XCEL solutions

An insured under a major medical expense plan with a zero deductible and 80/20 coinsurance provision files a $1,000 claim. How much of this claim is the insured responsible for?

$200

Ken is a producer who has obtained Consumer Information Reports under false pretenses. Under the Fair Credit Reporting Act, what is the maximum penalty that may be imposed on Ken?

$5,000

Kate has a Major Medial Plan with a 75/25 coinsurance and a deductible fo $25. How much will she have to pay if she, not having met any of her deductible, visits the doctor and receives a bill for $125

$50.00

A life insurance policyowner is allowed days upon policy delivery to return the policy for a full premium refund

10 days

Kathy pays a monthly premium on her health insurance policy. How long is her grace period?

10 days

Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss.

20

A life insurance applicant in Ohio may backdate the application for up to

3 months

An insurer can exclude coverage for a preexisting condition on a Medicare Supplement policy for up to

6 months

In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at

60%

Which policy feature makes a universal life policy different from a whole life policy?

A flexible premium income

How son can the benefit payments begin with a deferred annuity?

A minimum of 12 months after date of purchase

Major medical insurance will typically cover medical expenses that result from

A negative reaction to prescribed medication

A plan in which an employer pays insurance benefits from a fund derived from the employers current revenues is called

A self - funded plan

Which dividend option would an insurer invest the policyowner's money and add any interest earnings as the dividends accrue?

Accumulation at Interest Option

A long-term care policy typically provides all of the following levels of care EXCEPT

Acute care

People with higher loss exposure have the tendency to purchase insurance more often than those at average risk. This is called

Adverse selection

When does an immediate annuity begin making payments?

After the first premium has been paid

An error was made on Mary's life insurance application. Which of the following areas do errors commonly occur on applications and for which the incontestable clause does NOT apply?

Age

Which of these is NOT considered to be a purpose of an annuity?

Annuities are intended to create an estate

An insurance company advertises an accident and health insurance product in a local Ohio newspaper and refers to dollar amount benefits. This insurer must also disclose which of the following in the advertisement?

Any applicable benefit reduction

With a scheduled dental policy, how are covered expenses paid?

Benefits are limited to a specific maximum dollar amount per procedure

Maria is a PPO (preferred provider organization subscriber and received care from an out of networks provider. Which of the following is the likely result?

Care is covered

All of the following are included as part of a contract in the entire contract provision

Changes made by the producer

What would happen if a life insurance applicant is given a conditional receipt from an insurance agent and then dies the next day?

Claim will be paid if application is approved.

Intentional withholding of material facts would affect an insurance policies validity is called a(n)

Concealment

A health insurance policy where the insurer has the right to terminate the policy fr reasons other than the insureds health is called

Conditionally Renewable

Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)

Conversion

Which disability policy provision would address any concerns of the value of the benefits decreasing over time?

Cost of living benefit

Which of the following statements is NOT true regarding a Critical Illness Plan

Coverage is limited to a single devastating disease

All of the following are core benefits of Medicare Supplement Plan A EXCEPT

Deductible payments for the first 60 days of hospitalization under Medicare hospitalization insurance

Benefits provided by a Medicare Supplement policy must NOT

Duplicate Medicare benefits

The policyholder for a group health benefit plan is considered to be the

Employer

Which of these is NOT a qualifying event for a Medicare?

Falling below the federal poverty level

Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?

Guaranteed insurability rider

Which of these is a TRUE statement regarding HIC's

HIC's operate on a prepayment basis

Which approach predicts a persons earning potential and determines how much of that amount would be devoted to dependents?

Human life value approach

What does COBRA fo 1985 allow an employee to do ?

In the event of employment termination, group health insurance can be kept if the employee pats the premiums

A proposed insured for a health insurance policy was treated for heart disease within the past year. When applying for health insurance, the heart disease treatment

Indicates a preexisting condition

An agent's appointment may only be terminated by the

Insurer

Who is required to notify the agent in the event of appointment termination?

Insurer

Sharon is the policy owner of a $50,000 life insurance policy. Her son, Mike, is the beneficiary. If Sharon MUST obtain Mikes' signature in order to change the beneficiary, what kind of beneficiary designation is this?

Irrevocable

Which of the following statements regarding Group Disability Income is TRUE?

It provides benefits for nonoccupational illnesses and injuries

Which type of life insurance is normally associated with a Payor Benefit rider?

Juvenile insurance

The IRS states that a taxpayer's medical expenses that exceed 7.5% of their adjusted gross income is tax deductible. Which of the following may be considered a medical expense under this rule?

Long Term Care Insurance premiums

What is the contract called that is issued to an employer for a Group Medical Insurance plan?

