Life & Health Missed Questions
In underwriting a substandard risk, which of the following is INCORRECT A. A discounted premium would be charged B. The policy could be modified in the coverage or amount of coverage requested C. The applicant could be rejected for coverage D. Additional exclusions could be included to modify the underlying policy coverage
A. A discounted premium would be charged
Under what condition are group disability income benefits received by an employee NOT taxable as income? A. When the employee is 59 1/2 B. When the amount of the benefit is equal or less than the amount contributed by the employer C. When the benefits received are equal or less than the employee's percentage of the contribution D. When the employer makes all premium payments
C. When the benefits are equal or less than the employee's percentage of the contributions
Which of the following would NOT be considered an exception to the National Do Not Call List?
Calls based from outside the United States
Which of the following is an example of liquidity in a life insurance contract?
Cash value available to policyowner
How long is an open enrollment period for Medicare supplement policies?
6 months
Under the Affordable Care Act, a special enrollment period allows an individual to enroll in a qualified plan within how many days of a qualifying event?
60 days
An insured is covered by a partially contributory group disability income plan that pays benefits of $4,000 a month. If the insured pays 25% of the monthly premium, how much of the monthly benefit would be taxable?
$3,000 (premium paid by employer is taxable)
How long is the right to examine period for new individual annuities issued in this state?
10 days
An insured has a major medical policy with a $500 deductible and a coinsurance clause of 80/20. If he incurs a medical expense of $4,000, the insurer will pay
2,800
Regarding viatical settlements, the term terminally ill means a person who is expected to live no longer than
24 months
Adopting parents must inform their insurer that a child has been added to the family within
31 days
For the purpose of examination by the department, insurers must keep a record of all financial files for at least
5 years
Where would LTC services be rendered?
A nursing home or one's home
When an annuity is written, whose life expectancy is taken into account?
Annuitant
Which of the following is NOT correct regarding Medicare? A. Medicare Part B provides physician services B. Medicare Advantage must be provided through HMOs C. Medicare Advantage may include prescription drug coverage D. Medicare Part A provides hospice care
B. Medicare Advantage must be provided through HMO's
Which of the following is closest term to an authorized insurer? A. Certified B. Licensed C. Legal D. Admitted
D. Admitted
Patient Protection and Affordable Care Act includes all the following provisions EXCEPT A. Right to appeal B. No lifetime dollar limits C. Coverage for preventive benefits D. Individual tax deduction for premiums paid
D. Individual tax deductions for premiums paid
All of the following are considered to be basic benefits of an HMO plan EXCEPT A. Preventive services B. Out-of-area coverage C. Diagnostic laboratory services D. Prescription Drugs
D. Prescription Drugs
An insured buys a 5-year level premium term policy with a face amount of $10,000. The policy also contains renewability and convertibility options. When the insured renews the policy in 5 years, what will happen to the premium?
It will increase because the insured will be 5 years older than when the policy was originally purchased
In respect to the consideration clause, which of the following is consideration on the part of the insurer?
Promising to pay in accordance with contract items
Which of the following is an example of a peril covered in an accident and health insurance policy?
Sickness
What happens if a deferred annuity is surrendered before the annuitization period?
The owner will receive the surrender value of the annuity
What is the purpose of coinsurance provisions?
To help the insurance company prevent overutilization of the policy
An insured owns a life insurance policy. To be able to pay some of her medical bills, she withdraws a portion of the policy's cash value. There is a limit for a withdrawal and the insurer charges a fee. What type of policy does the insured most likely have?
Universal Life, able to withdraw a limited portion of policy's cash value & usually charged/limited
For the purpose of insurance, risk is defined as
the uncertainty or chance of loss
A person who gives money as consideration for a life insurance policy or interest in the death benefits of a life insurance policy is called a
viatical settlement purchaser
All of the following are true of key person insurance EXCEPT A. The plan is funded by permanent insurance only B. There is no limitation on the number of key employee plans in force at any one time The employer is the owner, payor, and beneficiary D. The key employee is the insured
A. The plan is funded by permanent insurance only May be funded by any type of insurance
What term best describes someone who is unable to preform at least 2 activities of daily living?
Chronically ill
Provision in health insurance policy that ensures that the insurer cannot refer to any document that is not contained in the contract is the
Entire contract clause
Which of the following is true about the requirements regarding HIV exams?
