examfx life and health

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10%

individuals who itemize deductions can claim deductions for medical expenses not covered by health insurance that exceed what percent of their adjusted gross income?

Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class

A guaranteed renewable health insurance policy allows the

The benefits will be coordinated

A husband and wife are insured under group health insurance plans at their own places of employment, and as dependent under their spouse's coverage. If one of them incurs hospital expenses, how will those expenses likely be paid?

Pay dividends to the policyowner

A participating insurance policy may do which of the following?

Convert to an individual health policy

A small company offers group health insurance to its employees, but recently has decided to terminate the health insurance contract, leaving the workers without insurance. What can the employees do regarding their insurance?

disability income

A waiver of premium provision may be included with which kind of health insurance policy?

Pregnancy will be covered immediately

A woman obtains health coverage through the Marketplace on October 1. Two weeks later she finds out that she is 3 months pregnancy. Which of the following is true about coverage for pregnancy?

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?

pay the claim

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

cash option

An insured receives an annual life insurance dividend check. What term best describes this arrangement?

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

Concerning group medical and dental insurance, which of the following statements in INCORRECT?

seek higher returns

Equity Indexed Annuities

Speculative Risk

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

reduction

Following a career change, an insured is no longer required to perform many physical activities, so he has implemented a program where he walks and jogs for 45 minutes each morning. The insured has also eliminated most fatty foods from his diet. Which method of dealing with risk does this scenario describe?

20% of covered charges above the deductible

Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket?

Nonpayment of premium

For which of the following reasons may an insurer terminate a small employer health insurance policy?

2

How many names (real or fictitious) may insurers have?

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

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

30

If a licensee changes his or her residence address, within how many days must the department be notified?

Guaranteed Insurability Rider

If a life policy allows the policyowner to make periodic additions to the face amount at standard rates, without proving insurability, the policy includes a

Cold Lead Advertising

Making use directly or indirectly of any methods of marketing which fail to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contract will be made by an insurance agent or insurance company is known as

6 credits

Minimum number of credits required for partially insured status for Social Security disability benefits is

attending physician

Occasional visits by which of the following medical professionals will NOT be covered under LTC's home health care?

Promptly forwarding premiums to the insurance company

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

100%

S is a sole business proprietor who owns a medical expense plan. what percentage of the cost of the plan may he deduct?

By state and local governments

Services provided by the Health Insurance Counseling and Advocacy Program are paid for

Notice Regarding Replacement

Shortly after a replacement transaction on a Medicare supplement policy, the insured decided to cancel the policy, but is unsure whether the free-look provision applies. The insured could find that information in the

Annually Renewable Term

The death protection component of Universal Life Insurance is always..

Part A

The part of Medicare that helps pay for inpatient hospital care, inpatient care in a skilled nursing facility, home health care and hospice care, is known as

Reduction of premium

The policyowner pays for her life insurance annually. Until now, she has collected a nontaxable dividend check each year. She has decided that she would rather use the dividends to help pay for her next premium. What option would allow her to do this?

Fiduciary Responsibility

The requirement that an agent not co-mingle insurance monies with their own funds is known as

Probationary period - Waiting Period - Benefit Period

Three time periods are common in medical expense policies. Which of the following is the normal chronological order of their occurrence?

The name of the writing agent

Under a group plan, Certificates of Insurance all of the following EXCEPT

PPO (Preferred Provider Organization)

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

Premiums always stay the same

Underwriting is a major consideration when an insured wishes to replace her current policy for all of the following reasons EXCEPT

The beneficiary will only receive payments of the interest earned on the death benefit.

Upon the death of the insured, the primary beneficiary discovers that the insured chose the interest only settlement option. what does this mean?

Attending Physician's Statement

What document describes an insured's medical history, including diagnoses and treatments?

Early detection through regular checkups

What is the goal of the HMO?

ownership

What is the major difference between a stock company and a mutual company?

To cover the expenses of retraining the insured to return to work

What is the purpose of the rehabilitation benefit in disability insurance?

money borrowed from the cash value is taxable

Which of the following is NOT true regarding policy loans?

The insurance contract

Which of the following is an agreement between an insured and an insurer, where the insurer agrees to indemnify the insured for specific losses in exchange for a premium?

loss of two limbs

Which of the following is considered a presumptive disability under a disability income policy?

Agent in charge must be licensed

Which of the following is true regarding branch agency licensing?

Dividends are not taxable

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

Monthly

Which of the following premium modes would result in the highest annual cost for an insurance policy?

