SERIES 6 EXAM

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f an employee terminates her employment, which of the following provisions would allow her to continue health coverage under an individual policy, if requested within 31 days?

Grace period

A universal life insurance policy has two types of interest rates that are called

Guaranteed and current

Premiums

not deductible

nonrenewal

policy termination at its expiration date

Guarantee of insurability option in long-term care policies allows the insured to

with the ability to purchase additional insurance at a later date without evidence of insurability

medicare

the united states federal government plan for paying certain hospital and medical expenses for persons who qualify

All of the following are characteristics of a group life insurance plan EXCEPT

there is a requirement to prove insurability on the part of the participants

Which of the following is true regarding METs?

they allow several small employers purchase less expensive insurance together

in order to collect social security disability, the claimant must be able to demonstrate that the disability will last at least

12 months

What is the minimum age for obtaining an insurance producer's license in this state?

18

To be eligible under HIPAA regulations, for how long should an individual converting to an individual health plan have been covered under the previous group plan?

18 months

Under which of the following annuity options does the annuitant select the time period for the benefits, and the insurer determines how much each payment will be?

3. Installments for a fixed period

Adopting parents must inform their insurer that a child has been added to the family within

31 days

How much inpatient care must be provided, following a vaginal delivery, by health insurance policies that provide maternity benefits?

48 hrs

How long is an open enrollment period for Medicare supplement policies?

6 months

Under the bronze plan, how much coverage

60%

f an employer provides long-term group disability insurance for its employees, what percentage of monthly wages are lower-paid employees eligible to collect?

66 and 2/3%

week grace period

7

How many eligible employees must be included in a contributory plan?

75%

Which of the following would be considered a peril

fire

if taken as a lump sum, life insurance proceeds to beneficiaries are passed

free of federal income taxation

in a long term care policy, pre existing condition limiations

must appear as a separate paragrah and be clearly labled - more than 6 months

using a class designation for beneficiaries means

naming beneficiaries as a group

dividends

not taxable, interest is taxable

SEP

qualified plan for small employer

full contributory

the employee pays the entire cost

All of the following are ture regarding accumulation interest option except

the interest is not taxable since it remains inside the insurance policy

Which of the following is not the purpose of HIPAA

to provide immediate coverage to new employees who had been previously covered for 18 months

warrantry

validity of the insurance

Which of the following individuals must have insurable interest in the insured?

Policyowner

Underlying assets for variable annuity contracts must be maintained in what type of account?

Securities account

Which of the following will NOT be an appropriate use of a deferred annuity?

Creating an estate

A situation in which a person can only lose or have no change represents

A Pure risk Pure risk refers to situations that can only result in a loss or no change. Pure risk is the only type insurance companies are willing to accept.

What is a foreign insurer

An insurer with a home office in another state

Which of the following is TRUE about a class designation?

Beneficiaries are not identified by name

which of the following meets the insureds personal needs, and is provided bt nonmedical personnel

CUSTODIAL CARE

Term values

DO NOT DEVELOP CASH VALUES

3. Which component increases in the increasing term insurance?

Death benefit

endodontics

Dental specialty that diagnoses and treats diseases of the pulp

The requirement that agents not commingle insurance monies with their own funds is known as

Fiduciary responsibility.

In which of the following locations would skilled care most likely be provided?

In an institutional setting

The type of term insurance that provides increasing death benefits as the insured ages is called

Increasing term

which is true regarding HMO coverage

It is divided into geographic territories

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.

The type of settlement option which pays throughout the lifetimes of two or more beneficiaries is called

Joint and survivor

If a contract provides a set amount of income for two or more persons with the income stopping upon the first death of the insured, it is called a

Joint life annuity.

Every insurer marketing Long-Term Care insurance must establish marketing procedures to ensure all of the following EXCEPT

LTC policies are marketed effectively to prospective insureds

Which of the following insurers are owned by stockholders who have the usual rights of ownership, including the right of voting?

Stock

Which of the following statements about a suicide clause in a life insurance policy is TRUE?

Suicide is excluded for a specific period of years and covered thereafter.

The Affordable Care Act requires all U.S. citizens and legal residents to have qualifying health care coverage. This is known as

The individual mandate.

'When a fixed annuity owner pays pays a monthly annuity premium to the insurance company, where is this money placed?

The insurance company's general account

. What must happen when an individual policy or annuity has been personally delivered to the policyowner?

The policyowner must sign a delivery receipt.

how does a member of an HMO see a specialist

The primary care physician refers the member

solvency

ability to meet financial obligations

Trust

an arrangement in which funds or property are held by a person or corporation for the benefits of another perosn

which of the following is not applied toward the deductible under a nonscheduled plan

annual dental exam

a viatical settlement provider must have certian docs before completing the contract. whic is NOT

birth certifate

what is the contract provision that allows the insurer to nonrenew health coverage if certain events occur

conditionally renewable - can be cancelled - does not specifiy condition or reason

When an insuer offers services like preadmission testing, second opinions regarding surgery, and preventitive care, which term would best apply

case managment provision

Which of the following is not a characteristic or service of an HMO plan

contracting with insurance companies

In insurance transactions, fiduciary responsibility means

handling insurer funds in a trust capacity

During partial withdrawal from a universal life policy, which portion will be taxed

interest

accumulations

interest taxable

common disaster provision

primary beneficiary dies first in a common disaster as long as the beneficiary dies within this specified period of time following the death of the insured (30 dyas)

taxable

subject to taxation

what is the purpose of insurance guaranty association

to protect policyowners against insurer insolvency

insolvent

unable to meet financial obligations

Pertaining to insurance, what is the definition of a fiduciary responsibility?

A legal obligation of one party to act in the best interest of another. The obligated party is typically a fiduciary, that is, someone entrusted with the care of money or property. Also called fiduciary obligation

participating

a term used to refer to any insurance policy that distributes its dividends by cash payments, reduced premiums, units of paid up life insurance, a savings program, or by the puchase of term insurance

which of the following is true regarding taxation of the accelerated benefits

a portion of the benefit up to a limit is tax free, the rest is taxable income

producer

agent or broker

If a policy includes a free-look period of at least 10 days, the Buyer's Guide may be delivered to the applicant

. With the policy.

In order to qualify for conversion from a group life policy that has been terminated to an individual policy of the same coverage, a person must have been insured under the group pan for how many years

5

In order to qualify for conversion from a group life policy that has been terminated to an individual policy of the same coverage, a person must have been insured under the group plan for how many years?

5

Which policy component decreases in decreasing term insurance?

Face amount

All of the following violations may result in an agent's imprisonment EXCEPT

Failing to report to the department a criminal prosecution taken against the agent in another jurisdiction.

Which of the following health care plans would most likely provide the insured/subscriber with comprehensive health care coverage?

Health Maintenance Organization plan HMO's provide a package of comprehensive health care services that include routine physicals, immunizations, well baby care, family planning, etc. as well as the treatment of sickness and injury

Medicare Part A services do NOT include which of the following?

Outpatient Hospital Treatment

. Which of the following do the Standard and Preferred risk categories share?

Premiums are not elevated.

Hospital indemnity/hospital confinement indemnity policy will provide payment based on

The number of days confined in a hospital.

Residual Disability

Type of disability income policy that provides benefits for loss of income when a person returns to work after a total disability, but is still not able to perform at the same level as before becoming disabled.

Which of the following policies would have an IRS required corridor or gap between the cash value and the death benefit

Universial life- option A

what are two components of a universail policy

insurance and cash account - always annual renewable term insurance

if a life insurance policy increases significantly in the face amount when the insured reaches a specified age, what type of policy is this

jumping juvenile policy - jumpes 5X

short term disability

less than2 years

Which Universal Life option has a gradually increasing cash value and a level death benefit?

option a

the reason for paying a benefit amount that is less than the insureds income is to

prevent overutilization and malingering

all of the following are considered to be supplemental benefits under an HMO plan except

preventitive services

Concurrent review

review for medical necessity of tests and procedures ordered during an inpatient hospitalization - monitor the stay

life contingency

dependent upon whether or not the insured is alive

all of the following are features and requirements of the living needs rider except

diagnosis must indicare that death is expected within 3 years

which settlement option provides a single beneficiary with income for the rest of their life

single life

Which of the following is excluded in a dental insurance plan?

Lost Dentures

What is the other term for the cash payment settlement option?

Lump sum

All of the following would be considered an insurance transaction EXCEPT

Obtaining an insurance license

How often may a viatical settlement provider contact an insured regarding the insured's health status if the insured's life expectancy is more than one year?

Once every 3 months

Which rider, when attached to a permanent life insurance policy, provides an amount of insurance on every family member?

Other insured rider

grace period

Period of time after the premium due date during which premiums may still be paid, and the policy and its riders remain in force.

In the executive bonus plan, who is the owner of the policy and who pays the premium

executive is the owner and the executive pays the premium

The patient protection and affordable care act includes all of the following provisions except

individual tax deduction for premiums paid

the patient protection and affordable care act includes all of the following provision except

individual tax deduction for premiums paid - does not offer tax deductions for health insurance premiums

policy endowment

maturity date

once a main order solicitation has been filed, how long may it be used

2 years

A producer's license must be renewed

Biennially.

What term is used to describe when the medical caregiver provides services to only members or subscribers of a health organization, and contractually is not allowed to treat other patients?

