Guaranteed Exam

All of the Following Health Insurance Disability Benefits are Income Tax Free EXCEPT

Employer-Paid Group Disability

Premiums collected on behalf of the insurance company by an agent will be held in what capacity?

Fiduciary

An agent delivers a life policy. He explains a policy change was made and asks the applicant to sign a statement acknowledging the changes were explained. The agent says the premium has not been paid and must be paid before the policy goes into effect and leaves. What did he do wrong?

He left the policy with the insured without collecting the premium

A person licensed as a producer or limited representative who solicits or negotiates an application for insurance of any kind, in any controversy between the insured and the insurer, will be regarded as representing the...

Insurer

All advertisements, regardless of their source of creation, are the responsibility of the...

Insurer

In health insurance the length of the grace period varies according to the...

Mode of premium payment

Following a covered loss the Time Payment of Claims Provision requires that an insurance company pay disability income benefits no less frequently than...

Monthly

Who is obligated to make sure all questions are answered and all necessary signatures are collected on the application?

The agent

Elaine's basic hospital expense policy has a $500 per day limit for room and board in a hospital for a max of 5 days. Elaine got sick and had to spend 3 days in the hospital at $650 a day. How much will Elaine have to pay to cover the rest of her room and board charges?

$450

Under the mandatory uniform provision "Notice of Claim" written notice of a claim must be submitted to the insurer within what time of parameters?

20 days

All resident producers must complete at least how many hours of continuing education every 2 years?

24

A medicare supplement policy must have a free-look period of at least...

30 days

Joe, age 63, was disabled and can no longer work. He meets the social security definition of total disability. How many work credits must Joe have accumulated to have the status of fully insured?

40

What is the maximum age that a disabled insured worker may receive Social Security disability benefits?

65

Which of the following definitions best describe a business entity

A corporation, association, or partnership

In health insurance, what is coinsurance?

A percentage of the cost of service that the insured and the insurer share

An applicant misstates his age on his application for a health insurance policy. He states that he is 39, he is actually 49. When he files a claim what will most likely happen?

Benefits paid will be those that would have been purchased at the correct age

Which of the following would describe the difference between a blanket life insurance & a franchise policy?

Blanket policy does not name individual insureds.

Conrad receives $50,000 from a $100,000 accidental death % dismemberment policy as a result of the loss of his left arm in an accident. Conrad has received the..

Capital Amount

Which of the Following is NOT a Typical Type of Long-Term Care Coverage?

Child Day Care

The chief and head of the TN Department of Insurance is the....

Commissioner

In order to be eligible for a producer's license in the state of TN an applicant must meet all of the following qualifications EXCEPT

Complete 40 hours of prelicinsing education

A Major Medical Expense policy would exclude coverage for all of the following treatments EXCEPT?

Drug Addiction

Which federal act defines pertaining to protected health information?

HIPAA

All of the following are features of a catastrophic plans EXCEPT?

High Premiums

Which of the Following is Provided by Skilled Medical Personnel to those who need occasional assistance or rehabilitation?

Intermediate Care

What happens to the copy of the application for health insurance once the policy is issued?

It becomes part of the entire contract

Which of the following time periods is the general enrollment period for medical part b?

Jan 1st - Mar 31st each year

If a business wants to make sure it will be able to cover losses due to the disability of its top employee, the business should get which type of insurance?

Key person disability Income

All of the following are excluded from coverage in an individual health insurance policy EXCEPT

Mental illness

What does Basic Medical Expense cover?

Nonsurgical Services a physician provides.

Among people in the same class and life expectancy, which of the following factors can be used to influence premium rates?

Occupation

Which of the following is NOT mandatory under the uniform provisions law as applied to accident and health policies?

Probationary period

What does the application of contract of adhesion mean?

Since the insured does not participate in preparing the contract, any ambiguities would be resolved in favor of the insured.

If an insured is not entirely satisfied with a policy issued, the insured may return it to the insurance company and receive a refund of the entire premium paid, at which of the following times?

Within 10 days of when the policy delivered

What advantage does the "recurrent disability" provision provide to the insured under a disability income policy?

It eliminates the imposition of a second elimination period for the same disability

An insurer is attempting to determine the insurability of an applicant and decides to obtain medical information from several different sources. Which of the following must be notified of the investigation?

The applicant

Which of the following statements is NOT true regarding health insurance policy provisions?

All additional provisions written by insurers are cataloged by their respective states

Which of the following is NOT true regarding a noncancellable policy?

An insurer can increase the premium above what is stated in the policy if claims experience is greater than expected

An employee is insured by a group major medical plan that is provided through her employer. The employer contributes 75% of the premium & the employee contributes the remaining 25%. If the insured received a benefit from this policy in the amount of $1,000, how much of this benefit would be taxed as income?

$0

During policy solicitation an insurer exaggerates the financial condition of one of its competitors and make it sound worse than it is. This is an example of...

False advertising

The presumptive disability provision assumes that the insured is totally disabled upon loss of all the following EXCEPT

Feeling

Which of the following criminal activities would be sufficient vioation to warrant rejection, revocation or suspension of an insurance producer's license?

