Insurance

Which payment method for a health claim settlement is typically made directly to the provider of the services?

Prepaid

Which of the following is a reinstatement condition?

Proof of Insurability

All of the following are considered to be nonforfeiture options available to a policyowner EXCEPT

Reduction of Premium

A life insurance company has transferred some of its risk to another insurer. The insurer assuming the risk is called the

Reinsurer

What does a life insurance policy guarantee to the stated beneficiary upon the death of the insured?

Specified amount of money

Which of these ensures that proceeds of a life insurance policy will be free from attachment or seizure by the beneficiary's creditors?

Spendthrift Clause

In Pennsylvania, no Legal Action may be taken against an insurer for failure to honor a valid claim after the expiration of how many years from the time proof of loss is furnished?

3 years

In Pennsylvania, the Time Limit on Certain Defense provision provides that no misstatements (EXCEPT fraud) made by the applicant on a health insurance application can be used to void the policy or deny coverage after the expiration of

3 years

Within how many days must a producer report to the Commissioner any charges made against him/her?

30 Days

Which of these annuities require premium payments that vary from year to year?

Can be converted to permanent coverage without evidence of insurability

In what part of an insurance policy are policy benefits found?

Declarations

An example of risk sharing would be

Doctors pooling their money to cover malpractice exposures

All of the following are qualifications for establishing a health savings account (HSA) EXCEPT

Enrolled in a health plan with a prescription drug benefit

Peter has a policy where 80% to 90% of the premium is invested in traditional fixed income securities and the remainder of the premium is invested in contracts tied to a stipulated stock index. What kind of policy is this?

Equity Index Whole Life

What is created after policy proceeds are obtained in a lump sum and then immediately invested?

Estate

Variable insurance and universal insurance are similar. Which of these features are held exclusively by variable universal life insurance.

Policy owner has the right to select the investment which will provide the greatest return

An immediate annuity has been purchased with a single premium. When does the annuitant typically begin receiving benefit payments?

1 month

The typical long-term care insurance policy is designed to provide a minimum of __ year(s) of coverage.

1 year

Every Pennsylvania insurer, upon receiving notification of a claim, must acknowledge receipt of the notice within

10 Days

Monthly health insurance grace period

10 days

The free look period provided in a life insurance policy is usually?

10 days

Medicare Part A does not pay for medical benefits provided for treatment in a skilled nursing facility beyond

100 Days

A Pennsylvania temporary producer license may be issued for a period not to exceed

180 days

According to Pennsylvania law, postnatal care must be delivered within how many days of discharge?

2 days

Written notice for a health claim must be given to the insurer ___ days after the occurrence of the loss.

20 days

A licensed Producer must report any administrative action taken against the licensee in another jurisdiction or by another agency department in Pennsylvania within how many days of the final disposition?

30 days

Which of these is NOT a characteristic of the Accelerated Death Benefit option?

The benefit can be offered as a rider at a specific extra cost or may be at no cost

A whole life insurance policy accumulates cash value that becomes

The policy loan value which the insured may borrow against

If an insured dies during the grace period with no premiums paid

the policy would be payable, minus the premium amount

"Maximum benefits" refers to the

upper limit of the total lifetime benefits the insurance company will pay

Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds

will no longer provide insurance protection

Level premium permanent insurance accumulates a reserve that will eventually

equal the face amount of the policy

Under a non-qualified annuity, interest is taxed after the

exclusion ratio has been calculated

An indemnity plan is a

fee for service plan

A beneficiary change can occur

normally at any time during the policy term

The role of the federal government was expanded when Medicaid was established by allowing the state to

receive matching funds to expand public assistance programs

Term insurance is appropriate for someone who

seeks temporary protection and lower premiums

A group Disability Income plan that pays tax-free benefits to covered employees is considered

Fully Contributory

Which of these will typically authorize treatment from a specialist?

Gatekeeper

An HMO that involves a partnership of physicians and other providers who practice out of a central facility is called a(n)

Group HMO

Tom has a rider on his disability income policy that guarantees the right to increase his benefits without a medical exam. What kind of rider is this?

Guaranteed Insurability Rider

Bryce purchased a disability income policy with a rider that guarantees him the option of purchasing additional amounts of coverage at predetermined times without requiring to provide evidence of insurability. What kind of rider is this?

Guaranteed insurability rider

Phil is shopping for an annuity that guarantees he CANNOT outlive the benefits. Which of these benefit options would he choose?