Closed panel

The gatekeeper of an HMO helps

Control specialist costs

What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan?

Diagnostic and preventive care

After three years of making payments into a flexible premium deferred annuity, the owner decides to surrender the annuity. The insurer returns all the premium payments to the owner, except for a predetermined percentage. What is this percentage called?

Surrender charge

With regards to premium rates, which of the following statements is NOT true?

The Commissioner sets all insurance premium rates used in Pennsylvania.

An insurance advertisement exaggerates the benefits of an insurance policy, due to human error at the insurer's advertising agency. Who will the Department of Insurance hold responsible for the exaggeration?

The insurer

riders

aded to the basic insurance polic, to add, modify, or delete policy provisions

in comparison to accidentl, a policy that used the accidental bodily injury definition would provide coverage that is

broader in general - provide broader coverage than a policy that uses the accidental means definition

how are state insurance guaranty associations funded

by their members- authorized insurers

if an insurance company offers medicare supplement policies, it must offer which of the following plans

A

a prospective insured receives a conditional receipt but dies before the policy is issued. the insurer will

Pay the policy proceeds only if it would have issued the policy - conditional receipt states that coverage will be effective either on the date of the application or the date of the medical exam, whichever occurs last, as only as the applicant is found to be insurable as a standard risk, and policy is issued exactly as applied for.

Buy- sell

any form of life insurance may be used to fund a buy sell agreement

employer contributions made to a qualified plan

are subject to vesting requirements

which of the following is considered to be a morale hazard

driving recklessly

Which of the following is NOT a metal level of coverage offered under the Patient Protection and Affordable Care Act?

iron

An employee is covered under COBRA. His previous premium payment was $100 per month. His employer now collects $102 each month. Why does the employer collect an extra $2?

to cover employer administation costs

why purchase life insurance over annuities

to create an estate

Why should the producer personally deliver the policy when the first premium has already been paid

to help the insured understand all aspects of the contract

when must insurable interst exist in a life insurance policy

at time of application

Which authority is Not stated in an agents contract buy is required for the agent to conduct business

implied

On participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are

not taxable since the IRS treats them as a return of a portion of the premium paid

which of the following docs must be provided to the policyowner or applicant during policy replacement

notice regarding replacement - signed by producer and applicant

in long term care insurance, what type of care is provided with intermediate care

occasional nursing or rehavilitative care

an inureds health claim internal appeal was denied. the insurer must do all of the following except

offer a payment plan

presumptive disability

offers full benefits for specified condition - two limbs, permanent blindness, loss of speech of hearing

Pertaining to insurance, what is the definition of a fiduciary responsibility

promptly forwarding premiums to the insurance company - position of trust

a licensee who has moved to pa from out of state must provide which of the following before becoming licensed as a resident in that state

proof of licensing or a letter of clearence from the previous home state

Under which provision can a physician submit claim information prior to providing treatment

prospective review

which is not true about beneficiary designations

the beneficiary must have insurable interest in the insured

If an annuitant dies before annuitization occurs, what will the beneficiary receive

the beneficiary will receive either the amount paid into the plan or the cash value of the plan, whichever is greater.)

Which of the following is not a characteristic of a group long term disability plan

the benefit can be up to 50% of one yearly income - max benefit is based upon monthly income

partial contributory

the cost is paid partially by employer and employee

n the event of loss, after a notice of claim is submitted to the insurer, who is responsible for providing claims forms and to which party?

insurer to the insured

indemnity

referred to as reimbursement

an insurance policy that only requires a payment of premium at its inception, provides insurance protection for the life of the insured and matures at age 100 is

single premium whole life - paid in one lump sum

all of the following are true regarding the covertability option under a term life life policy except

upon conversion, the death benefit of the permanent policy will be reduced by 50%

what is included in a policy summary

Premium amounts and surrender values - also producers name address, insurance company home office, generic name of policy issued, premium, cash value, surrender, death benefit

an insurer that holds a certificate of authority in the state in which it transacts business is considered a

authorized insurer

Enrollment of medicare PArt A

intial enrollment- starting 3 months before turning 65 and ending after 65th birthday general enrollment- between jan 1 and march 31 special enrollment- at any time - 10% fee if not enrolled at right time

Following a covered loss, the time payment of claims provision requires that an insurance company pay disability income benefits no less frequently than

monthly

which of the following describes gross annual premium

net premium plus expenses

Medicare Part D provides

Prescription drug benefit.

Part d

Prescription drug coverage

primary source of info used for insurance underwriting

application

qualified retirement plan

approved by IRS -exclusive benefit of employees and their beneficiaries - permanent

the full premium was submitted with the application for life insurance, and the policy was issued two weeks later as requested. when does the policy coverage become effective

as of the application date

Part a

hospital insurance - nursing facility, home health care, hospice care -- original medicare

Medicaid

A federal and state assistance program that pays for health care services for people who cannot afford them.

The interest earned on policy dividends is

taxable

Multiple Employer Trust (MET)

A group of small employers who do not qualify for group insurance individually, formed to establish a group health plan or self-funded plan.

9. Which of the following must the patient pay under Medicare Part B?

20% of covered charges above deductibles

Terminally ill patients are expected to survive how many months

24

To attain fully insured status under Social security. an individual must have earned how many credits

40

A tornado that destroys property would be an example of which of the following?

A peril

Which of the following persons is required to hold a producer license?

A person who negotiates insurance contracts

Which of the following would be required to be licensed as an insurance producer?

A salaried employee who advertises and solicits insurance

who might receive dividends from mutual insurer

policyholders - NOT taxable

Which of the following does not describe the principal goal of a preferred provider organization

provide medical services only from physicians in the network

second to die policy

survivorship

cash value gains

taxed surrender

7. What does "level" refer to in level term insurance?

. Face amount

What is the shortest possible elimination period for group short term disability benefits provided by an employer

0 days

which of the following would be a typical maximum benefit offered by major medical plans

1 million

HIPAA applies to groups of

2 or more

Within how many days must a producer respond to an inquiry from the Commissioner?

30

what is the elimination period for social secutiry disability benefit

5 months

Benefit periods for individual short-term disability policies will usually continue from

6 mon to 2 years

Which of the following ultimately determines the interest rates paid to the owner of a fixed annuity?

Insurer's guaranteed minimum rate of interest

The mode of premium payment

Is defined as the frequency and the amount of the premium payment.

Bob decides to sell his life insurance policy to a viatical settlement company. which of the following is true

It is the viatical settlement providers responsibility to inform his insurance company that the policy has been viaticated - written notice to the insurer - within 20 days

Which of the following is true regarding a single life settlement option?

It provides income the beneficiary cannot outlive.

Part C

Medicare Advantage

All of the following are true regarding rebates EXCEPT

Rebates are allowed if it's in the best interest of the client. TRUE Dividends are not considered to be rebates. Rebates are only allowed if specifically stated in the policy d) Rebating can be anything of economic value, given as an inducement to buy.

In which of the following cases would an "any occupation" disability income policy pay the benefits?

The insured is unable to perform any jobs in the field related to the insured's education and experience.

An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss?

Time of payment claims

Why should the producer personally deliver the policy when the first premium has already been paid?

To help the insured understand all aspects of the contract

When an individual purchases insurance, what risk management technique is he or she practicing?

Transfer

If the owner of a whole life policy who is also the insured dies at age 80, and there are no outstanding loans on the policy, what portion of the death benefit will be paid to the beneficiary?

a full death benefit

PPO

a group of physicians and hospitals that contract with employers, insurers, or third party organizations to provide medical care services ata reduced fee

How is emergency care covered for a member of an HMO?

a member of an HMO can receive care in or out of the HMO service area, but care is preferred in the service area

An insured is receiving hospice care. His insurer will pay for painkillers but not for an operation to reduce the size of a tumor. What term best fits this arrangement?

cost- containment - daily needs, pain releif

false about group disability income insurance

coverage applies both on and off the job

What characteristic makes whole life permanent protection

coverage until death or age 100

orthodontics

dental practice of straightening teeth

the death benefit in a variable universial life policy

depends on the performance of a separate account - is not fixed

which is true about the cash surrender nonforfeiture option

funds exceeding the premium paid are taxable as ordinary income

Under which of the following disability income plans would the benfits be subject to income tax

group

as it pertains to group health insurance, COBRA stipulates that

group coverage must be extended for terminated employees up to a certain period of time at the former employees expense

policy proceeds

in life insurance, the death benefit

ROTH IRA

individual retirement acount funded with after tax contributions -can contribute 100% of earned income - grows tax free as long as the account is open for 5 years

an insurer receives a report regarding potential insured that includes financial status, hobbies, and habits

inspection report

When the fixed annuity owner pay a monthly annuity premium to the insurance company, where is this money placed

insurance companys general account

all of the following statments about medicare part B are correct except

it is compulsory program

incorrect about medicaid

it is solely a federally administered program

not true concerning whole life insurance

lump sum death benefits are not taxable

Which of the following groups would most likely be covered under a blanket accident policy?

