Chapter 7 quiz questions

Chemical dependency treatment under a group health policy MUST include (over the life of the contract) a minimum benefit of

$16,000

an accident/ health policy holder has ___ days to return the policy and receive a full refund on premiums

10

z is an agent who violated the insurance information and privacy protection act. Z was the issued and served a statement of charges and notice of hearing by the commissioner of insurance. Z's hearing date must be at least ___ days after service of charges.

10

a group health policy's approved premium rate is guaranteed by the insurer for an initial period of at LEAST __ months

12

minors in NC age ___ and up can enter into life insurance contracts and have al the rights that come with ownership

15

An insured MUST submit a proof of loss on a health insurance claim within how many days after the date of loss?

180

A terminated employee must have been covered for at LEAST ___ month(s) under a group health insurance policy immediately prior to termination in order to be eligible for continuation of coverage

3

an eligible employee has a MAXIMUM of __ days after their 1st day of employment to be added to group health coverage.

90

In North Carolina, which of the following MUST be delivered to a policyowner upon the sale of an individual life insurance policy

A policy summary and buyer's guide

The Life and Health Insurance Guaranty Association is funded by authorized insurers in this state. One of the roles of this organization is to

Assist in the prevention of insurer insolvencies

the commissioner may exempt an applicant from the licensing exam if an applicant has obtained any of the following designations, except: - chief operating officer - charted life underwriter - life underwriter training council fellow - fellow ______

Chief operating officer (COO)

t is employed by an amusement park from june through september, working 50 hours per week. the amusement parks group policy would

Consider T NOT eligible for the insurance because as a seasonal employee, T does not meet the definition of "employee" under the NC law

Which of the following MUST be included with the continuation of coverage of a group Hospital, Surgical, and Major Medical Policy?

Hospital Expenses

Which of the following is an effort to influence a person to buy an insurance product from you?

Soliciting

If an agent is found to be incompetent, untrustworthy, or financially irresponsible, the Commissioner may

Suspend, revoke, or refuse to renew the agent's license

S is a life insurance policyowner and enters into a written agreement to receive immediate cash in exchange for the sale and transfer of her life insurance policy. This agreement is referred to as a(n): - 1035 exchange - vatical settlement - equity cash arrangement - cash conversion

Viatical Settlement * a written agreement to provide a life insurance policy holder immediate cash in exchange for the sale and transfer of a life insurance policy is a vatical settlement

according to NC's rules on disclosure, a life insurance applicant is expected to be provided with

a buyers guide and policy summary

After notice and a hearing, the Insurance Commissioner may revoke a producer's license for all of the following reasons EXCEPT the

agent is found to be insolvent

which of these circumstances REQURE an insurer to clearly specify questions designed to obtain information solely for marketing research?

any insurance transaction

XYZ insurance company would like to begin conducting business in NC. before XYZ can issue or deliver a Health policy, the form , classification of risks and premium rates MUST be filled with the

commissioner of insurance

in north carolina an agent obtains his/her insurance license from the

commissioner of insurance

what is one of the requirements for an applicant to become licensed as a NC accident and health insurance agent?

complete at lease 20 hours of instruction approved by the commissioner of insurance

according to the affordable care act (ACA), which of the following coverages is NOT required?

coverage for cosmetic surgery

All of the following statements about health coverage for newborns are correct EXCEPT: - coverage begins and benefits are payable from the moment of birth - coverage includes necessary care and treatment of congenital defects - coverage during the first year is limited to congenital defects - continued coverage after the first 31 days is dependent on notification

coverage during the first year is limited to congenital defects

the circulation of written literature that is maliciously critical of an insurers financial condition i called

defamation

how does the commissioner of insurance attain office?

elected by the people of NC to a 4 year term

anyone who knowingly provides an untrue, false or fraudulent claim to an insurance company is guilty of:

felony

which of the following is NOT regulated by the insurance information and privacy protection act? - agents - limited representatives - insurance regulators - insurance companies

insurance regulators

the PRIMARY purpose of the life insurance replacement regulation is to protect the

interest of policy owners

which of these actions is NOT considered an act of rebating

sharing commissions with other licensed and appointed agents

If a blank insurance contract application is signed by an agent, the agent:

is guilty of a misdemeanor * an agent who signs a blank contract application or policy of insurance is guilty of a misdemeanor

if a life insurance company becomes insolvent, the fund that guarantees policy owners payment of death benefits is known as the

life and health insurance guaranty association

the life and health insurance guaranty association in NC has regulations that apply ONLY to

life and health policies issued by companies authorized in NC

Which of the following is NOT an unfair claims settlement practice?

needing written documentation of claim details

K works for XYZ Clothing Store from September through December each year. K works 45 hours a week for this period of time. The employer's Group Policy would consider K

not eligible for the insurance Bc as a seasonal employee K does not meet the definition of an "employee"under the NC law

an applicant may NOT be refused insurance coverage due to - occupation - race -age - health

race

when an existing life insurance policy is being terminated so that a new lfie insurance policy can be purchased, this transaction is refferd to as

replacement

the commissioner of insurance may suspend or revoke the license of an agent who takes any of the following actions except:

represents more than one insurance company

which action by an insurance agent is considered rebating?

splitting commissions with a policyholder who has purchased additional coverage

An insurance applicant was recently denied insurance coverage. The applicant is requesting access from the insurer to recorded personal information regarding this decision. Under the Information and Privacy Protection Act, the insurer MUST make the information available within ___ business days

30

before an insurer can increase the rates for individual accident and health policy owners, the insurer must provide written notice at least ___ day before the effective rate increase

30

how long must every insurance agent maintain all records, books, and documents related to each insurance transaction?

5 years

lapsed individual life insurance may be reinstated at anytime within

5 years

ABC insurance company fails to pay death proceeds after satisfactory proof of loss was submitted. ABC must then begin paying interest on the death proceed after ___ days of receiving proof of loss.

30 * if after satisfactory proof of loss an insurer fails or refuses to pay death proceeds, the insurer must pay interest on all the proceeds after 30 days

A health insurance policy applicant unintentionally fails to list a previous visit to a neurologist. If the policy is issued and the insurer later decides to contest the policy, it must do so

within 2 years from the date of issue