Life/Health Insurance

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A Basic Hospitalization policy does all of the following except: Select one: a. Provide expense coverage for daily room and board while the insured is hospitalized. b. Provide coverage for doctor's fees while the insured is hospitalized. c. Provide first-dollar coverage. d. Provide coverage of only a limited amount for specific services

A Deductible is: Select one: a. a type of coinsurance where the insured pays the first amount of a claim before the insurer begins payment. b. the requiring of higher deductibles or coinsurance amounts. c. a system of delivering health care that includes providing for selectively contracting with specific health care professionals. d. controlling how policy holders utilize policies through various means.

A Health plan in which several small employers combine to purchase medical coverage for their employees is called a: Select one: a. Blue Cross/Blue Shield Organization. b. Multiple Employer Trust (MET). c. Risk Retention Group. d. Health Maintenance Organization.

A Health policy that has both renewability and premiums guaranteed is called: Select one: a. Guaranteed Renewable. b. Conditionally Renewable. c. Non-Cancellable. d. Optionally Renewable.

A Waiver of Premium provision in a Disability Income policy does which of the following: Select one: a. It allows the insured to keep the policy in force while disabled and unable to pay the premium. b. It allows the insured to extend the grace period until he/she is able to pay the back premium. c. It allows the insurer to extend the waiting period until the insured can once again pay premiums. d. It allows the insurer to decrease the amount of benefit paid by the amount of unpaid premium.

A beneficiary designation is not required in any of the following Health policies except: Select one: a. Medicare Supplemental insurance. b. Long Term Care insurance. c. Major Medical. d. Travel Accident.

A complaint is: Select one: a. any communication received by an insurer that expresses a grievance. b. any written communication received by an insurer that primarily expresses a grievance. c. any written communication received by the insured that primarily expresses a grievance. d. any communication received by an insured that expresses a grievance.

A dental insurance plan must state all of the following except: Select one: a. Benefits b. Reductions c. Deductions d. Exclusions

A family deductible is a feature of what type of insurance policy? Select one: a. Residual Disability b. Disability Income c. Basic Medical d. Major Medical

A feature of Basic Dental Plans is that benefits are: Select one: a. The minimum rate that area dentists will accept. b. Paid at the usual and customary rate (the average cost in a particular geographic area). c. Limited to preventive care. d. Lower than usual and customary charges.

A group health benefit plan administrator does not need to do which of the following? Select one: a. Provide all participants and beneficiaries with a summary of any material changes to the plan. b. File an annual report regarding the plan's operation. c. Provide all participants and beneficiaries with a summary plan description. d. Submit a report on used benefits each calendar year to each plan participant.

A group major medical policy would most likely have which of the following features? Select one: a. Double indemnity b. Recurrent disability c. Conversion privilege d. "At work" benefits

A major medical policy that has a calendar year deductible provision requires that: Select one: a. The deductible be met only once during the calendar year. b. The insured must pay a deductible for each claim submitted during the year. c. The insured must pay a deductible only for those expenses submitted on a claim during the first year, but not for any expenses into the next calendar year. d. Claims submitted during the first calendar year of the policy do not have a deductible applied against them.

A medical plan in which the insured chooses at the time medical services are needed whether they will go to a provider with in or outside the plan network is called a: Select one: a. Preferred Provider Organization b. Point of Service Plan c. Health Medical Organization. d. Producer Cooperative.

A permanent partial disability would be best covered under which definition of disability? Select one: a. Residual Disability b. Partial Disability c. Disability Waiver of Premium d. Own Occupation

A policy's probationary (waiting) period is best described as: Select one: a. The period of time before the insured can take legal action against the insurer. b. The period of time during which the insurer can cancel the policy for any cause. c. The period of time starting on the policy's effective date during which there is no coverage for certain illnesses. d. The period of time starting from the date of application during which there is no coverage for certain illnesses.

A rider that is BEST described as one that pays a partial benefit in the event the insured is diagnosed with a terminal illness as specified in the policy is a: Select one: a. Terminal illness rider. b. Qualified condition rider. c. Viatical agreement. d. LTC Accelerated Benefit rider.

