215 Exam

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Fixed period installments

All of the following are dividend options except

$0

What is the typical deductible for basic surgical expense insurance?

Absolute

What level of authority is given to the Office of Insurance Regulation with respect to examination of insurer's activities to determine compliance Unfair Trade Practice Laws?

A term life policy

Which of the following insurance products will be subject to the regulation on life insurance solicitation?

If paid by the individual, the premiums are tax deductible

Which of the following is incorrect concerning taxation of disability income benefits?

Is incapable of self-sustaining employment

A child is dependent upon her parents for support because of a physical disability. Coverage may be continued beyond the normal limiting age when the child

$12000 all of which is taxable

A noncontributory group disability income plan has a 30-day waiting period and offers benefits of $2000 a month. If an employee is unable to work for 7 months due to a covered disability, the employee will receive

Income

A typical accidental death and dismemberment policy covers all of the following losses except

Number of family dependents

All of the following are the most common variations in a long term care policy except

The company will continue to renew the policy until the insured has reached age 65.

An insurance agent proposed an individual health insurance policy that is guaranteed renewable. If the applicant accepts this policy, the insurer agrees that

Nothing

If one takes Social Security retirement benefits at age 62, what needs to be done at age 65 to qualify for Medicare?

24 hours of continuing education in every 2-year period

In order to maintain an insurance license, an agent will need to satisfy Florida's continuing education requirement of

90 days

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs within

Are made by the business and are not tax deductible

Under a key person disability income policy, premium payments

Monthly

Under an individual disability policy, the MINIMUM schedule of time in which claim payments must be made to an insured is

Preferred provider organization (PPO)

When health care insurers negotiate contracts with health care providers or physicians to provide health care services for subscribers at a favorable cost, it is called

The cash value available to the policyowner.

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

Counteroffer

Which of the following is not an essential element of an insurance contract?

Coverage for dependents

Which of the following is not an exclusion in medical expense insurance policies?

Medicare Advantage must be provided through HMOs.

Which of the following statements is NOT correct?

HMOs may pay for services not covered by Medicare.

Which of the following statements is correct?

Medicare Part A is automatically provided when an individual qualifies for Social Security benefits at age 65.

Which of the following statements pertaining to Medicare part A is correct?

Skilled care

All of the following long term care coverages would allow an insured to receive care at home EXCEPT

There will be a tax

An HSA holder who is 65 years old decides to use the money in the account for a nonhealth expense. Which of the following is true?

State taxes may be refunded upon a written request.

An agents appointment has been denied. Which of the following is true?

False Advertising

Circulating deceptive sales material to the public is what type of Unfair Trade practice?

Employee benefits are tax deductible the year in which they were received

Concerning group medical and dental insurance, which of the following statements is incorrect?

2 years

Continuing education requirements must be met every

Contracts of adhesion

Contracts that are prepared by one party and submitted to the other party on a take-it-or-leave-it basis are classified as

Obtain a list of all life insurance policies that will be replaced

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

The Genetic Information and Nondiscrimination Act

Health plan issuers are prevented from collecting genetic information for underwriting purposes or limited in their requests for genetic tests by

At least every 5 years.

How often must domestic insurance companies be examined by the CFO in Florida?

90 days

Most policies will pay the accident death benefits as long as the death is caused by the accident and occurs wothin

Attending physician

Occasional visits by which of the following medical professionals will not be covered under LTCs home health care?

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

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

100%of the total medical cost

The proprietors of a business may deduct the cost of a medical expense plan because they are considered to be self-employed individuals instead of employees. What is the highest percentage that may be deducted?

24 months

The relation of earnings to insurance provision allows insurance company to limit the insured's benefits to his/her average income over the last

Disability buyout

This arrangement specifies who will purchase a disabled partners interest in the event he or she becomes disabled

90 days of a loss

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

It needs IRS approval

Which of the following is not true concerning a nonqualified retirement plan?

100

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

True

HMOs may pay for services not covered by Medicare.

Income for two or more recipients until they die.

Life income joint and survivor settlement option guarantees

Promptly forwarding premiums to the insurance company

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

Relief for a major care giver.

What type of care is respite care?

Cancellable

What type of policy allows the insurance company to cancel a policy at any time?

It regulates group health insurance provisions provided by insurers or HMOs to small employers

All small employer group health plans in order to comply with the requirements of the Florida Health Care Access Act serves which of the following purposes?

Guaranteed Issue

All small employer group health plans, in order to comply with the requirements of the Florida Employee Health Care Access Act, must be issued on what basis?