Elderly insureds

Who does the secondary notice provision protect?

"own occupation" - less restrictive than other definitions

a brain surgeon has an accident and develops tremors in her right arm. which of the disability

limited-pay life

an insured has a life insurance policy that requires him to only pay premiums for a specific number of years until the policy is paid up

occupational

an insured has health insurance that covers them at work and at home. this policy has written on what basis?

the insured was in compliance with the policy requirements regarding claims.

an insured submitted a notice of claim to the insurer, but never received claims forms. he later submits proof of loss, and explains the nature and extent of loss in a hand-written letter. which of the following is true?

100%

for group medical and dental expense insurance, what percentage of premium paid by the employer is deductible as a business expense?

policyowner

if the policyowner, the insured, and the beneficiary under a life insurance policy are three different people, who has the ownership right?

control health insurance claims expenses

the purpose of managed care health insurance is to

30

what is the maximum age for qualifying for a catastrophic plan?

the policyowner has the right to change beneficiaries in any case

which of the following statements regarding the Change of beneficiaries provision is false?

pregnancy will be covered immidiately

A woman obtains health coverage through the Marketplace on October 1. Two weeks later she finds out that she is 3 months pregnant. Which of the following is true about coverage for pregnancy?

change of beneficiary

Alexander has a policy with his ex-wife as its beneficiary. What provision allows him to change the beneficiary to his new wife?

Speaking

All of the following are activities of daily living EXCEPT

Diagnosis must indicate that death is expected within 3 years

All of the following are features and requirements of the Living Needs Rider EXCEPT

Beneficiary's age

All of the following information about a customer must be used in determining annuity suitability EXCEPT

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?

Prepaid Basis

An HMO is regarded as an organized system of health care that provides a comprehensive array of medical services on a

The pre-existing condition waiting period fulfilled in the old policy will be transferred to the new policy, the new one picking up where the old one left off

An individual purchased a Medicare supplement policy in March and decided to replace it 2 months later. His history of coronary artery disease is considered a pre-existing condition. Which of the following is true?

It will increase because the insured will be 5 years older than when the policy was originally purchased.

An insured buys a 5-year level premium term policy with a face amount of $10,000. The policy also contains renewability and convertibility options. When the insured renews the policy in 5 years, what will happen to the premium?

$50,000

An insured owns a $50,000 whole life policy. At age 47, the insured decides to cancel his policy and exercise the extended term option for the policy's cash value, which is currently $20,000. What would be the face amount of the new term policy?

Revocable

An insured wants to name her husband as the beneficiary of her health policy. She also wishes to retain all of the rights of ownership. The insured should have her husband named as what type of beneficiary?

12 credits

If a person is disabled at age 27 and meets Social Security's definition of total disability, how many work credits must he/she have earned to receive benefits?

Medicare pars its share of the bill directly to the provider

In a situation when a Medicare insured uses the services of a non-participating provider, which of the following is NOT true?

Is not covered

In health insurance, if a doctor charges $50 more than what the insurance company considers usual, customary, and reasonable, the extra cost

Occasional nursing or rehabilitative care

In long-term care insurance, what type of care is provided with intermediate care?

100

In order for a debtor group to qualify for group life insurance, what should the minimum number of participants joining the plan every year?

Rates by class

Insurers may change which of the following on a guaranteed renewable health insurance policy?

Protecting the insurer against adverse selection

Profitable distribution of exposures serves the purpose of

Needs substantial hands on or standby assistance with ADLs.

Qualified long-term care policies covering home care must provide benefits if the insured is impaired in at least two of the six activities of daily living (ADL). The term "impaired" means

21 days

The Department of Insurance contacts an agent about a claim that was settled two months ago. Within what timeframe must the agent issue a complete response?

Expenses

The factor added to the net premium to cover the costs of the insurer in obtaining and maintaining the business is called

Americans with Disabilities Act

The federal act which mandates that "all personnel actions must be unrelated to either the existence or consequence of disability to include recruitment and selection of employees, compensation of employees, training, and all terms, conditions and privileges of employment" is known as

if the representation is false in a material point

The key factor of representation that allows the injured party to rescind the contract is

The policyowner can specify the way proceeds are split in the policy

The owner of a life insurance policy wishes to name two beneficiaries for the policy proceeds. What will the soliciting insurance producer say?

24 months

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

Increasing Term

What type of insurance would be used for a Return of Premium rider?

For 31 days.

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

for 31 days

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

November 1 through January 31

When is the annual open enrollment for state insurance exchanges?