A service that charges a flat fee for medical care provided at its own clinic is called a: Select one: a. Blue Cross/Blue Shield organization. b. Multiple Employer Trust (MET). c. Health Maintenance organization. d. Risk Retention Group.

AB Company wants to change disability insurers to one that will offer similar coverage at a far reduced premium. What are AB's options if the new insurer will not cover one of AB's employees because of a serious pre-existing condition? Select one: a. AB may transfer all other employees to the new plan and begin paying premiums for a new individual policy for the employee who cannot receive coverage under the new group plan. b. Under HIPAA, AB Company may require the new insurer to cover the pre-existing coverage of the one employee. c. AB Company may not change plans. d. AB may change plans, allowing the single employee to convert the existing group coverage to an individual policy.

After the insured makes a claim, the insurer has how long to open communications with the insured, acknowledge receipt of the claim, and provide necessary claim forms? Select one: a. 10 days b. 15 days c. 30 days d. 45 days

Agent Bob submits his client's application before receiving the initial premium from the applicant. Legally, this application is called: Select one: a. A waste of time. b. A counteroffer. c. An invitation to make an offer. d. A bona fide offer for coverage.

Agent Donna, in an effort to produce more business, decides to hold a drawing for a cruise for people who purchase a new policy within a specified time. This is an example of what? Select one: a. Misrepresentation b. Rebating c. Churning d. Policy Replacement

Agent Gloria is delivering a policy for which she did not collect initial premium when submitting the original application. Gloria should take all of the following actions when delivering the policy except: Select one: a. Collect the initial premium. b. Issue a conditional receipt upon collection of initial premium. c. Review the policy and any riders. d. Have the applicant complete and sign a statement of Continued Good Health.

Agent Raul needs to increase his number of clients and decides to offer incentives, such as reducing premiums, if people buy a policy. This practice is known as: Select one: a. Rebating b. Twisting c. Redlining d. Churning

Al gets disability income benefits from an employer-paid Group Disability plan. How does tax law treat his benefits? Select one: a. The benefits are exempt from taxation. b. Only 50 percent of his benefits are taxable. c. Only two-thirds of his benefits are taxable. d. His benefits are fully taxable.

All but which of the following statements regarding benefits received by an individual from a business disability buy-sell agreement is correct? Select one: a. The beneficiary does not need to pay income tax on benefits received. b. Benefits are not received by the individual within three months of the disabling injury. c. Benefits are used to provide an income to a business partner in exchange for his/her share of ownership in the company. d. The individual did not pay premiums for the insurance coverage.

All of the following are advertising violations except for: Select one: a. Using words or symbols similar to those of a government agency. b. Ambiguous presentations. c. The use of testimonials. d. Wording limitations as if they are advantages.

All of the following are commonly covered by group health insurance policies except: Select one: a. Maternity. b. Injuries occurring at work. c. Major Medical d. Dental.

All of the following are considered advertising EXCEPT: Select one: a. general announcements that new employees are eligible for group insurance or other company internal communications not intended for the general public b. A sales presentation by a producer. c. Paid advertisements. d. Sales brochures.

All of the following are considered health care cost containment measures except for: Select one: a. Medical Cost Management. b. Managed Care. c. Policy Design. d. Proliferated Care.

All of the following are not covered by Medicare Part B insurance except: Select one: a. dental. b. cosmetic surgery. c. prescription drugs. d. diagnostic tests.

All of the following are required parts of a contract except: Select one: a. Legal Assignment. b. Acceptance. c. Legal Capacity. d. Legal Purpose.

All of the following benefits are provided by Social Security except: Select one: a. Disability benefits. b. Survivorship benefits. c. Retirement benefits. d. Workers Compensation benefits.

All of the following do not need an insurance license EXCEPT: Select one: a. An individual who creates sales advertisements for insurance companies b. An individual who administers a group insurance policy and does not receive a commission for doing so c. An agent's staff assistant who collects premiums from insureds, processes applications and receives bonuses when the agency sells a certain number of applications. d. An insurer's employee who trains agents but does not actually sell policies

Allan is one of 15 employees who work at FUN Toys. If he decides to seek employment elsewhere, how long does he have under COBRA to convert his group coverage to individual coverage? Select one: a. 31 days b. 20 days c. 30 days d. None of these

An adopted child is covered as a dependent on an individual or group health insurance policy from: Select one: a. 30 days after birth. b. the date of placement. c. the moment of birth. d. 30 days after placement.