Consideration Clause

An applicant for an individual health policy failed to complete the application properly. Before being able to complete the application and pay the initial premium, she is confined to a hospital. This will not be covered by insurance because she has not met the conditions specified in the

The policy will not be affected.

An individual applies for a life policy. Two years ago he suffered a head injury from an accident, so he cannot remember parts of his past, but he is otherwise competent. He has also been hospitalized for drug abuse, but does not remember this when applying for insurance . The insurer issues the policy & learns of his history one year later. What will probably happen?

Nothing; illness is nor covered during the first 20 days of the contract.

An insured purchased a disability income policy with a 10-year benefit period. The policy stated a 20 day probationary period for illness. If the insured is hospitalized with an illness 2 weeks after the policy was issued, how much will the policy pay?

Employee benefits are tax deductible the year in which they are received.

Concerning group medical and dental insurance, which of the following statements is incorrect?

Pay a special deductible on his major medical policy

Don has both a basic Expense and a major medical policy. He is injured in an accident which requires several major surgeries. This quickly exhausts Don's basic expense policy. What must Don do before his major medical policy can pick up where the basic expense policy left off?

Adverse Selection

Group health insurance is characterized by all of the following except

The employer contributions are not included in the individual insured's taxable income.

How do employer contributions to a Health Savings Account affect the insured's taxes?

12

How many consecutive months of coverage (other than in an acute care unit of a hospital) must LTC insurance provide in this state?

Gets higher.

Regarding long term care coverage, as the elimination period gets shorter, the premium

Gets higher

Regarding long-term care coverage, as the elimination period gets shorter, the premium

Premiums are deductible and benefits are taxed

Regarding the taxation of business overhead policies,

15

The minimum age for purchasing life insurance policy in Florida is?

Insuring clause

The section of a health policy that states the causes of eligible loss under which an insured is assumed to be disabled is the

PPO

Under which of the following organizations are the practicing providers compensated on a fee for service basis

The insurer is considered to be notified since the notification to the agent equals notification to the insurer.

When Linda suffered a broken hip, she notified her agent, in writing, within 12 days of the loss. However, her agent did not notify the insurance company until 60 days after the loss. Which of the following statements correctly explains how this claim would be handled?

Aleatory

Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company?

The earnings in the plan accumulate tax deferred

Which of the following describes the tax advantage of a qualified retirement plan?

Coverage is unlimited

Which of the following is not true regarding Basic Surgical Expense coverage?

It does not have limits on contributions

Which of the following is not true regarding a flexible spending account?

Physical examination and autopsy

Which of the following provisions is mandatory for health insurance policies?

Impairment rider

Which of the following riders would not increase the premiums for a policyholder?

The mode of the premium payment

Which of the following will vary the length of the grace period in health insurance policies?

Notice of claim

Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss?

Time of Payment of Claims

Which provision states that the insurance company must pay Medical Expense claims immediately?

The group is assessed individually for insurability.

Which statement is NOT true regarding underwriting group health insurance?

Admitted

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

Copayment

Which of the following is the term for the specific dollar amount that must be paid by an HMO?

They are available for an additional premium

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

20%of covered charges above the deductible

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

Elimination period

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 was written with a 30 day

10 days

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

5 years

When a group policy terminates, every individual insured under the policy will be entitled to have an individual policy if the insured has been insured by the group policy for at least how many years prior to policy termination?

Provide a 30-day advance notice to the Comissioner

When an insurer terminates an agents appointment, the insurer must do all of the following except

Life income with period certain

Which life 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 continue to a designated beneficiary?

It regulates group health insurance provisions provided by insurers or HMOs to small employers.

The Florida Employee Health Care Access Act serves which of the following purposes?

Pay the claim

An insured pays her major medical insurance premium annually on March 1. Last March she forgot to mail her premium to the company. On March 19, she had an accident and broke her leg. The insurance company would

Unfair claims settlement

An insured submits a proof of loss form within 10 days of a loss. The insurer, however, does not acknowledge the form for three months. Which of the following violations has the insurer committed?

This is considered an illegal discrimination

An insured under a group health plan has a dependent child who has an intellectual disability. When the child was enrolled in the insured's policy, the insurer offered coverage at a much higher rate than for other dependents. Which of the following is true?

Adhesion

An insurer has made all of the decisions regarding the provisions included in the insured's policy. The insurer finds an objectionable provision and wants to negotiate it with the insurer but is not allowed to do so. Her only options are to reject the policy or accept it as is. Which contract feature does this describe?


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