life health and variable annuity
A core Medicare supplement policy (Plan A) will cover all of the following expenses EXCEPT a) Part A deductible b) The first 3 pints of blood c) 20% if Part B coinsurance amounts for Medicare-approved services d) Part A coinsurance
A. Part A deductible
In insurance, an offer is usually made when a. an applicant submits an application to the insurer b. the insurer approves the application and receives an initial premium c. the agent hands the policy to the policyholder d. an agent explains a policy to a potential applicant
A. An applicant submits an application to the insurer
Guaranteeing feature dividends is considered to be an unfair or deceptive act known as a. misrepresentation b. twisting c. false financial statements d. rebating
A. Misrepresentations
The policyowners spouse was designated as a primary beneficiary on a life policy issued 3 years ago. Last year the couple got divorced. which of the following is true regarding the beneficiary designation of the former spouse ? a. The designation will be void b. the designation will be changed to contingent beneficiary c. The designation will be changed to irrevocable d. the designation will not be affected by the divorce
A. the designation will be void
every medicare supplement policy must have a notice to buyer on the front page that states which of the following? a. this policy may not cover all of your medical expenses b. this policy does not always change with medicare provisions c. you may not own more than 3 medicare supplement policies d. the premium on the policy may increase on a class basis
A. this policy may not cover all of your medical expenses
all of the following statements concerning workers compensation are correct EXCEPT a. benefits include medical, disability income and rehabilitative coverage b. a worker receives benefits only if the work related injury was not his/her fault c. workers comp laws are established by each state d. all states have workers comp
B. a worker receives benefits only if the work related injury was not his/her fault
Riley reads an agreement on the first page of her policy which includes a list of losses that will be covered by her insurer. What is the name of this agreement? a. statement of Loss Coverage b. consideration clause c. Insuring clause d. Coverage provisions
C Insuring Clause
Which of the following elements of an insurance contract requires payment of premiums> a. competent parties b. offer and acceptance c. consideration d. legal purpose
C. consideration
what is the purpose of a benefit schedule? a. to include the average charges for producers b. to provide the dates for the payment of benefit c. to list the insureds co payments and deductibles d. to state what and how much is covered in the plan
D. to state what and how much is covered in the plan
can an individual who belongs to a POS plan use an out of network physician? a. no b. yes but they must use the POS physician first c. yes but they must the HMO physician first d. yes and they may use any preferred physician even if not part of the HMO
D> yes and they may use any preferred physician even if not part of the HMO
A Return of Premium term policy is written as what type of term coverage ? a. increasing b. decreasing c. renewable d. level
Increasing
All of the following must sign an application EXCEPT a. producer b. Insurer c. the proposed insured d. Applicant
Insurer
Ed is covered under a health plan provided by his employer. He was told that his insurance would pay the majority of the covered expenses if he would choose to see a provider in his plan's list. If Ed chose to be treated by a provider who was not on the list, his portion of the bill would be greater. Ed is covered under a/an a. Limited health plan b. Preferred Provider Plan c. Coordinated plan d. HMO group plan
Preferred Provider Plan
*Policy loan requests, except for loan requests for payment of due premiums, may be deferred for a period of up to a. 30 days b. 90 days c. 6 months d. 9 months
c. 6 months
Within how many days from termination of employment must an insured under a group health insurance policy provide notice to an insurer in order to continue coverage under the employers plan a. 15 days b. 23 days c. 42 days d. 63 days
d. 63 days
Life insurance can provide which of the following ? a. survivor protection b. protection against outliving ones estate c. creation of a future liability d. liquidation of ones estate
A. Survivor protection
All of the following are true of a non-qualified deferred compensation plan EXCEPT a. It does not require IRS approval b. It can be discretionary c. contributions are tax deductible d. it is a contractual agreement whereby the employee agrees to defer receipt of a portion of his compensation until retirement
C Contributions are tax deductible
which of the following would be required to become licensed as an insurance producer? a. a customer service representative who solicits no more than one policy a year b. agency supervisor whose actions do not include selling insurance c. A person whose activities are limited to insurance advertising d. an officer of an insurer who does not receive commissions
A. a customer service representative who solicits no more than one policy a year
Which of the following would not trigger the payment of Accelerated Death Benefits ? a. being permanently disabled b. terminal illness c. requiring an organ transplant for the insured to survive d. being permanently institutionalized
A. being permanently disabled
