Health insurance underwriting

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The IRS allows a taxpayer to deduct medical expenses that exceed 7.5% of their adjusted gross income. Which of the following is considered a tax deductible medical expense under this rule?

Long Term Care Insurance premiums

Which of these is likely to occur when life or health insurance policy is being applied for

Medical history may be reviewed or reported

Tara the producer is deliberating a specified disease insurance policy to a policy owner. Open delivery, she maybe be expected to collect all of the following except a(n)

Modified application with a new signature

All of these are considered sources of information that can assist an underwriter in determining whether or not to accept a risk except

National Association of Insurance Underwriters

Which of these characteristics of an applicant is not take. Into consideration when assessing risk for disability coverage?

Number of children

An insurance producer is often responsible for field underwriting during the application process. All of these are field underwriting roles except

Providing commission information to the applicant

All of these are considered sources of underwriting information about an applicant EXCEPT

Rating Services

Which of the following describes a person who is not acceptable by an insurer at standard rates because of health history, occupation, or hobbies?

Substandard risk

Which of the following statements is correct regarding an individual applying for life or health insurance?

The applicant's medical history may be analyzed and reported

Bill the producer is collecting the initial premium on a health policy. Which of the following statements is true?

The contract is not in force without the initial premium being paid

Which of the following statements most aptly describes health insurance benefits

The greater the benefits, the higher the premium

Which of the following would be a valid reason why a policy premium would be higher than an standard premium?

The insured does not meet the established underwriting requirements

Backdating an insurance policy occurs when

The policy's effective date is earlier than the present

Which of the following is the purpose of medical cost management?

To control health claim expenses

A field underwriters main task is

To ensure an applicants medical information is accurate and complete

What is the purpose of the medical information bureau (MIB)?

To help underwriters evaluate risk

Which of the following pertains to the analysis of an applicants personal information and determining whether insurance should be issued or declined?

Underwriting

When does a health insurance policy typically become effective

When initial premium is collected and policy is issued

Signatures for an insurance application MUST be obtained by the producer from all of the following sources EXCEPT

beneficiary

Preferred risk policies with reduced premiums are issued by insurance companies because the insured has

better than average mortality or morbidity experience

Premium mode is a term used to describe the

frequency of the premium payment

Underwriters can acquire information from all of the following sources EXCEPT Medical Information Bureau (MIB) consumer reports attending physician's statements genetic testing

genetic testing

Which of the following signatures is not required on an individual insurance application?

insurer

An example of a primary care physician would be a(n)

internist

An insured was injured as an innocent bystander when someone committed a felony. The insurer is

liable for the loss

Which of the following is considered to be a point of service (POS) plan?

managed care plan

Which of the following would probably not be considered in underwriting a health insurance risk?

marital status

Lorenzo is self employed with an S corporation. He is unmarried and had a net profit for the tax year. What are the tax ramifications of his health insurance premiums paid for the year?

100% of his health insurance costs can be deducted from his gross income

A 10% excise tax is normally applied to an early withdrawal from an IRA. According to HIPAA, this tax will not be applied if the withdrawal is used for medical expenses that exceed ____ of the individual's adjusted gross income.

7.5%

Upon policy delivery, which of the following must a producer have an applicant sign if no initial premium was collected with the life insurance application?

A good health statement

An attending physician's statement would be appropriate for which life insurance purpose? Attending physician's statements are mandatory during the application process At the request of the applicant to assist in the underwriting decision At the request of the producer to assist in the underwriting decision At the request of the insurer to assist in the underwriting decision

At the request of the insurer to assist in the underwriting decision

XYZ Corp pays the tax-deductible insurance premiums for a key employee disability policy. Which of the following would be the appropriate tax consequence?

Benefits are fully taxable

One of the most important considerations when replacing health insurance would be the

Exclusions on a new policy

XYZ company has applied for group health insurance for its employees. What information would the insurers underwriters likely use to determine the appropriate coverage and final premium rate given to the group?

Experience rating

An insurance company needs to obtain personal information from a third party concerning an applicant. Which law do all insurers and their producers need to comply with

Fair Credit Reporting Act

An applicant's character and personal habits can be obtained for underwriting purposes from which source?

Investigative consumer report

Pierre is covered by his employer's group major medical plan. His employer pays for 75% of the premium and he pays for 25%. How much would a $10,000 benefit be taxable as income under this plan?

$0

Field underwriting preformed by the producer involves

Application and premium

Which of the following is a requirement for any change in an insurance application

Change must be initialed by the applicant

Which of the following statements would be considered an underwriting duty of an agent?

Completing all applications and collecting initial premium

In which of the following processes will the insurer oversee the insured's hospital stay to confirm everything is going according to schedule and that the insured will he released as planned?

Concurrent review

All of these are typically sources of underwriting information for life or health insurance except

Disclosure authorization response

All of the following factors would affect a health insurance policy premium rate except

Geographic location

Which of the following typically does not provide a form of managed care?

Major medical indemnity plan

An underwriter's primary responsibility to an insurer is to protect against

adverse selection

How are premiums paid by the insured for personally owned disability income insurance treated for tax purposes?

not tax deductible

The difference between pre-certification and concurrent review is that pre-certification

occurs before the treatment is provided

Which of the following is not an example of utilization review?

ongoing inspection of accident prone individuals

A person who is a nonsmoker, of average weight, and in excellent health would most likely be in which risk classification?

preferred

An insurance applicant with a below-average likelihood of loss is typically considered to be a

preferred risk

Statements made by an insurance applicant on an application are considered to be

representations

What guarantees that the statements supplied by an insurance applicant are true?

warranty


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