students at a public school

which of the following statements about a suicide clause in a life insurance policy is trye

suicide is excluded for a specific period of years and covered thereafter

best interest of the insured

suitability

surrenders

surrender value- past premium= amount taxable

accelerated benefits

tax free to terminally ill

nonforfeiture values guarantee which of the following for the policyowner

that cash value will not be lost

which of the following determines the cash value of a variable life policy

the performance of the policy portfolio - variable fluctuates and is not guaranteed

general requitements of a qualified plan except

the plan must provide an offset for social security benefits

All of the following are true concerning the use of life insurance as an executive bonus except

the policy is owned by the company ACUTALLY OWNED BY THE EMPLOYEE

an insured stops making payments on a loan taken from his cash value policy. what will most likely happen

the policy will terminate when the loan amount with interest equals or exceeds the cash balue

all of the following statements about medicare supplement insurance policcies are correct except

they cover the cost of extended nursing home care

all of the following are requirements for life insurance illustrations except

they must be part of the contract

which of the following statements is true concerning employer group dental plans

they seldom contain a conversion privilege

Which option for universial life allows the beneficiary to collect both the death benefit and cash value upon the death of the insured

under option B the death benefit includes the annual increase in cash value so that the death benefit gradually increases each year by the amount that the cash value increases. - at any point the total death will ALWAYS be equal to the face amount plus the current amount of cash value.

a person who gives money as considereation for life insurance

viatical settlement purchaser

viatical settlement brokers represent

viators

the main difference between immediate and deferred annuities is

when the income payments begin

rollover

withdrawal of money from one qualified plan and placing it into another plann

Rebating is an unfair trade practice and is regulated by law. All of the following would be considered to be rebating EXCEPT

An agent misrepresents policy benefits to convince a policyowner to replace policies.

an underwriter is reviewing an applicant with an extensive medical history. which of the following would give the underwritier a better understanding of treated illness

Attending phyisican statment

A man is still employed at age 65 and is now eligible for Medicare. He wants to know what health insurance coverage he is eligible to receive. Which of the following options are available to him?

Continuation of group health only

If an insurer appoints a producer, which authority must be notified?

Department of Insurance

What is not a benefit of a POS plan

It allows guaranteed acceptance of all applicants.

What statement best describes the free look provision?

It allows the insured to return the policy within 10 days for a full refund or premiums if dissatisfied for any reason

Which of the following is TRUE regarding the annuity period?

It may last for the lifetime of the annuitant.

Prosthodontics

Replacement of natural teeth with artificial teeth or dentures

. Which of the following is a risk classification used by underwriters for life insurance?

Standard

Which of the following is TRUE about nonforfeiture values?

They are required by state law to be included in the policy.

Accidental bodily injury

Unplanned, unforeseen traumatic injury to the body.

estate

a person's net worth

Which of the following documents used in the underwriting process contains specific medical details about an applicant

attending physicians statement APS

which component increases in increasing term insurance

death benefit

life insurance death proceeds are

generally not taxed as income

buyers guide

generic consumer publication that explains life insurance in general terms in order to assist applicant in decision making

medicare part b covers all except

long term care

Which of the following is NOT true regarding the regulation of variable annuities? CHARACTERISTICS

1) Underlying Investment - the payments that annuitant makes into the varibe annuity are invested in the insurers separate account not their general account. 2)Interest Rates - issuing insurance company does not guarantee a minimum interest rate. 3) License Requirements - a variable annuity is considered a security and is regulated by the securities exchange commission in addition to state insurance regulations.

What is the civil penalty for violating a cease and desist order of the Commissioner?

1000

A producer licensed in Pennsylvania must notify the Insurance Department of any change of address in his or her residence or business address within how many days?

30

Which of the following provisions requires that any policy language that is in conflict with the state statutes of the state in which the insured resides is automatically amended to conform with those of the state of residence?

? Conformity with state statutes

All other factors being equal, what would the premium be like in a survivorship life policy as compared to the premium in a joint life policy?

?Lower

If an insured withdraws a portion of the face amount in the form of accelerated benefits because of a terminal illness, how will that affect the payable death benefit from the policy?

Accelerated benefits are life insurance death benefits that are paid before the death of an insured if he is suffering from a terminal illness."

Two individuals are in the same risk and age class; yet, they are charged different rates for their insurance policies due to an insignificant factor. What is this called?

Discrimination

Which provision allows the policyholder a period of time, while coverage is in force, to examine a health insurance policy and determine whether or not to keep it?

Free look period

Which of the following expenses is NOT covered by a health insurance policy?

Funeral

Which o the following is true about the premium on the children's rider in a life insurance policy?

It remains the same no matter how many children are added to the policy: it is based on an average number of children.

All of the following statements describe a MEWA EXCEPT

MEWAs are groups of at least 3 employers

In group insurance, what is the policy called?

Master policy

Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?

Parts A and B of Medicare

When an employee is still employed upon reaching age 65 and eligible for Medicare, which of the following is the employee's option?

Remain on the group health insurance plan and defer eligibility for medicare until retirement.

Which rule would apply if an agent knows an applicant is going to cash in an old policy and use the funds to purchase new insurance?

Replacement rule

Which of the following is an example of a peril covered in an accident and health insurance policy?

Sickness

How soon after the due date should the insurer pay the agent appointment fees?

Within 30 days

What is the amount a physician or supplier bills for a particular service or supply?

actual charge

When must insurable interest exist in a life insurance policy?

at the time of the loss

A policyowner fails to pay the premium due on his whole life policy after the grace period passes, but the policy remains in force. This is due to what provision?

automatic premium loan

All of the following are true regarding insurance policy loans EXCEPT

employer contributions are not tax deductible TRUE tax accumulation is deferred 2. they must be approved by the IRS 3. withdraws are taxed

Forcing a client to buy insurance from a particular lender as a condition of granting a loan is defined as

Coercion

Accelerated Benefits

Riders attached to life insurance policies which allow death benefits to be used to cover nursing or convalescent home expenses.

In individual health insurance coverage, the insurer must cover a newborn from the moment of birth, and if additional premium payment is required, allow how many days for payment?

Within 31 days of birth

the type of policy that can be changed from one that does not accumulate cash value to one that does is

convertible term policy - can convert to permanent insurance

Which statement regarding insurable risks is not correct

insureds cannot be randomly selected

concealment

intentional withholding of information of a material fact

Medicare Advantage

is not provided through HMO

which provision allows a person to return a medicare supplement policy within 30 days for a full premium refund

right to examine

Which of the following best details the underwriting process for life insurance

selection, classificaation, and rating of risks

A domestic insurer issuing variable contracts must establish one or more

separate accounts -

Beneficiary

the person who receives the proceeds from the policy when the insured dies.

cash value

the policy's savings element or living benefit

which of the following statements is correct regarding whole life policy

the policyowner is entitled to policy loans -

What happens when an individual policy or annuity has been personally delivered to the policyowner

the policyowner must sign a delivery receipt

deductible

the portion of the loss that is to be paid by the insured before any claim may be paid

Which of the following is true regarding optional benefits with long-term care policies

they are available for an addiional premium

in order for an insurer to legally transact insurance, it must obtain which of the following

certificate of authority

Taxable benefits

hsa- 20% penalty under 65, no penality over 65 for nonmedical use MSA- when taken out at the end of the year Business over head expense Group disability income

When would a misrepresentation on the insurance application be considered fraud

if it is intentional and material

total disability

inability of the insured to perform any occupation for which he or she is reasonabily suited by reason of education training or experience

A typical Accidental Death & Dismemberment policy covers all of the following losses EXCEPT

income

The type of settlemet option which pays throughout the lifetimes of two or more beneficiaries is called

joint and survivor option -beneficiaries are still living

determine how much insurance someone needs based on financial objectives

needs approach

enrollle

a person enrolled in a health insurance plan, an insured

Gatekeeper

a primary care physician in an HMO plan

a man is an attorney when he applies for a ehalth policy. he decides to become a professional bungee jumper. he flies a claim. what should happen?

the insurance company will pay the claim according to the benefits available if the correct premium had been paid

Which of the following would NOT be considered an exception to the National Do Not Call List?

-Calls based from outside of the United States Calls from outside the United States are not an exception to the National Do Not Call List.

n insurer publishes intimidating brochures that portray the insurer's competition as financially and professionally unstable. Which of the following best describes this act?

-Illegal under any circumstances When a company criticizes the financial situation of another company, with the intention of injuring that company, it has committed an illegal trade practice called "defamation."

Insurers must notify the Commissioner's office as to whether or not a life insurance policy will be marketed with illustrations. Certification of that notification must be provided annually within how many days of the anniversary of the original certification?

30 days

. According to the Entire Contract provision, a policy must contain

A copy of the original application for insurance

cease and desist order

A demand of a person to stop committing an action that is in violation of a provision.

All of the following are personal uses of life insurance EXCEPT

buy-sell agreement - business uses of life insurance

All of the following statments concerning dividends are true except

dividend amounts are guaranteed in the policy

defined contribution plans

focus on contrubutions rather than on the benefits promised to the employee

what type of insurance would be used for a return of premium rider

increasing term

Joint life with term certain

pays to two or more until the first one dies

Which clause allows both the insured and dentist to know in advance which benefits will be paid?

precertification

what is the purpose of the buyers guide

to allow the consumer to compare the costs of different policies

endow

to have the cash value of a whole life policy reach the contractual face amount

periodontics

treatment and prevention of diseases of the gums, bone, and structures supporting the teeth

At the time of initial licensing, what fee must a viatical settlement provider pay?