An employee is covered under his group health and long-term care insurance policies and discovers that his kidneys have stopped working for good. Which of the following will cover this situation? Select one: a. His long-term care policy b. A Medigap policy c. The group insurance policy d. Medicare

An individual owns two (2) Group Health plans. If both plans have a coordination of benefits provision, and the insured has a $2,500 claim, how much will the secondary policy pay if both policies would normally pay $1,500? Select one: a. $1,500 b. $2,500 c. $0 d. $1,000

An insurance producer may ask which of the following about HIV or AIDS? Select one: a. If the individual has ever tested positive for HIV. b. If the individual has ever received counseling about AIDS. c. If the individual is homosexual. d. If the individual ever had a blood test for AIDS.

An insurance producer may not ask if the applicant has ever: Select one: a. Had a blood test for AIDS. b. Visited a physician for any illness in the past year. c. ever been admitted to a hospital for surgery. d. Had a blood test.

An insurance producer must notify the Commissioner in the event of: Select one: a. a change in address. b. reaching his/her 65th birthday. c. a change in marital status. d. the death of the producer's spouse.

An insurance producer who delivers a life insurance policy to an insured and receives a signed acknowledgement receipt from the insured must keep the receipt for: Select one: a. Two years. b. One year. c. Three years. d. Five years.

An insurer believes that citizens of downtown Burntville are dangerous and decides to increase rates to an unreasonable amount to discourage applicants from Burntville. This is an example of: Select one: a. Rebating b. Redlining c. Churning d. Twisting

An insurer must notify an applicant that an investigative consumer report may be made on the basis of which of the following? Select one: a. MIB Reporting Act b. Consumer Report Act c. Freedom of Information Act d. Fair Credit Reporting Act

Angelique is handicapped and attends a special education school. If Angelique enters a sheltered workshop program, what will happen to her medical coverage under her father's Group plan? Select one: a. Her coverage will continue as long as she is dependent on her father for financial support. b. Her coverage will cease as soon as she is no longer a full-time student. c. Her coverage will cease when Angelique reaches age 21. d. She will be able to convert coverage to her own Individual policy when she leaves school.

Any company replacing one health insurance policy with another must give the insured a Notice Regarding Replacement. This notice must inform the insured that they have how long as a free look or right of return? Select one: a. 20 days b. 30 days c. 10 days d. 15 days

At least how often must periodic claim payments to an insured be made? Select one: a. Annually b. Monthly c. Quarterly d. On an as-needed basis

Axle Trucking wants to cover its employees' health benefits under a non-contributory plan. What percentage of Axle's employees must be offered coverage? Select one: a. 75% b. 50% c. 100% d. 25%

B and A are married and purchased Medigap policies from the same company. B's policy was cancelled two months later when the insurer discovered that he had committed fraud on a claim with another company just a few months prior to buying this policy. What can the insurer do with A's policy? Select one: a. Continue the policy in full force. b. The insurer may suspend coverage for A for 24 months until it is evident there will not be a similar problem with her policy. c. The insurer may surcharge A's policy because her husband may be eligible for coverage under her policy. d. The insurer must keep A's policy in force until the first renewal, at which time they may cancel her policy.

B has a medical policy that will pay for his hospital, surgery and physician expenses when he is admitted to a hospital because of a stroke. What type of policy does he have? Select one: a. AD & D b. Major Medical c. Basic Surgeon Expense d. Accident insurance

B's employer offers a group health plan with a family deductible of $2,500. How much may he contribute to an HSA for his family before a tax penalty will be assessed? Select one: a. $1,875 b. $2,000 c. $2,500 d. $1,250

B's employer offers a group health plan with a family deductible of $3,000. How much may she contribute to an HSA for her family before a tax penalty will be assessed? Select one: a. $2,250 b. $1,950 c. $2,400 d. $2,100

B, who starts receiving care on June 1, has a provider care for him 2 days a week. B's LTC policy has a 30 calendar days elimination period. When will the elimination period have been met? Select one: a. July 1st b. None of these c. After he has had a provider care for him 30 times d. 15 weeks later

Benefits in a long-term disability policy are usually limited to about what percent of the insured's income? Select one: a. 45% b. 60% c. 80% d. 90%

Benefits of group insurance over individual insurance include all of the following EXCEPT: Select one: a. Group policies often offer a wider range of benefits. b. Premiums are generally less expensive. c. Pre-existing conditions can never be taken into account for group policies. d. Individual members of a group cannot be turned down.

