HEALTH EXAM - LLOYD
The minimum grace period on a monthly pay policy is?
10 days
When a non-financial conduct examination is held and the party examined makes a written request for a hearing, at least how many days notice must the Director provide of time and place of a hearing as designated in the notice?
10 days
What is the largest dollar civil penalty that will be assessed for a single act of defamation?
10,000
It is the insured's responsibility to notify the principal about a claim under an Accident and Health policy within:
20 days
What is a contract's grace period if a premium is paid on a quarterly basis?
31 days
V has a group policy with a $1,000 annual deductible that renews every January 1st. On June 1, V receives a notice that the current health company is discontinuing benefits and a new company is replacing coverage, giving identical benefits. Up until this point V has paid $500 or her annual deductible. If V suffers a loss under the new policy, what is the maximum deductible she will have to pay under the new contract?
500
Under law, a Medicare supplement preexisting condition period is limited to __________ before the policy was issued.
6 months
The MINIMUM percentage of employees that must participate in a contributory group life plan is:
75 % - percent
K is age 56 and has a HSA plan through her employer with a $8,000 annual family deductible. The IRS limits annual contributions at $6,750. How much can K save in her HSA per calendar year?
7750
The Proof of Loss provision in an individual Accident and Health policy requires that written proof of loss be submitted to the insurance company within how many days after the date of loss?
90
Which of the following advertising concepts would violate the misrepresentation statute if an insurer engaged in such a practice?
A carrier advertises that their life insurance policies are the highest rated by the State Department of Insurance.
V has a policy with a Guaranteed Insurability Rider. V was 30 years old when the contract was issued but now, at age, 40, she would like to buy more coverage which is allowed under the rider. For the extra coverage amount V will pay premiums based on:
AGE 40
Y has been a producer for 20 years and if a client's policy is approved, Y likes to go back to the insured's home and explain coverage. Y's delivery style is known as:
Actual Delivery
Which of the following items are exempt under the legal definition of advertisement?
All of the above ---
L has just been approved for coverage under a podiatric LHSO. Under law, L must receive a written evidence of coverage which states:
All the above----
What is the primary difference between a Consumer Report and an Investigative report?
An Investigative Report uses interviews with people who know the insured's lifestyle, habits, and hobbies
All of the following are CORRECT about Medicare EXCEPT:
An insured who has Medicare Part A is eligible to enroll for Medigap policies within six months of enrolling in Part A.
On March 1 the Director mailed a notice of producer license suspension to R which he received on March 4. If R wishes to request a hearing on the matter, by which date must R make this demand in writing?
April 4th
How often must accounting posting occur with a Premium Fund Trust Account?
At least every 30 days
Which of the following may be considered an eligible expense found in a health policy?
Bus fare to receive treatment for a covered loss
All of the following are characteristics of a Long Term Care policy with Intermediate care EXCEPT:
Care can only be provided in a hospital
When an agent sells an Accident and Health policy, he/she should do which of the following with the application?
Complete it and have the applicant review and sign it
The strongest evidence an applicant would have that a recently applied for policy was immediately providing coverage upon medical information being received and the payment going through is:
Conditional Receipt
What is the name of the concept that states the insured cannot negotiate but rather accepts the terms of the policy or not?
Contract of Adhesion
Medicare Supplement policies MUST provide coverage for the:
Core benefits
All of the following are CORRECT about a PPO plan EXCEPT:
Doctors are paid per head of subscribers
In a Disability Insurance Policy, a specified delay in benefit payment from the time of loss occurs until some future specified time is known as the:
Elimination (Waiting) Period
The time from loss before benefits are paid by the policy for a disability claim is known as:
Elimination period
Under the Proof of Loss provision stipulates the amount of time the insured has to provide written notice of loss starting:
From the date of actual loss
B has a disability policy that will allow her to buy an extra $10,000 of coverage in three years. B has a(an):
Guaranteed Insurability Rider
N buys a disability policy at standard rates. At the end of the policy year, N is notified that while her coverage will still be in force, the insurer has raised premiums on all standard risks. N most likely has which of the following rights of renewability?
Guaranteed Renewable
Which of the following rights of renewability would be most beneficial for an insured?
Guaranteed renewable
Which of the following policies are considered Manage Care based contracts?
HMO
The entity that protects HMO subscribers against personal loss because of entity insolvency is:
HMO Guarantee Association.
J has a policy that pays $100 a day for a hospital stay. J has a:
Hospital Indemnity Plan
Disability Income insurance protects against:
Illness and Injury that occurs off the job.
If a producer is found to have failed to maintain the proper surety bond due to the brokering of business, what could be the result of this failure?
It could result in the revocation or denial of the producer's license.
K has a PPO and is going to a doctor that is considered outside of the provider network. Which of the following is true for how the PPO will handle K's claim?
K will have be covered for the claim but pay a higher out of pocket for the expense.
Fall Apart Shoe Company has X employed as their CEO. The company is concerned that if X was to fall ill or suffer a serious injury, the business would not be able to recover. Fall Apart Shoe Company should consider buying a:
Key Person Policy
Written defamation is known as
Libel
All of the following are required disclosure forms at application EXCEPT:
MIB
The statute that requires disclosure provisions is:
Minimum Standards
A producer earned a fee of $500 and a commission for the sale of an insurance product. Forty-five days after coverage began the insured cancelled the policy. What, if any, refund is the insured entitled to in this instance?
No refund amount is due.