$300

what fee must a viatical settlement provider pay

$300

Under which nonforfeiture option does the company pay the surrender value and have no further obligations to the policyowner

cash surrender

What limits the amount that a policyowner may borrow from a whole life insurance policy

cash value

What is an important feature of a dental expense insurance plan that is not typically found in a medical expense insurance plan

diagnostic and preventive care - covers treatment, care, and prevention of dental disease

nontaxed return of unused premiums

dividend

all of the following may be excluded from coverage in major medical expense policy, except

emergency surgery

What required provision protects against unintentional lapse of the policy

grace period

what required provision protects against unintentional lapse of the policy

grace period

Which of the following is true regarding the childhood immunization benefit in medical plans issued in this state?

its mandatory

Which statement is not true regarding a Straight Life policy

its premium steadily decreases over time, in response to its growing cash value

which statement is NOT true regarding a Straight Life policy?

its premium steadily decreases over time, in response to its growing cash value

during replacement of life insurance, a replacing insurer must do which of the following

obtain a list of all insurance policies that will be replaced - send to existing insurnce company

how often may a viatical provider contact an insured regarding the health status of insured

once every 3 months

the dividend option in which the policyowner used dividends to purchase a term policy for one year is referred to as the

one year term option

with respect to the entire contract clause in health policies, who has the authority to make changes to existing policy?

only an executive officer of the company

All of the following are true of an annuity owner EXCEPT

owner must be a party

when the owner of a participating whole life policy uses the dividend to provide more life insurance coverage, which of the following options is being used

paid- up additions

which of the following is another term for the accumulation period of an annuity

pay in period

Medicare select does not

prohibit payment for regularly covered services if provided by non network providors

When a life insurance policy stipulates that the beneficiary will receive payments in specified installments or for a specified number of years, what provisions prevents the beneficiary from changing or borrowing from the planned installments

spendthrift provision

Which of the following policies would be classified as a traditional level premium contract?

striaght life

In which of the following situations is it legal to limit coverage based on marital status?

t is never legal to limit coverage based on marital status.

which of the following would help prevent a universial life policy from lapsing

target premium

Qualified plans

tax deductible -approved by IRS -Cannot discriminate -earnings grow tax defrred -withdrawals are taxed

Which of the following is an example of liquidity in a life insurance contract

the cash value available to the policyowner - availability of cash to the insured.

profit sharing plan

where the employer will contribute monies into an employees retirement plan when the company shows a profit

buyer guide is given

with the policy

HMO

A group plan offering prepaid medical care to its members -must have 25 employees

Medicare SELECT policy

A medicare supplement policy or certificate that contains restricted network provisions conditioning the payment of benefits on the use of network providers.

extension of benefits

A provision that allows coverage to continue beyond the policy's expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to work or the dependent leaves the hospital.

accidental death and dismemberment

An insurance policy which pays a specified amount or a specified multiple of the insured's benefit if the insured dies, loses his/her sight, or loses two limbs due to an accident.

. In an annuity, the accumulated money is converted into a stream of income during which time period?

Annuitization period

Which of the following is not true of Disability Buy-Sell coverage?

Benefits are considered taxable income to the business.

Which of the following options best depicts how the eligibility of members for group health insurance is determined?

By conditions of employment

A man is injured while robbing a convenience store. How does his major medical policy handle the payment of his claim?

Claim is denied if his policy contains the Illegal Occupation provision

Combination plans are comprised of two types of plan features: basic and

Comprehensive.

Which of the following would be considered an illegal inducement to purchase insurance?

Confirming future dividends in a life insurance proposal

According to the Fair Credit Reporting Act, all of the following would be considered negative information about a consumer EXCEPT

Disputes regarding consumer report information

. All of the following statements concerning dividends are true EXCEPT

Dividend amounts are guaranteed in the policy.

Which of the following is true regarding taxation of dividends in participating policies?

Dividends are not taxable.

Which of the following is considered a qualifying event under COBRA

Divorce

what is the goal of the hmo

Early detection through regular checkups

Under which installments option does the annuitant select the amount of each payment, and the insurer determines how long they will pay benefits?

Fixed amount

If a settlement option is not chosen by the beneficiary or policyowner, which option will be used?

Lump sum

All of the following statements concerning Medicaid are correct EXCEPT

Medicaid is a state funded program that provides health care to persons over age 65, only

Which of the following is considered to be a morale hazard?

Morale hazard describes indifference to unintentional risk.

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

NAIC

What is the initial period of time specified in a disability income policy that must pass, after the policy is in force, before a loss can be covered?

Probationary period

. When a life insurance policy was issued, the policyowner designated a primary and a contingent beneficiary. Several years later, both the insured and the primary beneficiary died in the same car accident, and it was impossible to determine who died first. Which of the following would receive the death benefit?

The insured's contingent beneficiary

In forming an insurance contract, when does acceptance usually occur?

When an insurer's underwriter approves coverage

If an applicant for a life insurance policy and person to be insured by the policy are two different people, the underwriter would be concerned about

Whether an insurable interest exists between the individuals.

irrevocable beneficiary

a beneficiary who has a vested interest in the policy and therefore, the policyowner may not exercise certain rights with out the consent of the beneficiary

capital sum

a portion of the principal sum of a health insurance policy; paid for accidental dismemberment or loss of sight in one eye

Which of the following is another term for the accumulation period of an annuity?

pay - in period

an insured committed suicide one year after his life insurance policy was issured. The insurer will

refund the premiums paid

Accident

An unplanned, unforeseen event which occurs suddenly and at an unspecified place.

Which document helps ensure that full and fair disclosure is provided to the recipient of a policy?

Outline of coverage- relesed at the ime of application or upon delivery of the policy

When an individual is covered under two health insurance policies that have duplicate benefits which could make a claim for benefits because of an injury or illness profitable, it is called

Overinsurance

An employee has group life insurance through her employer. After 5 years, she decides to leave the company and work independently. How can she obtain an individual policy?

She can convert her group policy to an individual policy without proof of insurability within 31 days of leaving the group plan.

If a deferred annuity is surrendered prematurely, a surrender charge is imposed. How is the surrender charge determined?

The surrender charge is a percentage of the cash value and decreases over time.

A guaranteed renewable health insurance policy allows the

insurance policy feature that obligates the insurer to continue coverage as long as premiums are paid on the policy

How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?

Within 90 days or as soon as reasonably possible, but not to exceed 1 year

In a direct rollover, how is the money transferred from one plan to the new one?

directly from the trustee of the first plan to the trustee or administrator/custodian of the new IRA plan.

Individual long term

PREM Deductible for employer BEN NOT TAX

To avoid violations of unfair claims settlement regulations, insurers are required to acknowledge the receipt of a claim within how many days?

10 days

An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy?

10 days The grace period is 7 days if the premium is paid weekly, 10 days if paid monthly, and 31 days for all other modes.

According to OBRA, what is the minimum number of employees required to constitute a large group?

100

which of the following is not a cost saving service in medical plan

denial of coverage

lump-sum

payment of the entire benefit in one sum

hazard is best defined as

something that increases the risk of loss

Which of the following are the authorities that an agent can hold?

express or implied

An insured purchased an insurance policy 5 years ago. Last year, she received a dividend check from the insurance company that was not taxable. This year, she did not receive a check from the insurer. From what type of insurer did the insured purchase the policy?

Mutual: Funds not paid out after paying cliams and other operating costs are returned to the p olicowners in the form of a dividend

The primary eligibility requirement for Medicaid benefits is based upon

Need ( Medicaid is a program operated by the state with some federal funding to provide medical care for those in need)

A long-term care shopper's guide must be presented at what point?

Prior to the time of application

The annuity owner dies during the accumulation period without naming a beneficiary. Annuity's cash value exceeds premiums paid. Which of the following is TRUE?

The cash value will be paid to the annuitant's estate.

Which is NOT true regarding an insured who is considered to be a standard risk?

The insured may have to pay slightly higher premiums.

tax-sheltered annuity is a special tax-favored retirement plan available to

certain group of employees only - nonprofit charitable, educational, religious

Which of the following insurance options would be considered a risk sharing arrangement

reciprocal

month grace period

10

Which of the following disability income policies would have the highest premium

15 day waiting period, 10 year benefit period - longer the benefit, higher the premium

How long does a temporary producer's license last for the surviving spouse of a deceased producer?

180

A producer has successfully completed 52 hours of CE. How many hours can the producer apply to her current reporting period, and how many hours can she carry forward to the next reporting period?

24 hours will be applied to the current reporting period, and 24 can be applied to the period immediately following. The excess 4 hours may not be carried over.

if an individual willfully violates provisions of the fair credit reporting act, what is the max civil penalty

2500

For how long must a company maintain a complete file of all advertisements used?

4 years

Limited Pay Whole Life

A variation of whole life insurance that charges a level annual premium and provides a level, guaranteed death benefit to the insured's age 100 and will endow for the face amount if the insured lives to age 100. Limited-pay life is designed so that the premiums for coverage will be completely paid-up well before age 100.

A couple owns a life insurance policy with a Children's Term rider. Their daughter is reaching the maximum age of dependent coverage, so she will have to convert to permanent insurance in the near future. Which of the following will she need to provide for proof of insurability?

