Life and Health

Which of the following Life Insurance policies would be considered interest sensitive?

) Universal life

Legal amount of time between completing authorization form and disclosure of information

1 year

Any licensed person whose activities affect interstate commerce and who knowingly makes false material statements related to the business of insurance may be imprisoned for up to

10 years, if jeopardizes insurer up to 15 years

For how many days of skilled nursing facility care will Medicare pay benefits?

100

Eligible for tax credits under ACA

100-400% FPL

A temporary agent's license is valid for what time period?

15 months

An insured was involved in an accident and could not perform her current job for 3 years. If the insured could reasonably perform another job utilizing similar skills after 1 month, for how long would she be receiving benefits under an "own occupation" disability plan?

2 years

Existing insurers must provide policyowners with a policy summary for the existing life insurance how soon after receiving the written communication and replacement?

20 days

Treatment in a skilled nursing facility is covered in full for

20 days

replacement policy free-look

20 days

written notice of claim must be submitted to insurer within

20 days

Under a nonscheduled plan, what portion of the balance could an insured expect to pay for basic services?

20%

Max age for catastrophic plan

30

Free look for LTC

30 days

Licensees inform commissioner of name/address change within

30 days

representative must submit an appropriate application to the Commissioner and the Commissioner will, within _____________ issue a temporary license or reject the application

30 days

Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months?

30 months

COBRA covers employees and their dependents for

36 months

For how many years is an insurer required to maintain a complete file of its advertisements?

4 years

What is the elimination period for Social Security disability benefits?

5 months

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

6 credits during last 13-quarter period

How long is an open enrollment period for Medicare supplement policies?

6 months

LI can be backdated to affect lower premium for up to

6 months

Employees in a health benefit plan for a small employer may have to pay deductibles and cost-sharing for pre-existing conditions for what period of time?

6 months after becoming eligible for coverage

producer's license can be reinstated retroactively it is has been expired

60 days

would authorize the commingling of premiums with the agent's personal funds?

A letter of consent from the principal

For what time period can coverage be excluded on permissible pre-existing conditions applicable to a Medicare supplement insurance policy?

A policy not purchased during the open enrollment period and which does not replace an existing Medicare supplement policy, can exclude coverage on permissible pre-existing conditions for a period of up to 6 months.

The two types of assignments are

Absolute and collateral.

Rider that pays income during 6-month waiting period before SS benefits

Additional Monthly Benefit

Which of the following long-term care benefits would provide coverage for care for functionally impaired adults on a less than 24-hour basis?

Adult day care (need help with ADLs but not around clock)

If an insurance company makes a statement that its policies are guaranteed by the existence of the Insurance Guaranty Association, that would be considered

An unfair trade practice.

A Universal Life Insurance policy is best described as a/an

Annually Renewable Term policy with a cash value account.

In disability income insurance, if an insured is considered disabled if they cannot perform any job they are suited for by prior education, training or experience, they fall under which definition of total disability?

Any occupation

When must the Medicare Supplement Buyer's Guide be presented?

At the time of application

At what point must an Outline of Coverage be delivered?

At the time of application or upon delivery of the policy

After a person's employment is terminated, it is possible to obtain individual health insurance after losing the group health coverage provided by the employer. Which of the following is NOT true?

By law, the new, individual policy must provide the same benefits as the group insurance policy.

When a policyowner designates a group of individuals as the beneficiary of a life insurance death benefit without specifically naming the individuals, this is called

Class designation.

An insured is receiving hospice care. His insurer will pay for painkillers but not for an operation to reduce the size of a tumor. What term best fits this arrangement?

Cost-containment (doesn't cover curative measures)

Which of the following statements is true regarding LTC insurance?

Every policy must offer nonforfeiture benefits to the applicant.

A man wants to buy a life insurance policy in which he can count on guaranteed minimum benefits. Which type should he buy?

Fixed

If a beneficiary wants a guarantee that benefits paid from principal and interest would be paid for a period of 10 years before being exhausted, what settlement option should the beneficiary select?

Fixed period

An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The insured is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?

Full benefits

Which of the following is another name for a primary care physician in an HMO?

Gatekeeper

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

Guaranteed insurability rider.

The premium is guaranteed for an initial period and then the insurer can charge up to a maximum premium charge in what type of policy?

Indeterminate Premium

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

Is not covered

What is franchise insurance?

It is health coverage for small groups whose numbers are too small to qualify for true group insurance

An insurer invests the money it receives from premiums paid by its insureds. Which of the following is TRUE regarding the interest earned on these investments?

It is used to lower premiums.

Which of the following is NOT true regarding the Life with Guaranteed Minimum annuity settlement option?

It provides a higher monthly benefit than a pure life annuity.

General enrollment Medicare part B

Jan 1 to March 31

A married couple's retirement annuity pays them $250 per month. The husband dies and his wife continues to receive $125.50 per month for as long as she lives. When the wife dies, payments stop. What settlement option did they select?