Applicant gives her agent a completed application and the initial premium. What can the agent issue her that acknowledges the initial premium payment? a. conditional receipt b. provisional receipt c. Advanced premium receipt d. premium receipt
A. conditional receipt
Which of the following would make a child over the age of 5 INELIGIBLE for Florida Healthy Kids coverage ? a. Qualifying for medicaid b. having a low family income c. qualifying for medikids
A. qualifying for medicaid
In contrasting stock insurers with mutual insurers which statement is true a. stock insurers are owned by the shareholders and issue nonparticipating policies b. Stock dividends are tax free while policy dividends are taxable c. nonparticipating policies can pay out dividends to policyholders d. mutual insurers are owned by shareholders and issue participating policies
A. Stock insurers are owned by the shareholders and issue NONparticipating policies
which of the following statements regarding HIV testing is NOT true ? a. Test results must be sent to the Department of Insurance b. testing may be waived at the discretion of the insurer c. the insurer is responsible for the cost of HIV testing d. Written consent from the applicant is required prior to the examination
A. Test results may be sent to the Department of Insurance
what is the purpose of a disability buy-sell agreement ? a. to reimburse the business in case of a key employees disability b. to help the business meet overhead expenses in case of the owners disability c. to protect individuals against loss of income due to disability d. to allow the business buyout in case of owners disability
D. to allow the business buyout in case of owners disability
why do health maintenance organizations offer prepaid services? a. to lessen paperwork b. to fulfill quota requirements c. to keep premiums lower d. to encourage preventive medicine for individual members
D. to encourage preventive medicine for individual members
Upon the surrender of a life insurance policy, any cash value accumulated in excess of the premium payment is a. not taxed b. taxed as income on 50% of the excess c. Assessed a fine of 10% of the excess d. taxed as ordinary income
D. Taxed as ordinary income
In addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health? a. by obtaining MIB reports on each other b. by imposing cause management provisions c. by requiring that the insurance be incidental to the group d. by having each enrollee undergo a paramedical examination
C. by requiring that the insurance be incidental to the group
Your client wants to provide a retirement income for his elderly parents in case something happens to him. He wants to make sure that both beneficiaries are guaranteed an income for life. Which settlement option should this policyowner select? a. fixed-period installments b. Life income c. Joint and Survivor d. fixed-amount installments
C. joint and survivor
In health insurance the length of the grace period varies according to the A. length of the benefit period B. Age of the insured C. mode of premium payment d. Length of the waiting period
C. mode of premium payment
Which of the following best describes the type of care provided by HMOs ? a. Major medical b. fee for service c. preventive d. elective
C. preventive
Insureds have the right to do which of the following if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy? a. demand full payment immediately for the claim b. speak with a claims adjuster or another representative from the insurance company c. submit the description in their own words on a plain sheet of paper d. be reimbursed any copayment or deductible on the claim
C. submit the description in their own words on a plain sheet of paper
All of the following are true about key-person insurance EXCEPT a. The employee must give written consent by signing the application b. the business is the beneficiary c. the death benefit is taxable to the business d. the business is the applicant and owner
C. the death benefit is taxable to the business
All of the following are TRUE of the Survivorship Life policy EXCEPT a. the death benefit is not paid until last death b .the premium would be lower than a joint life policy c. it can insure more than 2 lives d. premiums based on the age of each insured
D. premiums based on age of each insured
Which is true regarding obtaining underwriting sources ? a. it is illegal to obtain information from outside sources in order to determine an applicants insurability b. the applicant must be informed of the sources contacted and how the information is being gathered c. the insurer doe not need to inform the applicant how the information is being gathered informing only of the source is sufficient d. the insurer only needs to inform the applicant of how the information is being gathered it is not necessary to disclose the sources
B. the applicant must be informed of the sources contacted and how the information is being gathered
upon payment of a loss the insured is obligated to surrender to the insurer the right to sue a negligent third party. this is called a. insurable interest b. Entirety c. Subrogation d. Indemnity
C subrogation
within how many days of receiving a written communication of replacement must an existing insurer provide a policyowner with a policy summary a. 5 days b. 7 days c. 10 days d. 15 days
C. 10 days
An insured and his wife are both involved in a head-on collision. The husband dies instantly, and the wife dies 15 days later. The company pays the death benefit to the estate of the insured. This indicates that the life insurance policy had what provision? a. survivor life b. second-to-die c. common disaster d. accidental death