Proof of insurability is not required. A children's term rider is attached to a life insurance policy, children can be covered under the policy until they reach the max age stated in the policy. At that point, they can convert their coverage to a new policy without having to issue proof of insurability.

What form of the annuity settlement options provides payments to an annuitant for the rest of the annuitant's life and ceases at the annuitant's death?

Pure life

Which of the following types of policies allows the policyowner to skip premium payments, provided that there is enough cash value in the policy to cover the premium amount?

Universal life

Who negotiates viatical settlement contracts on behalf of a viator

Viatical broker

Which of the following employees insured under a group life plan would be allowed to convert to individual insurance of the same coverage once the plan is terminated?

b) Those who have been insured under the plan for at least 5 years If the master contract is terminated, every individual who has been on the plan for at least 5 years will be allowed to convert to individual insurance of the same coverage.

Twin brothers are starting a new business. They know it will take several years to build the business to the point that they can pay off the debt incurred in starting the business. What type of insurance would be the most affordable and still provide a death benefit should one of them die?

joint life - based on an average age - would pay death benefit only at the first death

what are the licensing requirements for someone who sells variable universial life insurance

life insurance and securities

death benefit

not income Taxable - except for interest

if a court ordered payment for a loss that was not covered in the policy even if it was clearly worded, it would be an example of which legal concept

reasonable expectations - advertising or sales literature or statements by an agent, an insured could reasonably expect coverage, the courts have held that the insurer must provide that coverage

What type of insurer uses a formal sharing agreement

reciprocal insurers

An insured committed suicide one year after his life insurance policy was issued. The insurer will

refund the premium paid

What type of information is not included in a certificate of insurance

the cost the company is paying for monthly premiums

A group of 15 skydivers meet at a seminar and begin talking about life insurance during a break. Because it is expensive to get individual life insurance, they decide to band together to form a small group so that they will be eligible. They apply for small group life insurance and are rejected. Why?

the purpose of the group was to purchase life insurance

IRS

responsible for collecting of taxes and enforcement of the internal revenue code

An insured misstated her age on an application for an individual health insurance policy. The insurance company found the mistake after the contestable period had expired. The insurance company will take which of the following actions regarding any claim that has been issued?

Adjust the claim benefit to reflect the insured's true age

Level term insurance provides a level death benefit and a level premium during the policy term. If the policy renews at the end of a specified period of time, the policy premium will be

Adjusted to the insured's age at the time of renewal.

coinsurance

An agreement between an insurer and insured in which both parties are expected to pay a certain portion of the potential loss and other expenses.

Accidental death insurance

An insurance policy that provides payment if the insured's death is the result of an accident.

all of the following qualify for medicare PArt a except

Anyone who is willing to pay a premium

an underwritier is reviewing medical questions in the app and needs more info due to medical situation the app had in the past. What does he require

Attending physician statment - details about specific condition

Which of the following statements concerning buy-sell agreements is true?

Buy-sell agreements are normally funded with a life insurance policy

Concerning group Medical and Dental insurance, which of the following statements is INCORRECT?

Employee benefits are tax deductible the year in which they were received CORRECT Premiums paid by the employer are deductible as a business expense Benefits received by the employee are free from federal income tax D. Employee paid premiums may be deducted if certain conditions are met

Which statement regarding insurable risks is NOT correct?

Insureds cannot be randomly selected.

Which of the following best describes the MIB

It's a nonprofit organization that maintains underwriting information on applicants for life and health insurance.

Which of the following programs expands individual public assistance programs for people with insufficient income and resources?

Medicaid

describes gross annual premium

net premium plus expenses

Group Medical

premiums deductible for employer benefits not taxable

Where would the underwriter find relevant information not presented by the applicant but communicated by the producer?

application

Which of the following is the most common time for errors and omissions to occur on the part of an insurer?

application

A rider that may be attached to a life insurance policy that will adjust the face amount based upon a specific index, such as the Consumer Price Index, is called

Cost of living rider.

Which of the following types of agent authority is also called perceived authority

apparent - appearance/ assumption of authority based on actions, words, or deeds of the principle or because of circumstances the principal created

a producer in another state wants to become a produceer in pa. the other state gives the same privileges to pa producers wanting to be licensed in that state as it does its own producers. PA therefore extends the privileges of its producers to the prospective producer of the other state. What is this called

RECIPROCITY

Under the Fair Credit Reporting Act, if the consumer challenges the accuracy of the information contained in his or her report, the reporting agency must

Respond to the consumer's complaint.

In terms of parties to a contract, which of the following does not describe a competent party?

THe person must have at least completed secondary education

If a beneficiary is NOT named for annuity benefits, to which entity will the benefit be paid?

The annuitant's estate

Which of the following is NOT the consideration in a policy?

The application given to a prospective insured

All of the following are TRUE statements regarding the accumulation at interest option EXCEPT

The interest credited under this option is TAXABLE, whether or not the policyowner receives it. TRUE The annual dividend is retained by the company. BThe interest is credited at a rate specified by the policy. CThe policyholder has the right to withdraw the accumulations at any time.

annuity

a contract that provides income for a specified period of years or for life.

capitation

a payment arrangement that pays a phusician or group of physiscians a set amount for each enrolled preson assigned to them, per period of time, whehter or not that person seeks care.

benefit period

a period of time during which benefits are paid under the policy

during replacement, procedures must provide a list of insurance policies still in force. In addition, they must list policies sold during the past

5 years

If someone wants to buy a life insurance policy that will provide lifetime protection against premature death, what type of life insurance policy should that person buy

Permanent - provides lifetime death protection, and savings or investment option

guaranteed renewable

a policy that is written on a noncancellable basis with the right to renew

Underwriting for disability insurance is unique due to the type of risk involved. Which of the following situations illustrates this?

A construction worker pays a higher premium and receives a poorer classification of disability.

All of the following could own group life insurance EXCEPT

A group needing low-cost life insurance.

Which of the following best describes a misrepresentation?

A statement intended to distract, mislead, or deceive a party to a contract

All of the following qualify for Medicare Part A EXCEPT

Anyone who is willing to pay a premium Medicare was not designed for a specific class of society but primarily for citizens age 65 and over.

Which of the following does a producer NOT have the authority to do?

Bind an insurance company to a contract

All of the following are characteristics of a Major Medical Expense policy EXCEPT

Blanket coverage

Which of the following best describes fixed-period settlement option?

Both the principal and interest will be liquidated over a selected period Of time

Which of the following reports will provide the underwriter with the information about an insurance applicant's credit?

Consumer report

The type of policy that can be changed from one that does not accumulate cash value to the one that does is a

Convertible term policy

An insured has medical insurance coverage through 2 different providers, both covering the same expenses on an expense-incurred basis. Neither company knows in advance that the insured has coverage through any other insurers. The insured submits a claim to both insurers. How should the claim be handled?

Each insurer should pay a proportionate share of the claim

If an insurer becomes insolvent, which of the following would pay benefits to policyholders?

Guaranty association

Who must pay for the cost of a medical examination required in the process of underwriting?

Insurer

Which of the following statements about the reinstatement provision is true?

It requires the policy owner to pay, with interest, all premiums that are in arrears in order for the policy to be reinstated

Which of the following statements is TRUE about a policy assignment?

It transfers the ownership rights under the policy to the extent expressed in the assignment form

Which of the following is correct concerning the taxation of premiums in a key-person life insurance policy?

Premiums are not tax-deductible as a business expense

Which of the following are the main factors taken into account when calculating residual disability benefits?

Present earnings and earnings prior to disability. Residual disability will help pay for loss of earnings by making up the difference between the employee's present earnings and what they were earning prior to disability.

What would a physician utilize if he/she wanted to know if a treatment is covered under an insured's plan and at what rate it will be paid?

Prospective Review

Nonforfeiture values guarantee which of the following for the policyowner?

That the cash value will not be lost. Because permanent life insurance policies have cash values, there are certain guarantees built into the policy that cannot be forfeited by the policyowner. Nonforfeiture values give the insured the right to the cash value even if the policy lapses or is surrendered.

Which of the following is correct about Medicare?

The program is divided into four parts(A-D)

Which of the following named beneficiaries would NOT be able to receive the death benefit directly from the insurer in the event of the insureds' death?

William, Jr., minor son of the insured

Insurance producers that do not have company appointments are considered a/an

representative of the consumer

An insured receives a monthly summary for his life insurance policy. He notices that the cash value of the policy is significantly lower this month than it was last month. What type of policy does the insured have?

variable- life policies vary in value, as the name suggests, because the value is based on the stocks that support the policy. If a policyholder wants a more stable, reliable value, he/she should invest in a fixed policy.

waiting period

a period of time that must pass after a loss occurs before th insurer starts paying

all of the following are examples of risk rentention except

premiums - planned assumption of risk or acceptance of the loss

level term

premiums and death benefits stay the same for the life of the policy

regarding the taxation of business overhead policies

premiums are deductible, and benefits are taxed

medicare

A federal program of health insurance for persons 65 years of age and older available to social security disability income for 2 years or has permanent kidnet failure or ALS

Who is the owner and who is the benefiicary on a key person life insurance policy

the employer is the owner and beneficiary

All of the following are true of an annuity owner EXCEPT

The owner must be the party to receive benefits.

accumulation period

The time over which the annuitant makes payments or investments in an annuity, and when those payments earn interest tax deferred.