Investigative Consumer Report

Which document is used to assess risk associated with an applicant's lifestyle and character?

$5,000

an insured has a primary group health plan and an excess plan, each covering losses up to $10,000. The insured suffered a loss of $15,000. Disregarding any copayments or deductibles, how much will the excess plan pay?

revocable

an insured wants to name her husband as the beneficiary of her health policy. she also wishes to retain all of the rights of ownership. the insured should have her husband named as what type of beneficiary?

Conversion

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

The death benefit will be smaller

if an insured withdraws a portion of the face amount

unilateral

if only one party to an insurance contract has made a legally enforceable promise, what kind of contract is it?

insurable interest

stranger-oriented life insurance policies are in direct opposition to the principle of

owner's income

traditional IRA contributions are tax deductible based on which of the following?

premiums are tax deductible and benefits are not taxed

which of the following is correct regarding the taxation of group medical expense premiums and benefits?

Work-related disability

workers compensation insurance covers a worker's medical expenses resulting from work related sickness or injuries and covers loss of income from

Funds exceeding the premium paid are taxable as ordinary income.

Which is TRUE about the cash surrender nonforfeiture option?

Extended Term

Which nonforfeiture option has the highest amount of insurance protection?

reduced paid-up

Which nonforfeiture option provides coverage for the longest period of time?

Presuming the applicant is eligible for Medicaid, based on the nature of the policy

Which of the following is NOT among the goals of a Medicare supplement application?

Automatic Premium Loan

Which of the following protects the insured from an unintentional policy lapse due to a nonpayment of premium?

The larger the percentage that is paid by the insured, the lower the required premium will be

Which of the following statements is true regarding coinsurance?

Withdrawals are not taxable

Which of the following statements regarding the taxation of Modified Endowment Contracts is FALSE

Termination of employment due to downsizing

Which of the following would be a qualifying event as it relates to COBRA?

Option B

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

face amount

Which policy component decreases in decreasing term insurance?

Family Term Rider

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

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

Who can make a fully deductible to a traditional IRA?

Insurer

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

Payment of premium

With respect to the consideration clause, which of the following would be considered consideration on the part of the applicant for insurance?

join the group after the effective date

in a group health policy, a probationary period is intended for people who

No tax

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?

Both a life insurance license and a securities license

what license or licenses are required to sell variable annuities?

when the expenses exceed a certain percentage of the insured's adjusted gross income

when may an insured deduct unreimbursed medical expenses paid under a long term care policy

Payment is limited to a certain period of time

which of the following applies to partial disability benefits

present earnings and earnings prior to disability

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

policyowner

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

Premiums are tax-deductible

Which of the following is CORRECT regarding Business Overhead Insurance?

Coverage for dependents

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

it does not have limits on contributions

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

premiums are not tax deductible, and benefits are not taxable

which of the following describes taxation of individual disability income insurance premiums and benefits?

special risk policy

Which of the following special policies covers unusual risks that are NOT normally included under Accidental Death and Dismemberment coverage?

10%

An annuity contract is issued to a senior consumer over age 65. What is the maximum surrender charge for a withdrawal of money allowed on this annuity?

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 had not met the conditions specified in the

Students at a public school

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

this is a form of insurance that covers part time workers

Which of the following is NOT true regarding partial disability?

Money borrowed from the cash value is taxable

Which of the following is NOT true regarding policy loans?

a permanent resident lawfully present in the U.S.

which of the following individuals will be eligible for coverage on the Health Insurance Marketplace?

to allow the consumer to compare the costs of different policies

what is the purpose of the buyer's guide?

The capital amount in a lump sum

An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy?

Offer the supplement policy on a guaranteed issue basis

An applicant is discussing his options for Medicare supplement coverage with his agent. The applicant is 65 years old and has just enrolled in Medicare part A and B. what is the insurance company obligated to do?

Florida Healthy Kids

Which of the following government health programs provides health insurance coverage to children who do not have access to adequate health care services?

the insurance through his company is primary

a man works for company A and his wife works for company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim

To purchase a smaller amount of the same type of insurance as the original policy.

the paid-up option uses the dividend

The insured's estate

the sole beneficiary of a life insurance policy dies before the insured. if the policyowner fails to change the beneficiary before the insured's death. the proceeds of the policy will go to

a presentation of nonguaranteed elements of a policy

the term "illustration" in a life insurance policy refers to

Subrogation

the transfer of an insured's right to seek damages from a negligent party to the insurer is found in which of the following clauses?

flexible

what type of premium do both Universal Life and Variable Life policies have?


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