Benefits on the death benefits of a life insurance policy begin accruing interest how many days after the insurer receives proof of the insured's death? Select one: a. 10 days b. 90 days c. 20 days d. 30 days

Bill lists his wife, Pat, as the beneficiary on his Accidental Death and Dismemberment policy and his children as contingent beneficiaries. If Bill and Pat are killed in the same auto accident, policy proceeds will be paid to which of the following? Select one: a. The insured's estate b. The insured's state of residency c. The insured's children d. The spouse's estate

Blue Cross/Blue Shield plans: Select one: a. Are offered strictly through fraternal organizations. b. Are federally sponsored, but state-run programs. c. May be offered through either a Group or an Individual policy. d. Pay benefits directly to the insured.

C did not work and her husband did not work at a job that was covered by Social Security. When she turned 65 recently, which of the following Medicare options were available to her? Select one: a. C could enroll in Medicare Part A and pay a premium for the coverage. b. C could buy a Medicare supplement policy to take the place of Medicare because she is not eligible for Medicare. c. C cannot enroll in Medicare, but must enroll in Medicaid instead. d. C will be enrolled automatically in Part A with no premium, but she will need to pay a premium for Part B if she wants coverage.

C quit her job after 11 years, where she had group health insurance, and began working at another company the following week. She had developed chronic asthma which flared up again one week after she started her new job. Which of the following federal acts would prohibit the new company's insurer from excluding coverage for C's problem? Select one: a. USDA b. HIPAA c. Tricare d. The Worker's Compensation Act of 1933

COBRA allows a departing employee to have which of the following conversion privileges from the Group Health coverage of the company he or she is leaving? Select one: a. Allows Life coverage conversion privileges, but no Health policy conversions b. Convert the group policy to a permanent individual policy c. Rollover an employer's Group policy into that of another employer d. Remain in the employer's group for a limited period of time

COBRA coverage would not be allowed in which of the following situations? Select one: a. Divorce b. Death c. Changing jobs and eligibility for another group plan d. Employment termination

Charges for which of the following items are NOT considered a covered expense under a Medicare Supplement policy (Part B)? Select one: a. Oxygen tanks b. Dental services c. Physician's services d. Ambulance services

Charlotte has a whole life policy with a cash value of $100,000. Her agent told her that if she withdraws $35,000 of the cash value of her current policy and uses it to pay premium for another policy, she will have better coverage. This is an example of what? Select one: a. Rebating b. Churning c. Intimidation d. Twisting

Circulating an oral statement that is maliciously critical or derogatory of the financial condition of an insurer is what? Select one: a. Fraud b. Discrimination c. False Advertising d. Defamation

Claims or surrender options must be settled upon receipt of due proof of death of the insured or upon surrender of the policy within what time period? Select one: a. Two months b. Five months c. One month d. Three months

Conditions existing _________ prior to coverage may be excluded from coverage for __________ for Long Term Care insurance. Select one: a. 6 months, 12 months b. 6 months, 6 months c. 12 months, 12 months d. 12 months, 6 months

Consumer Reports may contain information older than 7 years regarding which of the following? Select one: a. Bankruptcy b. Paid tax liens, from the date of payment c. Records or arrest, indictment, or conviction of a crime from the date of disposition, release, or parole d. Accounts placed for collection

Consumer reports cannot contain information about most adverse information (i.e., arrests, liens or lawsuits) if it is how many years old? Select one: a. 10 b. 5 c. 14 d. 7

Coverage for nursing home care would be provided by which of the following? Select one: a. Medicaid b. Medicare c. Long Term Care insurance d. Social Security

D is handicapped and attends a special education school. If D enters a sheltered workshop program, what will happen to his medical coverage under his father's group plan? Select one: a. His coverage will cease when D reaches age 21. b. His coverage will continue as long as he is dependent on his father for financial support. c. He will be able to convert coverage to his own individual policy when he leaves school. d. His coverage will cease as soon as he is no longer a full-time student.