Master policy

Pete the agent recently had his license suspended because he was found to be in violation of state insurance law. Due to this suspension, Pete

May be assessed the administrative costs sustained by the Department

Which of these gaps in Medicare coverage is addressed with Medicare Supplemental Insurance?

Medicare in-hospital deductible

All of these are considered sources of information that can assist an underwriter in determining whether or not to accept a risk EXCEPT

National Association of Insurance Underwriters

An example of a health insuring corporation (HIC) specialty care provider is a(n)

Neurologist

A beneficiary has just received a claim payment for a life insurance policy. Which of the following is TRUE regarding the federal income tax liability owed?

No federal income tax is owed on life insurance proceeds

An insurer may refuse to renew an employer's small group health plan due to

Nonpayment of premium

A beneficiary change can occur:

Normally at any time during the policy term

How do interest earnings accumulated in a deferred annuity

On a tax-deferred basis

An individual covered under a Blue Cross Blue Shield plan is called a(n)

Participant

According to the Health Insurance Portability and Accountability Act (HIPAA), when can a group health policy renewal be denied?

Participation or contribution rules have been violated

What is known as the immediate specific event causing loss and giving rise to risk?

Peril

Unmarried children who are incapable of self support and have proof of incapacity are included under thier parents health coverage until

Policy termination

Under a Modified Endowment Contract, what are the likely tax consequences?

Pre-death distributions will become taxable

Which market index is normally associated with an indexed annuity's rate of return

S&P 500

Which of the following is typically NOT eligible for coverage in a group health policy?

Temporary employee

James is insured on a life insurance policy where his age was misstated on the application. Which of the following is CORRECT regarding the death benefit amount?

The death benefit paid will be what the premium would have purchased at the correct age

Bob and Tom start a business. Since each partner contributes an important element to the success of the business, they decide to take life insurance policies out on each other, and name each other as beneficiaries. Eventually, they retire and dissolve the business. Bob dies 12 months later. The policies continue in force with no change. Both partners are still married at the time of Bob's death. In this situation, who will receive Bob's policy proceeds?

Tom

A partial surrender is allowed in which of the following life policies?

Universal life

Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?

Unpaid premiums

All of the following riders can increase the death benefit amount EXCEPT

Waiver of Premium

Which of these would be the best example fo limited pay life insurance policy?

Whole life policy with premiums paid up after 20 years

Long-Term care polices or certificated issued in Ohio are required to have

a nonforfeiture value

Loss of income insurance provides

an individual the means to replace wages

Level premium term life insurance policies

automatically convert to permanent insurance at a predetermined date

Which of these factors is NOT taken into account when determining

automobile

What is issued to each employee of an employer health plan?

certificate

Naming a contingent beneficiary as "all surviving children" is described by which term?

class designation

An example of a presumptive disability would be

deafness

What type of policy would only provide coverage for specific types of illnesses (cancer, stroke, etc)?

dread disease insurance

A spouse and child can be added to the primary insured's coverage as what kind of rider?

family term

A non-admitted insurer

is not afforded protection by the guaranty fund

In contrast to a guaranteed renewable policy, a noncancellable policy

may never raise premiums

A whole life policy option where extended term insurance is selected is called a(n)

nonforfeiture option

A provision in a whole life policy that allows a poicy owner to terminate the policy in return for a reduced paid - up policy of the same type is called a(n)

nonforfeiture provision

The focus of major medical insurance is providing coverage for

preventative care

in order to activate the reinstatement clause of a lapsed life insurance policy, the insured MUST

provide evidence of insurability to the insurer

When comparing an HIC to a PPO, the PPO

provides a greater choice of providers

An example of endodontic treatment is a

root canal

Term insurance is appropriate for someone who

seeks temporary protection and lower premiums

An insured individual and the policy's beneficiary die from the same accident. The common disaster provision states the insurer will continue as if

the insured outlived the beneficiary

If the beneficiary dies from the same accident as the insured individual, the insurer will proceed as if

the insured outlived the beneficiary

If an insured dies during the grace period with no premiums paid

the policy would be payable, minus the premium amount

The free-look provision gives the policy owner

the right to return the policy for a full refund within a specified number of days

A disability elimination period is best described as a

time deductible

Which of the following does Medicare Part D cover ?

Prescription drugs

Who provides all preventative and routine medical care given to a health insuring corporation (HIC) member?

Primary Care Physician

Which of the following is NOT typically included under "hospital care" for most health insuring corporation (HIC) plans?

Private duty nursing

An insurance producer is often responsible for field underwriting during the application process. All fo these are possible field underwriting roles EXCEPT

Providing commission information to the applicant