life and health insurance which is correct
All of the following are characteristics of dental insurance plans, EXCEPT: A Orthodontic care is covered immediately following the effective date of the policy B Cleaning and x-rays are preventive care services C Deductibles and coinsurance generally apply to basic and major services D Purely cosmetic services are excluded from coverage
A
All of the following statements regarding sources of underwriting are correct, except: A The applicant may be denied coverage based solely on the MIB report B A medical exam may be requested based on the amount of coverage being applied for C A consumer investigative report may include a credit report D The agent's report is confidential between the producer and the insurer
A
If after a policy has been issued and delivered, the insurer discovers unanswered questions on the application, what can the insurer legally do at this point? A Nothing, the insurer has waived its right to that information B Increase the policy's premium C Cancel the policy D Require the applicant/insured to answer the questions and re-underwrite the policy
A
K meets with an insurance producer, completes an application, and writes a check for the initial premium. The producer submits the application and the premium to the insurer, and a policy is issued and mailed to the producer. Two weeks later, K has neither shown up to pick up the policy nor returned the producer's calls. Which of the following statements is correct? A The policy is in force--coverage began when the insurer sent the policy B The policy is in force--coverage began when the producer accepted K's check C The policy is not in force--the policy must be physically handed to K for coverage to begin D The policy is in force--coverage began when the policy arrived at the producer's office
A
Which of the following is not a core benefit in a Medicare Supplement policy? A Coverage for up to 365 days of long-term care expenses after three days of hospitalization B Coinsurance amounts payable under Part B C The cost for the first three units of blood administered in a calendar year D Coverage for up to 365 days of hospital charges after Medicare benefits run out
A
Which statement is false regarding Social Security Disability benefits? A Qualification for benefits is contingent only upon the employee's having 45 work credits and being unable to perform his or her usual job B The waiting period is 5 months C The benefit for a qualifying disabled worker is a percentage of the PIA D To collect disability benefits, an employee must be unable to engage in any kind of gainful work because of a medically determined physical or mental condition that has lasted, or is expected to last, at least 12 months or to result in death
A
All of the following are characteristics of group disability income plans, except: A Issued as nonoccupational B Benefits are based on a percentage of the employee's income at the time the policy was issued C Premiums are paid based on a contributory or noncontributory basis D Coverage can be offered based on short-term or long-term disability benefits
B
All of the following are false statements regarding group disability plans, except: A The plans usually cover work-related disabilities B The plans are typically written on a nonoccupational basis C Benefits are not available to individuals employed beyond age 65 D There is individual medical underwriting
B
All of the following statements regarding a Modified Endowment Contract are correct, EXCEPT: A Distributions received from a MEC are subject to a LIFO tax treatment B If a policy is deemed a MEC, the owner has 7 years to receive a refund of excess premiums and remove the MEC status C Distributions on gains withdrawn from a MEC prior to age 59 1/2 are subject to a 10% penalty in addition to taxation D A policy that fails the 7-pay test will be deemed a MEC
B
If an incomplete application is accepted by the underwriter and a policy is issued without requesting the missing information, which of the following statements applies? A The producer will be personally responsible out of pocket for any claims filed based on the missing information in the application B The insurer waives its right to contest a claim based on the incomplete application C The policy can be contested if a loss occurs within 2 years of the policy being issued D The insurer can void the contract at any time since this is considered fraudulent
B
Regarding the tax treatment of a qualified LTC policy, which of the following statements is correct? A Only premiums paid by individuals age 65 or older are tax deductible B LTC benefits are not taxable C All premiums are tax deductible D Only 10% of the benefits are taxable
B
The Medical Information Bureau (MIB) is formed by: A Medical professionals B Insurance companies C Employers D The Government
B
The Minimum Benefit Standards under a qualified LTC policy include all of the following, except: A Every LTC policy must offer optional inflation protection to offset the increased costs of care B Every LTC policy must be issued as noncancellable C An Outline of Coverage must be delivered to an applicant on the initial solicitation and prior to the presentation of the application form D Every LTC policy must include basic policy requirements in the policy provisions
B
When comparing individual and group health insurance plans, which of the following is a characteristic of group health insurance? A An insurance policy is issued to each employee B The group plan usually offers a conversion privilege C Premiums are paid solely by the employee D The employee is required to provide evidence of insurability
B
Which of the following is not a major source of underwriting information? A Attending Physician's Statement B Past life insurance owned C The application D Medical exams
B
Which of the following is not true about life insurance applications? A May contain all the necessary information to determine insurability B Confidential communication between the agent and the insurer C Contains two parts: General Information and Health History D Primary source of underwriting
B
Which of the following statements regarding reinstatement of a health insurance policy is NOT correct? A Upon reinstatement, a 10 day probationary period applies to losses due to sickness B The insurer must approve the reinstatement application within 45 days of submission or it will assumed to be rejected C Back premiums must be paid D Evidence of insurability may be required
B
Which statement is incorrect regarding COBRA? A The employer may require the former employee or beneficiary to pay an amount equal to 102% of the premium B The employee or beneficiary must respond to the notification of his/her right to continue coverage within 90 days, if he/she wants to continue the coverage C Coverage continues for 29 months for individuals receiving Social Security disability D Evidence of insurability is not required to continue coverage under COBRA
B