C. COMMON DISASTER
Medicare Part A services do NOT include which of the following? a. Private Duty nursing b. Post hospital skilled nursing facility care c. hospitalization
A. Private Duty Nursing
If an applicant submits the initial premium with an application which action constitutes acceptance? a. the underwriter approves the application b. the applicant submits a statement of good health c. the producer delivers the policy d. the insurance company receives the application and initial premium
A. Underwriter approves the application
An employee just started working for a small group corporation and works 25 hrs a week. The employee is a. eligible to receive full health coverage b. Not eligible to receive health insurance c. there is not enough information to answer the question d. eligible to receive partial coverage
A. eligible to receive full health coverage
When one insurer buys insurance from another company to minimize effects of catastrophic losses, they are? a. reinsuring b. forming a fraternal society c. self-insuring d. pooling risk
A. reinsuring
a policy will pay the death benefit if the insured dies during the 20 year premium paying period and nothing if death occurs after the 20 year period what type of policy is this ? a. level term b. term to specified age c. ordinary life policy d. limited pay whole life
A> Level term
which of the following is NOT true of life settlements? a. the seller must be terminally ill b. They could be used for key person coverage c. they could be sold for an amount greater then the current cash value d. they involve insurance policies with large face amounts
A> the seller must be terminally ill
Under a group health insurance plan, benefits may be extended to all of the following dependents EXCEPT a. dependent parent living with the primary certificate holder b. a 27-year old married daughter who is attending college and lives with her parents c. the spouse of the certificate holder d. a 30-year old mentally handicapped son of the primary certificate holder
B. a 27-year old married daughter who is attending college and lives with her parents
the "stop-loss" feature on a major medical policy is intended to a. establish the number of claims that may be filed on a policy in a calendar year b. establish a maximum amount of out-of-pocket expense that an insured will have to pay for medical expense in a calendar year c. establish a maximum amount of out-of-pocket expense that an insured will have to pay for medical expense for the life of the policy d. Discourage insured from making unnecessary appointments at the doctor's office
B. establish a maximum amount of out-of-pocket expense that an insured will have to pay for medical expense in a calendar year
What are the two types of Flexible Spending Accounts ? a. medical savings accounts and health reimbursement accounts b. health care accounts and dependent care accounts c. health care accounts and health reimbursement accounts d. medical savings account and dependent care accounts
B. health care accounts and health reimbursement accounts
what happens to the copy of the application for health insurance once the policy is issued? a. it is returned to the insured b. it becomes part of the entire contact c. it is filed with the department of Insurance d. it is discarded
B. i t becomes part of the entire contract
which of the following statements about the reinstatement provision is true ? a. it guarantees the reinstatement of a policy that has been surrendered for cash b. it requires a policyowner to pay all overdue premiums with interest before the policy is reinstated c. it permits reinstatement within 10 years after policy has lapsed d. it provides reinstatement regardless of the insureds health
B. it requires the policyowner to pay all overdue premiums with interest before the policy is reinstated
which of the following special policies covers unusual risks that are NOT normally included under Accidental death and dismemberment coverage ? a. credit disability b. special risk policy c. limited risk policy d. specified disease policy
B. special risk policy
All of the following are characteristics of group health insurance plans EXCEPT a. employers may require the employees to contribute to the premium payments b. the benefits under a group plan are more extensive than those under individual plans c. the parties that hold a group health insurance contract are the employees and employer d. the cost of insuring an individual is less than what would be charged for comparable benefits under an individual plan
C. the parties that hold a group health insurance contract are the employees and the employer
According to the common disaster clause if the insured and the primary beneficiary are killed in the same accident and it cannot be determined who died first which of the following will be assumed? a. the estate of the primary beneficiary and the contingent beneficiary split benefits equally b. the insured died before the primary beneficiary c. the primary beneficiary died before the insured d. the deaths occurred at the same time
C. the primary beneficiary died before the insured
considering the principals of liquidity, how would the policyowner use todays cash values in a life insurance policy? a. make down payments on a home in 5 years b. fund a retirement c. use if for emergency expenses d. secure a car loan next year
C. use it for emergency expenses