The applicant must give prior written consent
What happens if a non-member physician is utilized under a Point-Of-Service plan?
The attending physician will be paid a fee for service, but the member patient will have to pay a higher coinsurance amount
When the policy premium wasn't submitted with the application, what should the agent obtain from the insured upon policy delivery?
Statement of good health
Your client wants to know what the tax implications are for contributions to a HSA. You should advise her that the contributions are
Tax deductible
Which of the following is true regarding the elimination periods and the cost of coverage?
The longer the elimination period, the lower the cost of coverage
When is the insurability conditional receipt given?
When the premium is paid at the time of application
Which of the following is NOT a cost-saving service in a medical plan? A. Second surgical opinions B. Risk sharing C. Denial of coverage D. Preventive care
C. Denial of coverage
Which of the following is considered a presumptive disability under a disability income policy?
Loss of two limbs
Are insurance company underwriters allowed to discriminate?
Yes, but not unfairly
Regarding Medicare Part B, which statement is INCORRECT? A. It is fully funded by social security taxes (FICA) B. It is known as medical insurance C. It offers limited prescription drug coverage D. It provides partial coverage for medical expenses not full covered by Part A
A. It is fully funded by social security taxes (Part B is funded by monthly premiums & from general revenues from federal government)
Bob purchased a policy to provide coverage on himself, his wife Linda, and their two children, John and Kristen. All of them would need to prove insurability EXCEPT
Any children born to them after the inception of the contract (newborn children need not prove insurability)
What type of document includes a insured's medical history, including diagnoses and treatments?
Attending Physicians Statement (APS)
Which of the following is not an enrollment period for Medicare Part A applicants?
Automatic enrollment (3 types are Initial, general, and special)
All of the following are statements about Medicare supplement insurance policies are correct EXCEPT A. They are issued by private insurers B. They cover the cost of extended nursing home care C. They cover Medicare deductibles and copayments D. They supplement Medicare benefits
B. They cover the cost of extended nursing home care (only fill in the gaps)
All of the following may be excluded from coverage in a Major Medical Expense policy, EXCEPT A. Cosmetic surgery B. Coverage provided under workers compensation C. Emergency surgery D. Custodial care
C. Emergency surgery
Which of the following answers does NOT describe the principal goal of a Preferred Provider Organization A. Provide the subscriber a choice of hospitals B. Provide medical services at a reduced cost C. Provide medical services only from physicians in the network D. Provide the subscriber a choice of physicians
C. Provide medical serviced only from physicians in the network
Which of the following statements in INCORRECT concerning Medicare Part B coverage A. Participants under Part B are responsible for an annual deductible B. Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges C. It is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A D. Part B coverage is provided free of charge when an individual turns 65
D. Part B coverage is provided free of charge when an individual turns 65 (must enroll and pay monthly premium)
Which of the following best describes what the annuity period is? A. Period of time from accumulation to annuitization B. Period of time during which money is accumulated in annuity C. Period of time from the effective date of the contract to the date of termination D. Period of time during which accumulated money is converted into the income payments
D. period of time during which accumulated money is converted into the income payment
A waiver of premium provision may be included with which kind of health insurance policy?
Disability Income
What is the goal of an HMO?
Early detection through regular checkups
Which authority is NOT stated in an agent's contract but is required for the agent to conduct business?
Implied
What is the tax consequence of amounts received from a Traditional IRA after the money was left in the tax-deferred account by the beneficiary?
Income tax on distributions and no penalty
An insurer wishes to compare the information given in an insurance application with previous insurance applications by the same applicant but for different companies. What organization can help the insurer accomplish this?
Medical Information Bureau
When is the annual open enrollment for state insurance exchanges?
November 1 through January 31
Who might receive dividends from a mutual insurer?
Policyholders
How are employer contributions to Health Reimbursement Account treated in regards to taxation?
They are tax deductible
To attain currently insured status under Social Security, a worker must have earned at least how many credits during the last 13 quarters?
6 credits (partially insured)
An individual has just borrowed $10,000 from his bank on a 5-year installment loan requiring monthly payments. What type of life insurance policy would be best suited to this situation?
Decreasing term
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
If the owner of a whole life policy who is also the insured dies at age 80, and there are no outstanding loans on the policy, what portion of the death benefit will be paid to the beneficiary?
