Readiness exam questions

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what provision gives an employee the right to exchange group insurance for an individual policy within a certain number of days from termination of employment?

conversion provision

what is not a feature of a health insurance plan purchased on the health insurance marketplace?

dollar limits on essential benefits

Which or the following best describes a presumptive disability?

one that is severe enough that the insured automatically qualifies for full disability benefits

All of the following are true regarding key person disability income insurance EXCEPT

premiums are tax deductible as a business expense

all are true regarding key person disability income except:

premiums are tax deductible as a business expense

what is NOT true regarding key person disability income insurance?

premiums are tax deductible as a business expense

Which of the following best describes the type of care provided by HMOS

preventative

An insured purchased a health insurance policy with a renewability clause that states the policy is "Guaranteed Renewable." This means that as long as the required premiums are paid. the policy will continue until the insured

reaches age 65

an insured purchased a health insurance policy with renewability clause that states the policy is guaranteed renewable. this means that as long as the required premiums are paid, the policy will continue until the insured:

reaches age 65

what is NOT true regarding the federal fair credit reporting act?

reports may be sent to anyone who requests one

what is the advantage of reinstating a policy instead of applying for a new one?

the original age is used for premium determination

It the policy summary for a life insurance policy Is not given when the application is taken, when must the policy summary be given to the policyowner:

when the policy is delivered

if the policy summary for a life insurance policy is not given when the application is taken, when must the policy summary be given to the policyowner?

when the policy is delivered

Under the mandatory uniform provision Notice of Claim, written notice of a claim must b e submitted to the insurer within what time parameters?

within 20 days

Under the mandatory uniform provision Notice of Claim, written notice of a claim must be submitted to the insurer within what time parameters?

within 20 days

elaine's basic hospital expense policy has a $500 per day limit for room and board in a hospital for a maximum of 5 days. elaine got sick and had to spend 3 days in the hospital at $650 a day. how. much will elaine have to pay to cover the rest of her room and board charges?

$450

to qualify for an original certificate of authority, what minimum capital stock or surplus must an insurer have?

1.5 million

an insurer must supply claims forms to the insured within how many days of a notice of claim?

10 days

In a noncontributory group policy

100% of eligible employees must participate

A retail shoo owner is insured under a business overhead expense policy that pays a maximum monthly benefit of $2.500. His actual monthly expenses are $3.000. If the owner becomes disabled. the monthly benefit payable under his policy will be

2,500

cobra applies to employers with at least

20 employees

core benefits are included in all medicare supplemental policies. what percentage of part b coinsurance is required?

20%

when a disabled dependent child reaches the age limit for coverage, how long does the policyowner have to provide proof of dependency in order for the dependent to remain covered under the policy?

31 days

How long is open enrollment period for Medicare supplement policies?

6 months

a distribution from an employer sponsored retirement plan or from an IRA is eligible for a tax free rollover if it is reinvested in an IRA within:

60 days

a distribution from an employer-sponsored retirement plan or from an IRA is eligible for a tax free rollerover if it is reinvested in an IRA within :

60 days

what is the maximum age that a disabled insured worker may received social security disability benefits?

65

a life insurance policy qualifies as a modified endowment contract if the amount of premium paid exceeds the amount that would have provided paid up insurance in how many years?

7 years

what is incorrect concerning modified endowment contracts?

An MEC must always pass the 7 pay test

what is the purpose of a conditional receipt?

It is intended to provide coverage on a date earlier than the date of the issuance of the policy.

which of the following time periods is general enrollment period for medicare part B?

January 1st thru march 31st each year

what describes the relationship between the principal sum and a capital sum?

a capital sum is a percentage of the principal sum

all could qualify as a group for the purpose of purchasing group health insurance except:

an association of 35 people

In which of the following cases the insured must consent in writing to the life insurance contract

an employer is purchasing life insurance on the key employee

a producer advices a policyholder that he should replace his life insurance policy with another similar policy. the agent is advising this for the sole purpose of earning a commission. what violation has the agent committed?

churning

An applicant gives her agent a completed application and the initial premium. What can the agent issue her that acknowledges the initial premium payment?

conditional receipt

what is true regarding simple plans?

contributions and earnings are tax deferred until funds are withdrawn

A major medical expense policy would exclude coverage for all except

drug addiction

when life insurance proceeds are used to pay inheritance taxes and federal estate taxes, it is known as:

estate conservation

how often must the HMO be examined by the commissioner ?

every 5 years

an individual is purchasing a permanent life insurance policy with a face value of $25,000. while this all the insurance that he can afford at this time, he wants to be sure that additional coverage will be available in the future. which option should be included in the policy?

guaranteed insurability option

Under which or the following conditions would life insurance proceeds be taxable by the federal government?

if there is a transfer for value

under which conditions would life insurance proceeds be taxable by the federal government?

if there is a transfer for value

Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by her insurer. What is the name of this agreement?

insuring clause

what is correct concerning medicare part B?

it pays for physician services, diagnostic tests, and physical therapy

an annuitant pays the annuity premium on the 14th of each month. which best describes this arrangement?

level

medicare part B covers all except

long term care

An insurance agent visits a potential client and explains various types or policies. The customer displays a lack or interest, so the agent guarantees higher dividends than he knows would be possible. which term describes what the agent has done?

misrepresentation

Guaranteeing future dividends is considered to be an unfair or deceptive act known as

misrepresentation

When may HIV-related test results be provided to the MIB?

only if the individual is not identified

a married couple purchase a life insurance policy on their newborn baby, they are concerned about what would happen to the policy if either one of them were unable to continue making the premium payments due to death or disability. which policy rider should their agent recommend?

payor benefit

what is the difference between a straight life policy and a 20 pay whole life policy?

premium payment period

an insured was diagnosed two years ago with kidney cancer. she was treated with surgeries and chemotherapy and is now in remission. she also has a 30 year smoking history. the insured is now healthy enough to work and have just started a full time job. what describes the health insurance that she will most likely receive?

she would be covered under her employer's group health insurance plan, without higher premiums

what does the application of contract of adhesion mean?

since the insured does not participate in preparing the contract, any ambiguities would be resolved in favor of the insured.

insureds have the right to do what if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy?

submit the description in their own words on a plain sheet of paper

what is NOT an unfair claims settlement practice?

suggesting negotiations in settling the claim

life insurance can provide what?

survivor protection

The premiums paid by an employer for his employee's group life insurance are usually considered to be

tax deductible to employer

what is NOT a consideration in an insurance policy ?

the cash value in the policy

All of the following are consideration in an insurance policy EXCEPT

the csh value in the policy

All of the following are advantages of a qualified retirement plan except:

the income at retirement is tax free

An employee is insured under her employer's group life plan. If she terminates her group coverage, which of the following statements is INCORRECT?

the insured may choose to convert to term or permanent individual coverage

which of the following entities is considered the principal?

the insurer issuing a policy

what is not true about indexed whole life insurance?

the policy face amount remains level throughout the life of the policy

what is the purpose of the impairment rider in a health insurance policy?

to exclude coverage for specific impairment

Which of the following statements is INCORRECT regarding the definition or total disability?

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

to which of the following do replacement regulations apply in this state?

whole life insurance

Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within

90 days of a loss


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Chapters 38&39: GI and Oral Disorders

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