Forgery

An insured's cancelable health insurance policy is being cancelled. One day before the policy is scheduled to end he is involved in a major accident and is hospitalized for a week. Which of the following best describes the coverage that he would receive?

Full benefits, as if the policy were still completely in effect

All of the Following are changes to Health insurance plans introduced by the PPACA EXCEPT

Full-cost Coverage for all medical coverage

An Insured's Hospital Policy States That it Will Pay Him a Flat Fee of $75 per day for each day he is in the hospital. The Policy Pays Benefits on What Basis?

Indemnity

The benefits in Medical Expense Insurance are....

Taxed when they reach $25,000 per year

Which of the following statements concerning the medical information bureau is correct?

The medical information bureau assists underwriters in evaluating and classifying risks.

If an applicant submits the initial premium with the application which action constitutes acceptance?

The underwriters approve the application

An insured needs ongoing treatment for diabetic condition. Under PPACA which of the following is correct?

Treatment is subject to pre-existing conditions exclusion.

Which of the following MUST the commissioner do before suspending or revoking the license of an agency?

Hold a hearing to determine if a violation has been committed

Which of the following will NOT be provided by HMO?

Unlimited coverage for treatment for drug rehabilitation

In order to assist in the performance of his/her duties, the commissioner may share confidential and privileged documents regarding a termination of appointment with all of the following EXCEPT

The general public

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

Only an executive officer of the company

In addition to participation requirements how does an insurer guard against adverse selection when underwriting group health?

By requiring that the insurance be incidental to the group

Which of the following elements of an insurance contract requires paying premium & providing a statement of good health?

Consideration

Agents may be found guilty of defamation if they make a false statement that is intended to....

Maliciously criticize another insurance company

An Insured Individual Disability Income policy with a 30-day elimination period. He became disabled on June 1st for 15 days. When will he collect on his disability income payments?

He won't collect anything

The "stop-loss" feature on a major medical policy is intended to

Establish a max amount of out-of-pocket expense that an insured will have to pay for medical expense in a calendar year

An underwriter is reviewing an applicant with an extensive medical history. Which of the following would give the underwriter a better understanding of how the applicant has been treated for various illnesses?

MIB report

In order for an alumni association to be eligible to purchase group health insurance for its members, all of these statements must be true EXCEPT when the association...

Has been active been active for five years minimum

The uniform provision law that prevents an insurance company from altering its agreement with a policyholder by referring to documents or other items not contained in the policy is called the...

Entire contract provision

Insurance contracts are unilateral in nature. what does that mean?

Only one party makes a promise

An insured purchased a health insurance policy with a renewability clause that states the policy is "guaranteed renewable" this means that as long as the required premiums are paid the policy will continue until the insured..

Reaches age 65

An insured who is 44 years old, falls while mountain climbing on vacation. He is left paralyzed. After a year doctors feel he will never recover from his injuries. From which of the following programs will he be able to collect disability income?

Social Security

Testimony, documents, or other evidence obtained by the Commissioner may NOT be used in which of the following situations?

A private civil proceeding against agency or producer

Which of the following best describes a rebate?

A producer returning part of her commission to her client as an inducement to buy.

Which of the following best defines the probationary period in group health insurance policies?

A specified period of time that a person joining a group has to wait before becoming eligible for coverage

Regarding the consideration clause, which of the following is NOT correct?

Consideration of the insurer and the insured must be equal.

HMO members pay a small fee when they see their primary care physician. This fee is called a...

Copay

In TN how often must an insurance license be renewed?

Every 2 years

Which of the following is a daily nursing and rehabilitative care that can only be provided by medical personnel under the direction of a physician?

Skilled Care

Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a Major Medical Policy?

Submit the description in their own words on a plain sheet of paper

Upon payment of a loss, the insured is obligated to surrender to the insurer the right to sue a negligent party. This is called?

Subrogation

A man is an attorney when he applies for a health policy. He decides to become a professional bungee jumper. He files a claim, what should happen?

The insurance company will pay the claim according to the benefits available if the correct premium has been paid.

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

To cover the employer's administration costs.

What is the purpose of the impairment rider in a health insurance policy?

To exclude coverage for a specific impairment

What is the purpose of a benefit schedule?

To state what and how much is covered in the plan

Two individuals of the same age, health status, and life expectancy apply for individual insurance coverage. When policies are issued by the same insurer the premium rates are different based on the insured's race. What practice does this describe?

Unfair discrimination

An individual is approaching retirement age and is concerned about have proper coverage should he have to be placed in a long-term care facility. His agent told him that LTC policies would provide necessary coverage for all of the following levels EXCEPT

Acute

An underwriter is reviewing an application with an extensive medical history, which of the following would give the underwriter a better understanding of how the applicant has been treated for various illnesses?

Attending Physician's Statement

What specific kind of insurance is often written in conjunction with hospital expense policies and includes surgeon's and anesthesiologists fees?

Basic surgical expense insurance

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

A customer service representative who solicits no more than one policy a year