J has a disability policy with an elimination period of 60 days. J suffers a covered accident while at home and is going to receive benefits:
No sooner than 60 days from loss
Which of the following policies have provider networks?
POS, HMO & PPO - ALL OF THE ABOVE
A basis of prepayment in which a fixed amount of money is prepaid per individual and found in some managed care plan is known as:
Per Capita Prepaid
J has a policy with maternity benefits. J's pregnancy began after the policy was in force, however the insurer has a limit of $50,000 of expenses for maternity. This limit is an example of a(an):
Per Cause Limit
H is a legendary flamenco guitar player. If H would like to have only her fingers insured for $500,000 each, which of the following policies would be most likely to insure her potential loss?
Special Risk Policy
Medicaid is:
State Subsidized and partially federally reimbursed
Six months into a policy year, the insured has satisfied all deductible and coinsurance requirements and no longer has to share in out of pocket expenses. This is known as:
Stop limit loss
Which of the following statements are CORRECT about a Health Savings Account?
The HSA must be coordinated with an HDHP
What action is required of a life insurance company when a death claim is submitted?
The carrier is required to search their records for other possible policies that may be in force and payable on the same life
Which entity listed below has the authority to issue a limited lines producer license?
The director
Which of the following statements is CORRECT about a Guaranteed Renewable policy?
The insured has a unilateral right to renew
H is 65 and enrolled into Part A of Medicare. Three months into enrollment H applies for a Medigap Plan A. Which of the following is most likely to happen?
The insurer will deny the application
R has an individual major medical policy. On October 1 R has an accident causing $10,000 of damages. On October 31, the insurer is first notified by R that an accident occurred. Which of the following is most likely occur?
The insurer will deny the claim
If an insured wants to change a Revocable beneficiary, which of the following statements is CORRECT?
The policy owner must make an endorsement to the insurer
A producer receives a notice in the mail indicating their license has been terminated although the producer is very ethical and has never had a single complaint lodged. What is the most likely reason for the producer's license termination?
The producer failed to complete the required continuing education in a timely fashion.
Which of the following circumstances may lead to the renewal of a producer license without the requirement of completing continuing education requirements?
The producer is called up to military duty and secures a military waiver.
When a licensed producer solicits the sale of an insurance policy, which of these actions is NOT required?
The producer must disclose their home address upon an insurance sale solicitation
Which of the following actions on the part of a producer could lead to license denial?
The producer signed an insurance application on behalf of the applicant with the applicant's full knowledge and verbal permission to do so.
Once a producer has a felony conviction entered officially against him, what action is most likely to be taken pertaining to his producer license?
The producer will have his license revoked.
All of the following are true regarding Social Security disability EXCEPT:
To qualify an insured must be disabled for a year or longer or die within a two year period.
Another name for a Binder is:
Unconditional Receipt
The policy owner has all of the following rights EXCEPT:
Unilateral right to renew an Optionally renewable policy
Under which of the following circumstance can the Director cancel the right of an insurance company to hire producers under the temporary License for Producer Application authority?
When, during any six months period, more than half of a company's temp licensees fail to obtain their full producer license within the 90 day licensing period
Under HIPAA regulations a small group is defined as:
a minimum of 2 employees but not more than 50
The only way an insurer can legally discriminate against an individual during underwriting is based on:
actuarial principles
The Free Look Provision:
all of the above ------
Which of the following provisions is mandatory in an individual policy?
all of the above -------
The best definition of a "fiduciary" is
any licensed person who collects money in the course of their employment.
All licensed Life and Health companies:
are required to be part of the Life and Health Guarantee Association to transact business in IL
An example of a conditional contract is when:
both parties must perform certain duties
T has recently replaced her Medicare Supplement policy which was in force for 7 months. The contract has a probationary waiting period on all illness related losses for the first ten days of coverage. On day 5, T suffers an illness. The replacing insurer is most likely to:
cover the loss
If a Cease and Desist order is issued the Director must serve notice to the recipient of the order of a hearing to be held at a fixed time and place which
may not be less than 20 or more than 30 days after the notice of hearing is served to the recipient
Company Q, a health insurer headquartered in Indiana is advertising directly to Illinois residents about their health plans but Company Q is not a licensed insurance company in Illinois. Company Q is violating which of the following Illinois insurance regulations?
misreprensentation
Insurance producers who make misleading statements about benefits under a policy paid by insurers may be found guilty of:
misrepresentation
In the event that long term care benefits are funded through a life insurance policy by the acceleration of a death benefit, the insurer must provide a report during benefit payment status every:
month
An agent takes an application for Disability Income insurance and realizes that two minor changes must be made in the application. The agent:
must initial all changes made and must also have the applicant initial all changes made
The sale, solicitation or negotiation of legal expense insurance requires
requires the appropriate limited lines producer license.
The party that dictates what a reasonable or customary charge is for a health policy is the:
the insurer - company
People working with insurers who belong to the following organizations are exempt from licensing, EXCEPT:
the president of a life insurance company who is paid commission directly from the sale of an insurance policy.
Which of the following would be an allowable definition of disability under IL minimum standard law?
unable to do any job in the US economy
In a health policy, the probationary period begins:
upon issuance of a policy
If a husband and wife are each covered by more than one group policy at the same time, the primary payor of benefits for dependent children are determined by:
whoever's birthday is first in the calendar year
A licensing candidate must have obtained a license from the Department of Insurance
within one year from the first date of class attendance in the line of authority obtained.