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 of 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 the premium payments
C> when the benefits received are equal or less than the employee's percentage of the contribution
what is the maximum amount of individual life insurance coverage that a person can convert to if the existing group policy has been terminated ? a. 1,000 b. 2,000 c, 5,000 d. 10,000
D 10,000
Ab elimination (waiting) period may NOT have to be satisfied for a disability in which of the following? a. an insured suffered the disability from the results of active duty with the USA Armed Forces b. an insured is disabled from a work-related injury c. an insured contracts an incurable disease d. An insured suffers a relapse of a prior disability within 6-months of the initial covered disability
D. An insured suffers a relapse of a prior disability w/i 6 months of the initial covered disability
Participants under a group life insurance plan are issued a. both policies and certificates b. participant identification number c. master policies d. certificates of insurance
D. Certificates of insurance
what is the purpose of the gatekeeper in an HMO ? a. making sure that patients do not go to physicians outside of the HMOs region b. Establishing stronger preventive care c. Making sure that services are properly repaid d. Controlling costs
D. Controlling Costs
Who regulates the minimum standards for coverage in health insurance? a. Federal law b. County law c. individual insurance companies d. Florida Law
D. Flawda law
which of the following statements is NOT true concerning the COBRA act of 1985 a. it covers terminated employees and/or their dependents for up to 36 months after a qualifying event b. it applies only to employers with 20 or more employees that maintain group health insurance plans for employees c. COBRA stands for Consolidated Omnibus Budget Reconciliation Act d. it requires all employers regardless of the number or age of employees to provide extended group health coverage
D. It requires all employers regardless of the number or age of employees to provide extended group health coverage
which of the following statements is true about a policy assignment ? a. it authorizes an agent to modify the policy b. it transfers rights of ownership from one owner to another person c. it is the same as a beneficiary designation d. it permits the beneficiary to designate the person to receive the death benefits
D. It transfers rights of ownership from one owner to another person
An agent has completed 28 hours of continuing education to renew her license. Upon renewal she realizes she has 4 extra hours of credit. what will happen to those extra hours? a. they will be forfeited b. they will apply as extra credit to give the agent better standing with the Department c. the agent may get a refund for the extra hours d. They will be carried over to the next 2 year period
D. They will be carried over to the next 2 year period
which of the following named beneficiaries would NOT be able to receive the death benefit directly from the insurer in the event of the insureds death? a. a business partner of the insured b. the wife of the deceased insured c. the former wife of the deceased insured d. a minor son of the insured
D. a minor son of the insured
According to the life insurance replacement regulations, which of the following would be an example of policy replacement? a. A term policy expires and the insured buys another term life policy b. term insurance is changed to a whole life policy c. A lapsed policy is reinstated within a specific timeframe d. a policy is reissued with a reduction in cash value
D. a policy is reissued with a reduction in cash value
The term illustration in a life insurance policy refers to a. a deception of policy benefits and guarantees b. pictures accompanying a policy c. charts and graphs d. a presentation of nonguaranteed elements of a policy
D. a presentation of nonguaranteed elements of a policy
An applicant misstates his age on his application for a health insurance policy. He states that he is 39, but his actual age is 49. When he files a claim, what will most likely happen? a. benefits will not be paid b. the policy will automatically be dropped c. if the mistake was found after incontestability period, the benefit will be paid in full d. benefits paid will be those that would have been purchased at the correct age
D. benefits paid will be those that would have been purchased at the correct age
All of the following apply to short-term disability plans EXCEPT a. group plans can provide benefit periods of up to 52 weeks b. individual plans can provide benefit periods of up to 2 years c. a benefit period of 26 weeks is most common for group plans d. both group and individual plans are renewable
D. both group and individual plans are renewable
If a life insurance company uses HIV testing as a part of its underwriting when must an applicant be notified of the procedure? a. prior to ordering a physical examination b. prior to solicitation of the policy c. prior notice is not required d. prior to performance of the test
D. prior to performance of the test
The family term rider incorporates a. whole-life and other-insured term b. key person whole life c. cost of living rider and family protection rider d. Spouse term and children's term
D. spouse term and childrens term
If the annuitant dies during the accumulation period, who will receive the annuity benefits? a. the annuity owner b. the insurance company c. the annuitants estate d. the beneficiary
D. the beneficiary