Full death benefit
All of the following are business uses for life insurance EXCEPT
Funding against company's general financial loss
What type of hospital policy pays a fixed amount each day the insured is in the hospital?
Indemnity
Which of the following is TRUE of a qualified plan?
It has a tax benefit for both employer and employee
Which of the following is true regarding the childhood immunization benefit in medical plans issued in this state?
That's a mandatory benefit
An employee becomes insured under a PPO plan provided by his employer. If the insured decides to go to a physician who is not a PPO provider, which of the following will happen?
The PPO will pay reduced benefits
Which of the following entities must approve all continuing education courses in this state?
The commissioner
How do employer contributions to a Health Savings Account affect the insured's taxes?
The employer contributions are not included in the individual insured's taxable income
How are excess funds in an employee's HSA handled?
The funds can be carried forward to the next year
Which of the following effectuate a viatical settlement contract?
Viatical settlement providers
ALL of the following are general requirements of a qualified plan except A. The plan must provide an offset for social security benefits B. The plan must be communicated to all employees C. The plan must be for exclusive benefits of the employees and their beneficiaries D. The plan must be permanent, written and legally binding
A. The plan must provide an offset for social security benefits (Plans must meet general requirements established by IRS)
An insured has a major medical policy with a $500 deductible and 80/20 coinsurance. The insured is hospitalized and sustains a $2,500 bill. What is the maximum amount that the insured will have to pay?
$900 (deductible + coinsurance)
All of the following violations may result in an agent's imprisonment EXCEPT A. Knowingly obtaining information about a consumer under false pretenses B. Engaging in the business of insurance after being convicted of breach of trust C. Failing to report to the department a criminal prosecution taken against the agent in another jurisdiction D. Embezzling funds from the insurer
C. Failing to report to the department a criminal prosecution taken against the agent in another jurisdiction (required to notify, the act alone won't result in imprisonment)
All of the following are long-term care coverages would allow an insured to receive care at home EXCEPT A. Respite care B. Home health care C. Skilled care D. Custodial care in insured's house
C. Skilled care (institutional setting)
Attempting to determine how much insurance a family would require based upon their financial objectives is known as
Needs approach
An applicant wants to buy a policy that has cash value element. What type should she buy?
Permanent, lifetime death protection and a savings or cash value option
How are contributions to a tax-sheltered annuity treated with regards to taxation?
They are not included as income tax for the employee but are taxable upon distribution
An insured receives a monthly summary for his life insurance policy. He notices that the cash value of the policy is significantly lower this month than it was last month. What type of policy does the insured have?
Variable, vary in value because value is based on the stocks that support the policy
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company?
Within 90 days or as soon as reasonably possible, but not to exceed 1 year
According to the provisions of the Patient Protection and Affordable Care Act, all of the following are required preventive care services EXCEPT A. Cervical cancer exams for all women starting at age 40 B. Diet counseling for adults C. Well-women visits and counseling D. Screenings for autism and behavioral disorders in children
A. Cervical cancer exams for all women starting at age 40 (only for women at higher risk)
A guaranteed renewable health insurance policy allows the
Policyholder to renew the policy to a stated age, with the company having the right to increase premiums on the entire class
All of the following would be different between qualified and nonqualified retirement plans EXCEPT A. IRS approval requirements B. Taxation on accumulation C. Taxation of withdrawals D. Taxation of contributions
B. Taxation on accumulation (deferred in both plans)
What is necessary in order to be eligible to receive benefits from a long-term care policy?
The insured must be unable to preform some activities of daily living (bathing, dressing, toileting, transferring, contingence, and eating)
An insured submitted a notice of claim to the insurer, but never received claims forms. He later submits proof of loss, and explains the nature and extent of loss in a hand-written letter to the insurer. Which of the following would be true?
The insured was in compliance with the policy requirements regarding claims
An individual is insured under his employer's group disability income policy. The insured suffered an accident while on vacation that left him unable to work for four months. If the disability income policy pays the benefit, which of the following would be true? A. Benefits that are attributable to the employer contributions are fully taxable to the employee as income B. The insured has to wait 2 months to start receiving benefits C. For the business, payments are not considered tax deductible as an ordinary business expense D. The insured can deduct his medical expense benefits from his income tax
A. Benefits that are attributable to the employer contributions are fully taxable to the employee as income (in a plan funded fully by employer, income benefits are include din the employees gross income and taxed as ordinary income)