David has straight life insurance with a face value of $100,000 dollars and a premium of $250 every six months. What is another name for David's policy? Select one: a. Linear life insurance b. Direct life insurance c. Continuous premium d. Indeterminate premium

Defamation is: Select one: a. the making of disparaging remarks about another insurance agent or company. b. the charging of different rates for the same exposure based on non-actuarial data, or not founded in actual statistics. c. the misrepresentation of the terms of an insurance policy of another company. d. the inducing of a policyholder to drop an existing policy in order to take a similar policy with a new agent.

Dependent unmarried children of an insured who are full-time enrolled students at a technical school are covered under the insured's group health insurance policy until what age: Select one: a. 21 b. 18 c. 17 d. 24

Doug and John own a computer consulting business. They are worried about what will happen to the business if one of them becomes disabled. Which of the following policies would best protect them in this situation? Select one: a. Key Employee insurance b. Disability Buy-Out c. Short-Term Disability insurance d. Major Medical insurance

ERISA is administered by: Select one: a. the Department of Commerce. b. the Department of Labor. c. the individual states. d. the Department of Organizational Human Resources.

Each individual enrolled in a LHSO must be given an evidence or certificate of coverage which must contain all of the following EXCEPT: Select one: a. An explanation as to where and how services may be obtained. b. The premium cost for the current policy year. c. The method for resolving complaints. d. The limited health services to which each enrollee is entitled.

Ed bought a Disability insurance policy with a Change of Occupation clause. Two (2) years later, he took a more hazardous job and did not tell the insurer of the change. If Ed becomes disabled, what will the insurer most likely do? Select one: a. Cancel the policy and refund premiums from the time Ed changed occupations b. Settle the claim according to the policy because the statute of limitations has expired c. Settle the claim after deducting a penalty charge for neglect of notification d. Settle the claim according to what the premiums would have bought under the more hazardous occupation

Evan wants to apply for an insurance license. How old does he need to be? Select one: a. At least 22 b. At least 20 c. At least 25 d. At least 18

Fillings and crowns would be covered under what dental care category? Select one: a. Prosthodontia b. Endodontic care c. Prophylaxis d. Restorative care

For which of the following policies would an insurer need to explain how relatively high premiums and possible anticipated generous dividends could allow the insured to not pay premiums after a certain point? Select one: a. Variable Universal Life b. Vanishing Premium policy. c. Decreasing Premium Policy. d. Endowment policy

For which of the following reasons would a producer's license be voluntarily terminated? Select one: a. Not meeting sales production requirements b. Violation of a cease and desist order c. Handling claims in an inappropriate manner. d. Not meeting continuing education requirements

Frank submitted an application for Health insurance, along with the first premium paid in full, and was given a conditional receipt. Information is discovered during the subsequent medical exam that causes the policy to be issued differently than the one Frank submitted. When Frank receives the policy from the agent, he pays the additional premium required. What is the effective date of Frank's Health insurance policy? Select one: a. The date Frank submitted the application and received a conditional receipt b. The date of the medical exam c. The date of policy delivery d. The date of policy issue

GHI Agency has been found guilty of an unfair claims practice. Which of the following is not one of the possible actions for which GHI was found guilty? Select one: a. Knowingly misrepresenting relevant facts about coverage to claimants. b. Failure to adopt and implement standards for prompt investigation and settlement of claims. c. Attempting to settle a claim for less than a reasonable amount. d. Paying consideration to a financial institution pursuant to a lease agreement.