Prior to purchasing a Medigap policy, a person must be enrolled in which of the following?

a and b

Contingent beneficiary

a beneficiary who has second claim to the policy proceeds after the death of the insured

a provision in a life insurance policy that provides for the early payment of some portion of the policy face amount should the insured suffer from a terminal illness

accelerated benefit provision -given without an increase in premium -will deduct an interest charge from proceeds paid out to make up for their loss earnings

limited policies

accident only accidental and death dismemberment travel accident specified disease (dread) hospital indemnity (income) critical illness blanket insurance perscription durgs vision and health care dental

which of the following provisions must be included on the first page of a medicare supplement policy, which states the insureres right to change premium amount

continuation provision

Which of the following is true concerning creditors of the deceased insured

creditors have rights to the proceeds if they can show evidence of valid assignment

a health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is

critical illness

an agents is filling out an insurance applicantion for a client. the applicant realizes she should have answered an earlier question differently. Which of the following methods should the agents use to change the problem

cross out in incorrect info and write the correct answer, and have the applicant initial the changeW

When a person applies for Medicare supplement insurance, whose responsibility is it to confirm that the applicant does not already have accident or sickness insurance already in force? a) Federal government b) Agent c) Insurer d) State government

insurer

All the following are characteristics of group life insurance except

premiums are determined by the age, sex, and occupation of each individual - Determined of the entire group, not each individual

Which of the following is not provided by an HMO

reimburesement

An insured purchased a 10-year level term life policy that is guaranteed renewable and convertible. What happens at the end of the 10-year term?

the insured may renew the policy for another 10 years, but at a higher premium rate - do not need evidence of insurability

The insured under a $100,000 life insurance policy with a triple indemnity rider for accidental death was killed in a car accident. It was determined that the accident was his fault. The triple indemnity rider in the policy specifies that the death must not be contributed to by the insured in any manner. In this case, what will the policy beneficiary receive?

$100,000 (not the triple amount - the triple indemnity rider was voided bc he caused the accident)

An insurance company forwards fixed annuity premiums to their general account, where the money is invested. The guaranteed minimum interest is set at 2.5%. During an economic downswing, the investments only drew 2%. What interest rate will the insurer pay to its policyholders?

2.5%

According to the telemarketing sales rules, what are the permissible calling hours for telemarketing calls?

8am- 9 pm

If a licensed person is moving to Pennsylvania, he or she may become licensed as a resident if they submit a completed application within how many days of establishing residence in Pennsylvania with proof of licensing from their prior home state?

90

An insured has chosen joint and 2/3 survivor as the settlement option. What does this mean to the beneficiaries?

The surviving beneficiary will continue receiving 2/3 of the benefit paid when both beneficiaries were alive. When the reduced option is written as "joint and 2/3 survivor," the surviving beneficiary receives 2/3 of what was received when both beneficiaries were alive.

The insurer must be able to rely on the statements in the application, and the insured must be able to rely on the insurer to pay valid claims. In the forming of an insurance contract, this is referred to as

Utmost good faith

In a replacement situation, all of the following must be considered EXCEPT

asssets

Which statement accurately describes group disability income insurance?

The extent of benefits is determined by the insured's income

accidental death benefits

A policy rider that states that the cause of death will be analyzed to determine if it complies with the policy description of accidental death.

accident insurance

A type of insurance that protects the insured against loss due to accidental bodily injury.

An insured does not have to pay co-insurance or deductibles on a full-series mouth x-ray, but does have to pay a deductible to get his cavities filled. Which dental plan does he have?

nonscheduled

death benefits payable to a beneficiary under a life insurance policy are generally

not subject to income taxation by the federal government

Nonqualified

not tax deductible -does not need IRS approval -plan cannot discriminate earnings grow tax deferred excess over cost basis is TAXED

if an immediate annuity is purchased with the face amount at death or with the cash value at surrender, this would be considered a

settlement option

when the insured initiates the cancellation of a policy, the unearned premium will be refunded on a

short rate basis

Upon policy delivery, the producer may be required to obtain any of the following EXCEPT

signed waiver of premium

if the policy is rated-up, which of the following is true

the premium increases

Level premium

the premium that does not change throughout the life of a policy

one an insurer receives a claim, within how many days must the insurer provide claim forms to the insured

10 working days

For how many days of skilled nursing facility care will Medicare pay benefits?

100

in a noncontributory health insurance plan, what percentage of eligible employees must participate in the plan before the plan can become effective

100%

an agent receive some inaccurate inf and as a result he publicly misstated te financial condition of another entity 12 times over a period of 3 months. this is fact is revealed, the agent may face a fine up to

10000

n order to collect Social Security disability benefits, the claimant must be able to demonstrate that the disability will last at least

12 months.

According to the 2001 CSO table, at what age will the terminal reserves be reached?

120

once a viatical contract has been established, how long does the viator have to rescind the contract

15 calendar days

if a viatical settlement provider transfers ownership of an insurance policy, how long does the insurer have to infrom the insured of the change?

20 days

If a consumer requests additional information concerning an investigative consumer report, how long does the insurer or reporting agency have to comply?

5 days

An insurer may provide commissions to an agent for the sale of a long term care policy only if the first year commission is not greater than what percentage of the first year premium

50 %

To attain currently insured status under Social Security, a worker must have earned at least how many credits during the last 13 quarters?

6

What is the waiting period on a Waiver of Premium rider in life insurance policies?

6 month

Under the affordable care act, a special enrollment period allows an individual to enroll in a qualified health plan within how many days of qualifiying event

60

Chronically ill

90 days

Jason is insured under his employer's group health insurance. He splits the cost of the premiums with his employer. This is an example of

A contributory plan.

Part b

medical insurance - original medicare

Under which nonforfeiture option does the company pay the surrender value and have no further obligations to the policyowner?

Cash surrender

When must an IRA be completely distributed when a beneficiary is not named?

December 31 of the year that contains the fifth anniversary of the owner's death

which of the following is correct about medicare

the program is dividd into four parts

All of the following are penalties a producer may face for violating the insurance laws of this state EXCEPT

Fines of up to $1,000 for each act.

what type of benefit helps to pay for accidental injuries that are not severe enough to qualify as diabilities

medical reimbursement benefit

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

Legal action

Under the Fair Credit Reporting Act, individuals rejected for insurance due to information contained in a consumer report

Must be informed of the source of the report

Who is involved in completing the agent's report?

Only the agent

under the affordable care act, which classificiation applies to health plans based on the amount of covered costs

metal level classification

The insured had his wife named as the beneficiary of his life insurance policy. To ensure that his wife had income for life after the insured's death, he chose the life income settlement option. The amount of payments will be determined by taking into account all of the following EXCEPT

The insured's age at death.

. An agent is in the process of replacing the insured's current health insurance policy with a new one. Which of the following would be a proper action

The old policy should stay in force until the new policy is issued.

Which of the following statement is true concerning irrevocable beneficiaries

They can be changed only with written consent of that beneficiary

When is the earliest a policy may go into effect?

When the application is signed and a check is given to the agent

an insurance agent visits potential client and expalins various types of policies. The customer displays a lack of interes, so the agent guarantees higher dividends than he knows would be possible.

misrepresentation

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

misrepresentation

Which of the following hospice expenses would not be covered in cost containment settng

`antibiotics

When J. applied for a life insurance policy, the agent informed him that a medical exam would be required. The exam may be completed by

a paramedic or examining physican at the insurers expense

Medigap

a private insurance policy that pays the difference between the medical charge and the amount that Medicare pays

tax deductible

a qualified expense that may reduce the amount of income subject to taxation

Two types of assignments are

absolute and collateral =entire and parts

Two major causes of loss under health insurance

accidental sickness

at age 30, an applicant want to start an insurance program, but realizing that his insurance needs will likely change, he wants a policy that can be modified to accommodate those changes as they occur. Which of the following policies would most likely fit his needs.

adjustable life - allow for increase or decreases in the face amount/ premium

an insured misstates her age at the time of the life insurance application is taken. this misstatment may result in

adjustment in the amount of the death benefit

Which of the following is the closest term to an authorized insurer

admitted

obra requires large group health plans must provide primary coverage for disabled individual under

age 65 who are not retired

What documentation grants express authority to an agent

agents contract with the principal

when transacting business in this state an insurer formed under the laws of another country is known as

alien insurer

if a life insurance policy develops cash value faster than a 7 pay whole life contract it become

modified endowment contract

which is not true regarding needs approach method of determing the value of individuals life

need is predicted using the number of years until retirement

In which Medicare supplemental policies are the core benefits found?

all plans

scheduled plan

also known as basic pays benefits from a list of procedures up to the amount shown in the schedule

nonscheduled

also known as comprehensive benefits paid on a reasonable and customary basis and are subject to deductibles and coinsurance -diagnostic, preventive, basic 80/20, major (50%)

