Life & Health Final
an insured has a major medical policy with a $500 deductible and a coinsurance clause of 80/20. if he incurs medical expenses of $4,000 the insurer would pay
$2,800
at the time of intitial licensing what fee must a viatical settlement provider pay
$300
any licensed person whose activities affect interstate commerce and who knowingly make false material statements related to the business of insurance may be imprisoned for up to
10 years
once a viatical contract has been established how kind does the visitor have to rescind the contact
15 calendar days
HIPAA applies to groups of
2 or more
the relation of earning to insurance provision allows the insurance company to limit the insureds benefits to his average income over a period of what time
2 years
within how many days must a producer respond to an inquiry from the commissioner
30 days
how soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company
90 days but not to exceed 1 year
which of the following statements is correct about HMO
HMO may pay for services not covered by Medicare
all of the following are true regarding the medical information bureau except
MIB reports are based upon information supplied by doctors and hospitals
an individual has been contributing to a retirement account after taxes are taken out of his paycheck. his advisor told him. that he will be allowed to make contributions after age 70.5. the account owner does not have to pay taxes on the growth of his account. what type of retirement account is this
ROTH IRA
according to the entire contract provision a policy must contain
a copy of the original application for insurance
which statement best defines a multiple employer welfare arrangement
a joining together by employers to provide health benefits for employee
the term illustration in a life insurance policy refers to
a presentation of nonguaranteed elements of a policy
which of the folllowing would be required to be licensed as an insurance producer
a salaried employee who advertises and solicits insurance
an individual was just caught acting as an exclusive general agent- even though he is not properly licensed. assuming that this occurred in a single day what is the maximum penalty he faces
a third degree misdemeanor and a 1,000$ fine
which of the following is the closes term to an authorized insurer
admitted
which of the following is the closest term to an authorized insurer
admitted
the omnibus budget reconciliation act of 1990 requires that large group health plans must provide primary coverage for disabled individuals under
age 65 who aren't retired
what is a foreign insurer
an insurer with a home office in another state
in disability income insurance if an insured is considered disabled if they cannot perform any job they are surer for by prior education training or experience they fall under which definition of total disability
any occupation
an insurance contract must contain all of the following to be considered legally binding except
beneficiarys consent
an insured receives an annual life insurance dividend check: what term best describes this arrangement
cash option
an insurer neglects to pay a legitimate claim that is covered under the terms of the policy. which of the following insurance principles has the insurer violated
consideration
when an insured makes truthful statements in the application for insurance and pays the required premium, it is also known as which of the following
consideration
which of the following includes information regarding a persons credit character reputation and habits
consumer report
which of the following is not an essential element of an insurance contract
counteroffer
all of the folllowing statements concerning accidental death and dismemberment coverage are correct except
death benefits are paid only if death occurs within 24 hours of an accident
on a major medical insurance policy, the amount that the insured must pay on a claim before the insurer will pay is known as
deductible
which of the following is not a cost saving service in a medical plan
denial of coverage
the death benefit in a variable universal life policy
depends on the performance of a separate account
which of the following is not a term for the period of time during which the annuitant receives income?
depreciation period
a producer agent must do all of the following when delivering a new policy to the insured except
disclose commissions earned from the sale of the policy
an insured is hospitalized with a back injury. upon checking his disability income policy, he learns that he will not be eligible for benefits for at least 30 days. this indicates that his policy is written with a 30 day
elimination period
life insurance that has a guaranteed minimum and fixed benefits
fixed life insurance
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
an individual is purchasing a permanent life insurance policy with a face value of $25,000. while this is all the insurance that he can afford at this time, he wants to be sure that additional coverage will be available in the future. which of the following options should be included in the policy
guaranteed insurability option
which of the following health care plans would most likely provide the insured with comprehensive health care coverage
health maintenance organization plan
which of the following is incorrect concerning taxation of disability income benefits
if paid by the individual, the premiums are tax deductible
which of the following statements about the reinstatement provision is true
if required the policyowner to pay all overdue premiums with interest before the policy is reinstated
which of the following statements best describes the effect the accelerated benefit provision would have on the benefits paid to the beneficiary
if will decrease the benefits paid
a man purchased a $90,000 annuity with a single premium. and began receiving payments 2 months after that. what type of annuity is it
immediate
in which of the following locations would skilled care most likely be provided
in an institutional setting
issue age policy premiums increase in response to which of the following factors
increased benefits
what do individuals use to transfer their risk of loss to a larger group
insurance
who makes up the medical information bureau
insurers
all of the following actions by a person could be described as risk avoidance except
investing in the stock market
bob decides to sell his life insurance policy to a viatical settlement company. which of the following is true
it is the viatical settlement providers responsibility to inform the insurance company that the policy has been viaticated
which of the following is not considered a misrepresentation as it pertains to unfair trade practices
making comparison between different policies