Guaranteed lifetime withdrawal benefit

Medicare part C is a

Managed health care plan

In contrast to a guaranteed renewable policy, a noncancellable policy

May never raise premiums

When an insured has a major medical plan with first dollar coverage, how does this impact the benefits paid?

No deductible required

Jennifer is required to pay a specific sum out of pocket before any benefits are paid in a year. Her health policy most likely contains a(n)

deductible

The legal action provision in a health contract is limited to no more than ___ years.

5 Years

The legal action provision in a health contract is limited to no more than ___ years.

5 years

How many months can a life insurance policy normally be backdated from the date of application?

6 months

No Long-Term Care policy may exclude pre-existing conditions for a period of more than

6 months

A rollover from a Traditional IRA to another IRA MUST be done within ___ days to avoid tax consequences.

60 days

In Pennsylvania, an employee must request spousal coverage under a group sponsored accident and health plan within ___ days of marriage.

60 days

If a health insurance claim is not promptly paid, legal action may be taken against the insurer after

60 days after proof of loss is furnished.

In Pennsylvania, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period that a new group health plan can apply. This rule is applicable as long as there has been no gap in creditable coverage for a period greater than

63 days

As classified by the Affordable Care Act (ACA), a Silver Plan offers

70% actuarial level of coverage provided

What would happen if a life insurance applicant is given a conditional receipt from an insurance agent and then dies the next day?

Claim will be paid if application is approved

An indemnity plan limitation that will pay the dental bills after a small amount is paid by the insured is called

Coinsurance

Pat is insured with a life insurance policy and Karen is his primary beneficiary. They are both involved in an automobile accident where Pat dies instantly and Karen dies 5 days later. Which policy provision will protect the rights of the contingent beneficiary to receive the policy benefits?

Common Disaster Clause

Medical expense Insurance would cover

Injury occurring at the insured residence

The principle of insurable interest, in regards to a life insurance contract, is accurately described in which statement?

Insurable interest can be based on the love and affection of individuals related by blood or law

Which of the following types of deductibles would apply a single deductible to both medical and dental insurance coverage?

Integrated Deductible

Sharon is the policyowner of a $50,000 life insurance policy. Her son, Mike, is the beneficiary. If Sharon MUST obtain Mike's signature in order to change the beneficiary, what kind of beneficiary designation is this?

Irrevocable

A life insurance policy written on one contract for two people in which it is payable upon the first death is called

Joint

Which type of annuity stops all payments upon the death of the annuitant?

Life Annuity

Which settlement option pays a stated amount to an annuitant, but no residual value to a beneficiary?

Life Income

Which of these is NOT considered to be a common life insurance nonforfeiture option?

Life Income Annuity

A permanent life insurance policy where the policyowner pays premiums for a specified number of years is called a(n)

Limited Pay Policy

A life insurance policy that has premiums fully paid up within a stated time period is called

Limited Payment Insurance

Low frequency diseases can be exclusively covered by what kind of health insurance policies?

Limited Policies

A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n)

Optional Renewability Clause

Which type of disability would be less than total impairment and equal to permanent impairment?

Permanent Partial Disability

Under a modified Endowment contact what are the likely consequences

Pre-death distributions will become taxable

Which type of policy combines the flexibility of a universal life policy with investment choices?

Variable Universal

All of these statements concerning whole life insurance are false EXCEPT

When a whole life policy is surrendered, income taxes may be owed

Which of these would be the best example of a limited pay life insurance policy?

Whole life policy with premiums paid up after 20 years

A medical provider that accepts Medicare Assignment must

accept payment based upon a defined Medicare schedule as payment in full

A Modified Endowment Contract (MEC) is best described as

A life insurance contract which accumulates cash values higher than the IRS will allow

The double indemnity provision in a life insurance policy pertains to an insured's death caused by a(n)

Accident

People with higher loss exposure have the tendency to purchase insurance more often than those at average risk. This is called

Adverse Selection

When does an immediate annuity begin making payments?

After the first premium has been paid

Fixed period settlement options are considered to be a form of a(n)

Annuity

Which of these factors would an insurer consider when determining whether to accept a group life plan?

Average Age

A spouse and child can be added to the primary insured's coverage as what kind of rider?

Family Term

Which of these riders will pay a death benefit if the insured's spouse dies?

Family Term Insurance Rider

Which of these annuities require premium payments that vary from year to year?

Flexible Premium Deferred Annuity

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

Managed Care Plan

If the beneficiary dies from the same accident as the insured individual, the insurer will proceed as if

The Insured Outlived the Beneficiary