Joint and survivor

On its advertisement, a company claims that it has funds in its possession that are, in fact, not available for the payment of losses or claims. The company is guilty of

Misrepresentation.

Which of the following is NOT true regarding the needs approach method of determining the value of an individual's life?

Need is predicted using the number of years until the insured's retirement.

When is the open enrollment period through Maryland Health Connection?

November 1 through January 31

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 Part B. What is the insurance company obligated to do?

Offer the supplement policy on a guaranteed issue basis

Which renewability provision allows an insurer to terminate a policy for any reason, and to increase the premiums for any class of insureds?

Optionally renewable (insurer can also increase premium for any class)

A rider attached to a life insurance policy that provides coverage on the insured's family members is called the

Other-insured rider.

A participating insurance policy may do which of the following? and based on what

Pay dividends to the policyowner based upon actual mortality cost, interest earned and costs

Which type of dental treatment addresses the supporting tissue of teeth?

Periodontics

Which of the following will be included in a policy summary?

Premium amounts, surrender values, DB

Regarding the taxation of Business Overhead policies,

Premiums are deductible and benefits are taxed.

Which of the following insurance options would be considered a risk-sharing arrangement?

Reciprocal

An insured committed suicide one year after his life insurance policy was issued. The insurer will

Refund the premiums paid.

What method do insurers use to protect themselves against catastrophic losses?

Reinsurance

A policyowner who is also the insured wants to name her husband as the beneficiary of her life policy. She also wishes to retain all of the rights of ownership. The policyowner should have her husband named as the

Revocable beneficiary.

Roger has insurance coverage through his company. Who owns the policy?

Roger's employer

If an immediate annuity is purchased with the face amount at death or with the cash value at surrender, this would be considered a

Settlement option.

An applicant buys a nonqualified annuity, but dies before the starting date. For which of the following beneficiaries would the contract's interest NOT be taxable?

Spouse

An individual applied for an insurance policy and paid the initial premium. The insurer issued a conditional receipt. Five days later the applicant had to submit to a medical exam. If the policy is issued, what would be the policy's effective date?

The date of medical exam (later than application)

The market value adjustment in modified guaranteed annuities refers to which of the following?

The difference between the contracted interest rate and the rate at surrender

Regarding the return of premium option for LTC policies, what happens to the premium if the policy lapses?

The insurer will return a percentage of the premiums paid.

Which of the following is TRUE regarding a policy issued to a labor union insuring members of the organization for the benefit of persons other than the union or organization?

The members eligible for insurance under the policy must be all the members of the union or organization. b) The premiums for the policy must be paid either from funds of the union, or from funds contributed by the insured members specifically for their insurance, or from both. c) An insurer may exclude or limit the coverage on any person who provides unsatisfactory evidence of insurability to the insurer.

Hospital indemnity/hospital confinement indemnity policy will provide payment based on

The number of days confined in a hospital.

What is the advantage of reinstating a policy instead of applying for a new one?

The original age is used for premium determination (need proof of insurability)

Which state has jurisdiction over a group policy that covers individuals that reside in more than one state?

The state in which the policy was delivered

Which of the following policies would have an IRS required corridor or gap between the cash value and the death benefit?

Universal Life - Option A

When would a 20-pay whole life policy endow?

When the insured reaches age 100

Medicare Part B covers dental expense resulting

accident only

Medicare Part B covers dental expense resulting from

accident only

managed care plan

comprehensive case management, preventive care, controlled access providers; NOT risk retention

who determines if particular group can be excluded from group health coverage

employer

Restoring insured financially

indemnity

Survivorship life based on _______ and has _______ prem. compared to joint life

joint age; lower

rider provides payment of part of DB if terminal illness

living needs

Catastrophic plans

low prem., high deductible

higher stop loss

lower premiums

The premium is guaranteed for an initial period and then the insurer can charge up to a maximum premium charge in what type of policy?

ndeterminate Premium

Reduction of prem. uses dividend to reduce

next years prem

Which of the following is true regarding a term health policy?

nonrenewable.

Accumulation at interest is

retained by the company and taxable whether the policy receives it or not

HMO pays w/

services not reimbursement

Not a policy replacement

term conversion to whole

The restitution may not exceed

the amount of the actual economic damage, subject to the policy limits.

An annuitant dies before the effective date of a purchased annuity. Assuming that the annuitant's wife is the beneficiary, what will occur?

the interest will continue to accumulate tax deferred.

considered a nonmedical insurance application?

the medical information is completed by the applicant and the agent only

General disability policies do not cover losses caused by

war, military service, intentionally self-inflicted injuries, overseas residence, or injuries suffered while committing or attempting to commit a felony.

If a policyowner transfers or gives away a life insurance policy _______________ prior to his/her death, the entire face amount of the policy will be included in his or her taxable estate.

within 3 years