stand for
primary insurance amount
To be considered a _________ contract, a long-term care insurance policy must follow NAIC's long-term care insurance model regulations, which address the following: policy replacement, conversion, marketing standards, prohibitions on limits and exclusions, and policy renewability, among other things. These regulations do not address premium charges.
qualified
Which of the following situations regarding covered employees is NOT considered a qualifying event? A)Dmitri's hours are reduced. B)Laurie becomes eligible for Medicaid. C)Doreen becomes legally separated from her spouse. D)Santino's son who no longer meets their dependent status
Laurie becomes eligible for Medicaid.
Which of the following statements regarding the conversion privilege in group health insurance is CORRECT? A)An insurer cannot change the premium amount for an insured who is converting to an individual policy. B)To obtain a conversion policy, an insured employee must show evidence of insurability. C)An insured employee who resigns or is terminated has up to 1 year in which to take out a conversion policy. D)During the period when the insured is converting from the group to the individual plan, she is still insured.
During the period when the insured is converting from the group to the individual plan, she is still insured.
Def. of persistency
an insurance term used by insurers to measure the percentage of business that renews coverage year after year. Employers that keep their group coverage with the same insurance company helps to reduce the insurer's administrative expenses
Which of the following statements regarding the waiver of premium provision is NOT correct? A)It pays policy premiums when the insured becomes disabled after a defined waiting period. B)It refunds any premiums paid during the waiting period. C)The waiver may apply retroactively to the original date of disability following a waiting period. D)It is frequently included with both individual and group policies.
if is frequently included with both individual and group policies
Employer paid group long term care insurance is/isn't deductible to the employer
is deductible to the employer
An insurance agent's license remains valid until any of the following happens EXCEPT: A)it is revoked, suspended, limited, or surrendered. B)its term expires. C)the licensee dies. D)the licensee is judged incompetent.
its term expires
An insurance plan that's certified by the Health Insurance Marketplace, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act.
qualified plan
additional medicare supplement coverage may be added as A)a second identical Medicare supplement policy to double coverage. B)the enhanced supplement policy that overlaps Medicare coverage to provide greater financial security. C)Part C of the Medicare program. D)separate specific riders.
separate specific riders
When the premiums for qualified long-term care insurance are paid by an employer, A)the benefits are tax-free up to a specified inflation-indexed limit for employees B)the employer may not deduct the premiums C)the employee pays taxes on the benefits D)the employee pays taxes on the premiums
the benefits are tax-free up to a specified inflation indexed limit for employees