A Long-Term Care policy provides benefits in each of the following settings, EXCEPT: A The home of the insured B Hospice care in a family member's home C Therapeutic care in a an acute care hospital D Intermediate care nursing facility
C
A long-term care rider: A Pays 25% of the death benefit as monthly income for an insured who cannot perform all of the six activities of daily living B Establishes a trust fund for the insured's family so that nursing home care can be paid for with insurance premiums instead of paying premiums directly to the life insurance company C Provides up to 100% of the policy benefits if the insured qualifies for benefits as specified in the rider but will reduce the amount of death benefit protection based on the amount paid under the rider D Provides an amount equal to the death benefit plus any cash value to a terminally ill insured expected to die in the next 6 months
C
All of the following are characteristics of a qualified retirement plan, EXCEPT: A Employer contributions are immediately tax deductible to the employer B The penalty for premature distributions may be waived for death, disability, qualified education costs, medical expenses and first -time homebuyers C Employers in private industry are required to establish pension plans D Employee contributions are either pre-tax or tax deductible
C
All of the following are correct regarding employer group health insurance eligibility requirements and benefits, EXCEPT: A Employees must be considered full-time and actively at work B Employees must sign up during the enrollment period to avoid providing proof of insurability C Employees can enroll at any time without restrictions D Newly hired employees must usually satisfy a probationary period before they can enroll in the plan
C
All of the following are policy requirements of a Medicare Supplement policy, except: A The Guide to People with Medicare must be provided at the time of application B The insurer/producer must explain the relationship of this coverage to the benefits of Medicare C A 10-day free look period D The Outline of Coverage contains information on the benefits, deductibles, exclusions, and premiums
C
Common exclusions in accident and health insurance policies include all of the following, except: A Elective cosmetic surgery B Medical expenses covered under Workers' Compensation C Newborn infant D Commission of a felony
C
Concerning PPOs, which is a true statement? A The insured may only utilize providers contracted with the insurer B PPOs are typically not for profit C The insured has a financial incentive to use providers who have agreed to predetermined reimbursements for medical services rendered D PPOs provide all services at one location
C
The time period that must elapse after a loss before benefits are payable under a policy is the: A Grace period B Free look C Elimination or waiting period D Probationary period
C
Which of the following regarding Medicare Part B is true? A It is free for those who qualify B Provides coverage for inpatient services C Generally pays 80% of covered physician, surgeon, and outpatient hospital expenses, with a monthly premium and annual deductible D It covers routine dental checkups
C
All of the following are differences between a PPO plan and an HMO, EXCEPT: A Use of a Primary Care Physician B Freedom to choose any service provider C Providers charge a discounted fee negotiated in advance D It is a managed care plan
D
All of the following are potential risks of replacement of an individual health or disability insurance policy, except: A Coverage may be reduced or excluded due to a pre-existing condition B A new probationary period may go into effect limiting coverage for losses due to sickness C Premiums may be higher than the original policy D Coverage due to an accident will be restricted for 30 days after the effective date of the policy
D
All of the following are true of a substandard risk, except: A The coverage could be reduced for a period of time B The insured may have a flat additional premium added to their base premium C The insured may be rated as older than their actual age D The premium would be discounted
D
All of the following statements regarding a group Accidental Death and Dismemberment policy are incorrect, except: A The premiums paid by the employer are considered part of the employee's income B Accidental Death and Dismemberment Insurance is not available on a group basis, only on an individual basis C The premiums paid by the employer are not deductible as a business expense to the employer D Any benefits received are not taxable to the recipient
D
In a replacement transaction, all of the following are insurer duties and responsibilities, except: A Notify the existing insurer B Maintain copies of the information provided by the producer C Abide by the state required holding period for all replacement documentation D Contact the client to assure that they understand the transaction
D
In order for an insurance company to determine if it will issue a policy, what document must always be submitted for review? A A premium check B A copy of the applicant's driver's license C A conditional coverage receipt D The application
D
Policy loan provisions include all of the following, EXCEPT: A Outstanding loans will be deducted from the face amount at time of claim B Unpaid interest is added to the value of the loan C Interest is charged annually D The death benefit of a policy is automatically reduced when a loan is requested
D
Under ERISA qualified plans must meet all of the following requirements, except: A Must be approved by the IRS B Must benefit employees and beneficiaries C Must have a vesting requirement D May discriminate in favor of highly compensated employees
D
Under the Fair Credit Reporting Act, which of the following statements is correct? A The reporting agency has no responsibility to investigate inaccurate information B The Act is designed to protect reporting agencies from the public C The reporting company can provide confidential information to anyone requesting it D If an individual is denied coverage, they can request a copy of the report
D
Which of the following is true? A The insured and the policyowner are always the same B Any changes to a policy must be approved by both the insured and policyowner in writing C The applicant, insured, and policyowner must approve any changes to a policy in writing D The insured and the policyowner are usually the same, but not necessarily
D
Which one of the following is the primary source of underwriting information? A Attending Physician Statement B Investigative consumer report C Medical exam D Application
D
Which statement is incorrect regarding HMOs? A HMOs emphasize wellness programs and diagnostic screenings for early detection which reduces unnecessary treatment in the future B Members are required to pay a small copayment for basic health care services to discourage unnecessary use of medical resources C Coverage will not be provided outside the service area except in case of emergencies D HMOs must provide basic health care services including physical therapy, vision and dental care
D