an individual's tendency to be dishonest would be indicative of a
moral hazard
an insured purchased an insurance policy 5 years ago. last year she received a dividend check from the insurance company that was not taxable. this year she did not receive a check from the insurer. from what type of insurer did the insured purchase this policy
mutual
policy that distributes its dividends to policy owners by cash payments
mutual life insurance "participating"
which of the following can surrender a deferred annuity contract
only the annuity owner
a prospective insured receives a conditional receipt but dies before the policy is issued. the insurer will
pay the policy proceeds only if it would have issued the policy
if someone wants to buy life insurance policy that will provide lifetime protection against premature death, what type of policy should that person buy
permanent
various forms of whole life insurance that remain in effect until age 100
permanent life insurance
which of the following documents delivered to the policyowner includes information about premium amounts, cash values, surrender values and death benefits for specific policy years
policy summary
all of the following are examples of risk retention except
premiums
which of the following licensees is classified as a representative of the insurance company and not allowed to represent an insured or claimant
producer
a situation in which a person can only lose or have no change represents
pure risk
the risk of loss may be classified as
pure risk and speculative risk
another name for a substandard risk classification is
rated
if a court ordered payment for a loss that was not covered in the policy even if it was clearly worded, it would be an example of which legal concept
reasonable expectations
which of the following factors determines the amount of each installment paid in a life income option arrangement
recipients life expectancy and amount of principal
purpose of risk retention
reduce expenses and improve cash flow increase control of claim reserving fund for losses that can't be insured
in dental insurance what type of care will cover crowns
restorative
which is the appropriate action by the insurer if a prospective insured submitted an incomplete application
return the application to the applicant for completion
how is risk retention assumed
self insurance copayments deductibles
when the insured initiates the cancellation of. a policy, the unearned premium will be refunded on a
short rate basis
events in which a person has both the chance of winning or losing are classified as
speculative risk
which of the following statements about a suicide clause in a life insurance policy is true
suicide is excluded for specific period of years and covered thereafter
temporary life insurance provided for a specific period of time "pure"
term life insurance
which of the following may not be included in an insurance companies advertisement
that it's policies are covered by a state guaranty association
the annual contribution limit of a dependent care flexible spending account is set by
the IRS
in which of the following examples would a contract between an insurer and prospective insured be legal
the applicant has a prior felony conviction
an insured loses her left arm in an accident that is covered by her accidental death and dismemberment policy. what kind of benefit will she most likely receive from this policy
the capital amount in a lump sum
in insurance an offer is usually made when
the completed application is submitted
in comparison to consumer reports which of the following describes a unique characteristic of investigative consumer reports
the customers associates friends and neighbors provide the reports data
which of the following is not true regarding a variable universal life policy
the death benefit is fixed
which of the following would not fall into the category of costs associated with death
the expense of vacation for surviving family members
which of the following entities established the DO NOT CALL registry
the federal trade commission
a life insurance policy does not have a war clause. if the insured is killed during a time of war, what will the beneficiary receive from the policy
the full death benefit
the insured had his wife named as the beneficiary of his life insurance policy. to ensure that his wife had income for life after the insureds death he chose the life income settlement option. the amount of payments will be determined by taking into account all of the following except
the insureds age at death
which of the following is not a characteristic of an insurable risk
the loss must be catastrophic
an insurer wishes to compare the information given in an insurance application with previous insurance application by the same applicant but for different companies. what organization can help the insurer accomplish this
the medical information bureau
all of the following are true regarding a decreasing term policy except
the payable premium amount steadily declines throughout the duration of the contract
if an insured continually uses the automatic premium loan option to pay the policy premium
the policy will terminate when the cash value is reduced to nothing
which of the following best defines target premium in a universal life policy
the recommended amount to keep the policy in force throughout its lifetime
in an adjustable life policy all of the following can be changed by the policy owner except
the type of investment
which of the following is not true regarding equity indexed annuities
they earn lower interest rates than fixed annuities
which of the following is true regarding medicare supplement policies
they must be guaranteed renewable
which of the following is not a goal of risk retention
to minimize the insureds level of liability in the event of loss
what is the job of a viatical settlement broker
to negotiate contracts between viatical settlement providers and viators, on the behalf of the viators
which type of life insurance policy allows the policyowner to pay more or less than the planned premium
universal life
contracts in which the cash values accumulated based upon a specific portfolio of stocks
variable life insurance
a policyowner of a life insurance policy who is also the insured is diagnosed with a terminal illness, so he sells the policy to a viatical company in order to pay medical bills. what term best describes the policyowners role in this transaction
viator
what types of services may not be provided under the long term cares assisted living care
visits by an RN
which of the following is a statement that is guaranteed to be true and if untrue may breach an insurance contract
warranty
if a policy includes a free look period of at least 10 days, the buyers guide must be delivered to the applicant
with the policy