Who can make a fully deductible contribution to a traditional IRA

an individual not covered by an employer sponsored plan who has earned income

If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered

an unfair trade practice

the death protection component of universal life insurance is always

annually renewable term - Two components 1. insurance component 2. cash account

All other factors being equal, the least expensive first-year premium payment is found in

annually renewable term - death remains level, but premium increases each year with age

in disability income insurance, if an insured is considered disabled if they cannot perform any job they are suited for the prior education, training or experience, they fall under which definition

any occupation

which statement below is incorrect regarding the type of term insurance that fits best with the applicants needs

applicants who may require a larger death benefit in the future should buyt convertible term insurance

all of the following are true of federal tax advantages of a qualified plan except

at distribution, all amounts received by the employee are tax free

Health insurance policies providing maternity benefits must also provide coverage for postpartum inpatient hospital care. how much coverage must be provided for delivery by c section

at least 96 hours

not tru of key person disability income policy

benefits are considered taxable income to the business

not true about business overhead expense policies

benefits are usually limited to 6 months - insurance sold to small businesses for the purpose of reimbursing the policyholder for business overhead expenses during aperiod of total disability - tax deductible - benefits received are taxable as income

non forfeiture values

benefits in a life insurance policy that the policy owner cannot lose even if the policy is surrendered or lapses

who must sign the notice regarding replacement

both the agent and the applicant must sign

Which of the following would describe a legal doc which would dictate wo can buy a deceased partners share of busienss

buy sell

After a person's employment is terminated, it is possible to obtain individual health insurance after losing the group health coverage provided by the employer. Which of the following is NOT true?

by law, the new, individual policy must provide the same benefits as the group insurance policy

insurers cannot transact insurance in this state without a

certificate of authority

Which of the following would be an example of an insurer participating in the unfair trade practice of discrimination

charging the insured higher premiums based on her race

Which of the following children related to the insured are not eligible for a health insurance plan

children of an insureds sibling

An insured and his wife are both involved in a head-on collision. The husband dies instantly, and the wife dies 15 days later. The company pays the death benefit to the estate of the insured. This indicates that the life insurance policy had what provision?

common disaster

an insurer neglects to pay a legitmate claim that is covered under the terms of the policy. which of the following insurance principles has the insurer violated

consideration - binding force in any contract - promise to pay in the event of loss

when an insured makes truthful statements on the application for insurance and pays the required premium, it is known as which of the following

consideration - something of value that each party gives to the other.

in an individual long term care insurance plan, the insured is able to deduct the premiums from taxes. What income taxation will be imposed on the benefits received

no tax

An insured is hospitalized with a back injury. Upon checking his disability income policy, he learns that he will not be eligible for benefits for at least 30 days. This indicates that his policy is written with a 30-day

d) Elimination period. The elimination period is the time immediately following the start of a disability when benefits are not payable. This is used to reduce the cost of providing coverage and eliminates the filing of many claims.

an individual applied for an insurance policy and paid the inital premium. the insurer issued a conditional receipt. 5 days later the applicant had to submit a medical exam. if the policy is issued, what would be the policys effective date?

date of medical exam -

If an insured withdraws a portion of the face amount in the form of accelerated benefits because of a terminal illness, how will that affect the payable death benefit from the policy?

death benefit will be smaller

insured changes his payment from monthly to annually, what happens to the total premium

decreases - because the insurer would have the entire premium to invest for a full year, they would reduce the premium amount

on a major medical insurance policy, the amount that an insured must pay on a claim before the unsurer will pay is known as

deductible

Group disability income

deductible PREM TAXABLE BEN

When a producer holding a certificate or a broker's license has a change in his/her residence or business address, he/she must notify the Department of Insurance and any company for which the producer holds an appointment within

defamation

General diability policy

do not cover losses caused by war, military, intentionally, oversears or injuries during crime

which of the following best describes an insurance company that has been formed under the laws of this state

domestic

if the annuitant dies before annuitization occurs, what will the benefiicary receive

either the amount paid into the plan or the cash value of the plan, whichever is greater

SIMPLE

employ no more than 100 employees who receive at least 5000 in compensation from the employer during the previous year. - 3%

flexible spending account

employees are allowed to deposit a certain amount of their paycheck into an account before paying income taxes

which of the following statements is correct concerning taxation of long term care insurance

excessive benefits may be taxable

when an employer offers to give an employee a wage increase in the amount of the premium on a new life insurance policy. this is called

executive bonus

In the Executive Bonus plan, who is the owner of the policy, and who pays the premium?

executive is the owner and pays the premium

which nonforfeiture option has the highest amount of insurance protection

extended term

partial surrenders

fIFO

decreasing term

face amount gradually declines each year, but premiums are level

securities

financial instruments that may trade for value (stocks, bonds, options)

violation of unfair discrimination law may result in all of the following except

fines of up to $1000 for each - fines up to $500

how many pints of blood will be paid for by medicare supplement core benefits

first 3

All of the following are dividend options except

fixed period installments

when an employee terminates coverge under a group insurance policy, coverage continues in force

for 31 days

An insurance company assures its new policyholders that their premium costs will not increase for a period of at least five years. However, due to increasing financial strain, they plan to raise premium costs for all insureds by 10% over the next two years. What term best describes this act?

fraud

does not hold proper certification to conduct business

fraudulent viatical settlement act

What phase begins after a new policy is delivered?

free look

Which of the following statements concering buy-sell agreements is true?

funded with a life insurance policy - simple contract that establishes what will be done with a business in the event that an owner dies.

all of the following are business uses of life insurance except

funding against general company financial loss

In which of the following health plans are benefit payments attributed to employer contributions taxable to the employee

group disability income

Prem deductible for employer

group disability income group medical group long term care group medicare supplement Business overhead expense

What option allows the insured to periodically increase benefit levels without providing evidence of insurability

guarantee of insurability

Which of the following health care plans would most likely provide the insured/ subscriber with comprehensie health care coverage

hMO -routine physicals, immunizations, family planning, sickness, injurt

events or conditions that increase the chances of an insured loss occurring are

hazards

2 types of flexible spending accounts

health care accounts and dependent care accounts

comprehensive coverage

health insurance that provides coverage for most types of medical expenses

twisting

high-pressure tactics and misleading advertising

medicaid does not cover

income assistance for work related injurt

life income joint and survivor settlement option guarantees

income for 2 or more recipients until they die

what is the tax consequences of amounts received from a traditional IRA after the money was left in the tax-deferred account by the beneficiary

income tax on distributions and no penalty - attain age 70 1/2 subject to tax

Issue age policy premiums increase in response to which of the following factors?

increased benefits

a return of premium term life policy is written as what type of term coverage

increasing -pays an additional death benefit to the beneficiary equal to the amount of the premiums paid

Not deductible premiums

individual disability income individual medical individual long term care individual medicare supplement buy sell key person FSA

Who makes up the MIB

insurers

uring partial withdrawal from a universal life policy, which portion will be taxed?

interest

when a beneficiary receives payments consisting of both principal and interest portions, which parts are taxable as income

interest only

the insurer may suspect that a moral hazard exists if the policyholder

is not honest about his health on an application for insurance - fraudulant claims

the mode of premium payment

is the frequency and the amount of the premium payment

When Y applied for insurance and paid the initial premium on August 14, he was issued a conditional receipt. During the underwriting process, the insurance company found no reason to reject the risk or classify it other than as standard. Y was killed in an automobile accident on August 22, before the policy was issued. In this case, the insurance company will

issue the policy and pay the face value to the beneficiary

which of the following is true about the mandatory 10 day free look in life insurance policy

it commences when the policy is delivered

True of a qualified plan

it has a tax benefit for both employer and employee

which of the following is not true regarding a certificate of authority

it is issued to group insurance participants

Which of the following best describes annually renewable term insurance

it is level term insurance - offers the most insurance at the lowest cost

which of the following best describes the effect the accelerated benefit provision would have on the benefits paid to the beneficiary

it will decrease the benefits paid to the beneficiary - allows for early payments - face amount is reduced

An insured buys a 5-year level premium term policy with a face amount of $100,000. The policy also contains renewability and convertibility options. When the insured renews the policy in five years

it will increase because the insured will be 5 years older when the policy was originally purchased

Multiple Employer Welfare Association (MEWA)

its a method for small employers to band together with other similar groups to buy group insurance - must have common affiliation (ie chamber of commerce) - at least two employeers

which of the following insurance settlement option guarantees payments for the lifetime of the recipient, but also specifies a guaranteed period, during which, if the original recipient dies, the payments will contine to a designated beneficiary

life income with period certain

example of a limitied pay life policy

life paid up at age 65

all of the following are used to keep costs down for dental insurance except

limination on the number of teeth that may be treated in a given yeat

which of the following riders provides for the payment of part of the policy death benefit if the insured is diagnosed with a terminal illness that will result in 2 years

living need rider

Two types of loss and benefits

loss of income from disability medical expense dental expense long-term care expense

what would the premium be like in a survivorship life policy as compared to the premium in a joint life policy

lower - insures two or more lives - pays on the last death

Which of the following is usually true of a participating life insurance policy?

may be converted to a term life policy

which of the following info about the applicant is not included on part 1 of the application for insurance

medical background - part 1 is general questions part 2 is medical

Which renewability provision allows an insurer to terminate a policy for any reason, and o increase the premiums for an class of insureds

optionally renewable -allows to increase the premium for any class of optionally renewable insureds

a participating insurance policy may do which of the following

pay dividends to the polciyowner

Which of the following allows the insurer to relieve a minor insured from premium payments if the minors parents have died or become disabled

payor benefit

Which of the following is true of participating life insurance policy

pays dividends to policyowers

indemnity plan

pays health policy benefits to the insured based on a predetermined, fixed rate, regardless of the actual expense incurred

buy a policy that has a cash value element

permanent - provides lifetime death protection and savings or cash value option

part a does not cover

physician and surgeon survices

not true of key person insurance

plan is funded by permanent insurance only = can be funded by any type

Which of the following is the most common time for errors and omissions to occur on the part of an insurer

policy delivery - insurers must document all conversations - errors occur duing sales interview and policy delivery - important to have proof of interactions

based on human life value approach, which of the following is not used to calculate an individuals life value

predicted needs of the family after insureds death - determines the value of an individuals life requires the calculation of future earnings, wages, expenses, inflation, amount of time until retirement, and the time value of money.

Which of the following will be included in a policy summary

premium amount and surrender values

Which of the following is true regarding insureds who have been classified as preferred risk

premiums are lower

which of the following is correct concering the taxation of premiums in a key person life insurance policy

premiums are not tax deductible as a business expense if key employee dies, the benefits paid to the business are usually received tax free

Which of the following is correct regarding taxaation of group medical expense premiums

premiums are tax deductibl and benefits are not taxed

all of the following are cosndiered to be basic benefits of an HMO plan except

prescription drugs

What is the term for the entity that an agent represents regarding contractual agreements with third parties.

principal

What is the initial period of time specifed in a disability income policy that must pass, after the policy is in force, before a loss can be covered

probationary

info concerning personal activities and character of an applicant

producers report] - agents observations

when a whole life policy lapses or is surrendered prior to maturity, the cash value can be used to

purchase a single premium policy for a reduced face amount.

what form of the annuity settlement options provides payments to an annuitant for the rest of the annuitants life and ceases at the annuitants death

pure life

a situation in which a person can only lose or have no change represents

pure risk only type of insurance companies are willing to accept

another name for a substandard risk classification

rated "rated-u[" - higher premium

Which nonforfeiture option provides coverage for the longest period of time

reduced paid- up -protection until 100, but the face amount is reduced to what the cash would buy

when benefits are paid directly to the insured under a health insurance policy, the policy provides benefits on what type of basis

reimbursement

Which of the following is a provision found in life insurance policies

reinstatement

in the event of loss, a business overheard insurance will pay for

rent

claim

request filled with an insurance company asking for payment according to the terms of an insurance policy

COBRA (Consolidated Omnibus Budget Reconciliation Act)

requires any employer with 20 or more employees to extend group health coverage to terminated employees and their families after a qualifying event - voluntary termination of employment - termination of employment for reasons other than gross misconduct - employment status change: full to part time - extended up to 18 months - exercise benefits within 60 days of termination

Which of the following statements about the reinstatment provision is true

requires the policyowner to pay all overdue premiums with interest before the policy is reinstated

in dental insurance, what type of care will cover crowns

restorative

which type of care re-establishes functional use to natural teeth

restorative

a policyowner who is also insured wants to name her husband as the beneficiary of her life policy. She also wishes to retain all of the rights of ownership. the policyowner should have her husband named as the

revocable beneficiary - may change at any time and without consent

insurance is the transfer of

risk

FSA

salary reduction and employer contibution; annual maximum and use or lose rule

an individaul receives a lump sum inheritance. hed like to use the money to create a lifetime income since he will be retiring soon. he purchases an annuity and wishes to reseive payments beginning in 2 months. what did he buy

single premium immediate annuity

An insurance policy that only requires a payment of premium at its inception, provides insurance protection fro the life of the insured, and matures at the insureds age 100 is

single premium whole life - the entire premium to be paid in one lump sum at the policys inception

which of the following determines the length of time that benefits will be received under the fixed amount settlement option

size of each installment

Events in which a person has both the chance of winning or losing are classified as

speculative risk

life income

stright ife -income that she cannot outlive - payments stop at the beneficiarys death

a producer is helping a married couple determine the financial needs of their children in the event one or both should die prematurely. this is a personal use of life insurance known as

survivor protection

When a group disability insurance policy is paid entirely by the employer, benefits paid to disabled employees are

taxable income to the employee

The interest earned on policy dividends is

taxable-dividends are a return of unused premiums on which the insured has already paid taxes any interest earned is taxable as ordinary income

childrens riders attached to whole life policies are usually issued as what type of insurance

term

Which of the following is true regarding the childhood immunization benefit in medical plans issued in this state?

thats a mandatory benefit

principal sum

the amount of coverage paid for an accidental death under a health insurance policy

stop loss

the amount that the insured pays out of pocket during the year

in fixed annuity, which of the following is true regarding the guaranteed interest rate on the investment

the annuitant will receive the higher of either the guaranteed minimum rate or current rate

in insurance, an offer is usually made when

the applicant submits an application to the insurer - acceptance takes place when an insurer underwriter approves the app and issues a policy

Which of the following is not the consideration in a policy

the application given to a propective insured

all of the following are ways in which a major medical policy premium is determined except

the average age of the group

If a policy has an automatic premium loan provision, what happens if the insured dies before the loan is paid back?

the balance of the loan will be taken out of the death benefit

peril

the cause of a possible loss

the policyowner of an adjustable life policy wants to increase the death benefit. Which of the following statement is correct regarding this change<

the death benefit can be increased by providing evidence of insurability

noncontributory

the employer pay the entire cost

Which statement accurately describes group disability income insurance

the extent of benefits is determined by the insureds income

Principal amount

the face value of the policy proceeds after the death of the insured

IRA direct transfer

the full amount gets reinvested from one plan to the other

how are excess funds in an employees HSA handled

the funds can be carried foreard to the next year

the affordable care act requires all US citizens and legal residents to have qualifying health care coverage. this is known as

the individual mandate

in order to become license to become viatical settlement provider, an application must be made with

the insurance department

an applicant is considered to be a high risk, but not so much that the insurer wants to deny coverage. Which of the following is not true

the insurer will issue a conditional coverage

all of the following are true statments regarding the accumulation at interest option except

the interest is not taxable since it remains inside the insurance policy

Which of the following is not a characteristic of an insurable risk

the loss must be catastrophic

an agent is in the process of replacing the insureds current health insurance policy with a new one. what is the porper action

the old policy should stay in force until the new policy is issued - must make sure that the current policy is not cancelled

What is the advanatage of reinstating a policy instead of applying for a new one

the original age is used for premium determination

An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?

the ppo will pay reduced benefits

how are contributions to a tax sheltered annuity treated with regards to taxation

they are not included as income for the employee, but are taxable upon distribution -taxable with withdrawal

which of the following is true about nonforfeiture values

they are required by state law to be included in the policy - table must be included for the next 20 years

true regarding conditional receipts

they are temporary insuring agreements - effective of the date of the receipts

which of the following is true regarding medicare supplement policies

they must be guaranteed renewable

nonforfiture values

those guaranteed values in a life insurance policy that cannot be taken from the insured, even if he ceases to pay premiums

Elimination period

time between the disabling event and the beginning of payments in your disability coverage

an insured owns a life insurance policy. To be able to pay some of her medical bills, she withdraws a potion of the policy's cash value. there is a limit for a withdrawal and the insurer charges a fee. What type of policy does the insured most likely have

universial life

Which of the following types of policies allows the policyowner to skip premium payments, provided that there is enough cash value in the policy to cover the premium amount

universial life - flexible - can increase the amount of premium going into the policy and to later decrease it again. - may skip premium payments and will not lapse

Under the Physical Exam and Autopsy provision, how many times can an insurer have the insured examined, at its own expense, while a claim is pending?

unlimited

an insured owes this insurer a premium payment. Since then, he incurs medical expenses. The insurer deducts the unpaid premium amount from the claim amount and pays the insured the difference. What provision allows this

unpaid premium - if the premium is past due and the insurer owes claim payment, the amount of the premium will be deducted from the amount of the claim

how long will the beneficary receive payments under the single life settlement option

until the beneficiarys death

how long will the beneficiary receive payments under the single life settlement option

until the beneficiarys death

Which of the following is not true regarding the regulation of variable annuities

variable annuities are regulated solely by the state department of insurance - regulated by state department, securities and exchange commission, fIRA

in forming an insurance contract, when does acceptance occur

when an insurers underwriter approves coverage

An agent and an applicant for a life insurance policy fill out and sign the application. However, the applicant does not wish to give the agent the initial premium, and no conditional receipt is issued. When will coverage begin?

when the agent delivers the policy

if an applicant for a life insurance policy and person to be insured by the policy are two different people, the underwriter would be concerned about

whether an insurable interest exists between them - spouses, parents, children, certain business relationships

Which of the following types of policies will provide permanent protection

whole life -PERMANENT Protection

If a policy includes a free-look period of at least 10 days, the Buyer's Guide must be delivered to the applicant

with the policy

which of the following about taxation of modified endowment contracts is false

withdrawals are not taxable

Deferred

withheld or postponed until a specified time or event in the future

Rollovers

within first 60 days - paid directly to the participant-20% of the distribution must be withheld by the payor

Federal law makes it illegal for any individual convicted of a crime involving dishonesty or breach of trust to work in the business of insurance affecting interstate commerce

without receiving written consent from an insurance regulatory authority

Are insurance company underwriters allowed to discriminate?

yes, but not unfairly

For the purpose of examination by the department, insurers must keep a record of all financial files for at least

3 years


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