Gene, the manager of FHE, Inc., provides a group health plan for his employees. If the plan is a contributory one, and Gene has 100 employees, how many of his employees need to participate? Select one: a. 75 b. 70 c. 51 d. 67

Gina took out health insurance coverage two and one-half years ago and claimed she was three (3) years younger than she actually was. During a claim settlement, the insurer discovers her true age and does which of the following? Select one: a. Pays the claim in full because the two (2) year discovery period has passed b. Denies the claim due to material misrepresentation c. Pays the claim according to what benefits would be for the premium at Gina's true age d. Denies the claim and return all paid premiums

Greg was required to have some genetic testing done when applying for health insurance. Under which of the following situations may this information be disclosed? Select one: a. Specific authorization of Greg's legal representative b. As a condition of employment c. To reject or limit coverage under a group health insurance plan d. Subpoena

Group coverage is terminated in all but which of the following situations? Select one: a. The group cancels coverage b. The group changes coverage but one individual cannot obtain coverage with the new company c. An individual decides to take insurance through his/her spouse's company's health plan d. An individual changes employment

H has a Basic Medical policy with coverage of $3,000, and a Major Medical policy with $2 million in lifetime benefits, a $700 deductible, and 80/20 coinsurance. If there are actual costs of $25,000, H will owe how much? Select one: a. $4,960 b. $4,400 c. $4,260 d. $5,100

HMOs provide all of the following services except: Select one: a. Diagnostic laboratory services. b. Hospital Inpatient services. c. Preventive services. d. Solicitation of enrollees for related health services.

Harvey's son William just turned 10 years old. How much longer will William be able to continue to receive coverage under his family's health insurance plan? Select one: a. 13 years b. 16 years c. 8 years d. 11 years

Home health care coverage does NOT include: Select one: a. at least 100 home visits per year, with each visit allowing up to 6 hours of services. b. medical supplies, drugs, medicines, and laboratory services to the same extent that coverage would be allowed on a hospital in-patient basis. c. services provided by an RN or LPN. d. health services provided by a home health aid.

How long a period does an insurer have to discover misrepresentations in a group health policy application and possibly cancel the policy because of them? Select one: a. One year b. Three months c. Two years d. Ninety days

How long after the event can information about credit transactions of $150,000 or more remain on a person's consumer report? Select one: a. 7 years b. 14 years c. 10 years d. There is no limit.

How long after the event can negative information remain on a person's consumer report if the individual is purchasing life insurance? Select one: a. There is no limit. b. 21 years c. 14 years d. 7 years

How long could Raymond keep his group health coverage when his employment was terminated? Select one: a. 180 days b. 31 days c. 6 months d. 9 months

How many hours of continuing education are required in Louisiana for license renewal? Select one: a. 24 hours for Property & Casualty only; 16 hours for Life & Health only; 40 hours of any approved courses if a combined license. b. 12 hours for each licensed line of insurance c. 24 hours for each licensed line of insurance d. 24 hours, including 3 hours of ethics, of CE must be completed each license renewal period.

How many hours of pre-license education must a producer candidate obtain before taking the Louisiana life and health or property and casualty licensing exam? Select one: a. 40 hours for each line b. 20 hours c. 40 hours d. 32 hours for each line.

How many months of full-time employment status does an employee usually need before they will be eligible to participate in group insurance plans? Select one: a. 6 months b. 2-4 months c. 3 months d. 1-3 months

If J has a dental insurance plan that pays benefits that are usually lower than usual and customary charges in his city, he most likely has what type of plan? Select one: a. Basic plan b. Common plan c. Non-scheduled plan d. Restricted plan

If John Producer splits his commission with Alyce Customer when Alyce buys an insurance policy, John is practicing: Select one: a. Rebating. b. Twisting. c. Redlining. d. Intimidation.

If Maria applied for a Medicare Supplement policy on April 1 to replace one that she currently owns and the policy is delivered on April 25, When does Maria's "free look" period end? Select one: a. May 15 b. May 1 c. June 24 d. May 25

If Robert chooses to stay with his current insurer even after he becomes eligible for Medicare Part D, which of the following is true? Select one: a. He will not be able to obtain Part D coverage after 31 days of becoming eligible. b. He will be able to switch to coverage D with no penalty if he is over age 67. c. He will be able to switch to coverage D at any time with no penalty. d. He will have to pay a penalty fee to obtain Part D later.

If a life insurance policy is being replaced, how long a "free look provision" is extended to the insured? Select one: a. 30 days b. 20 days c. 45 days d. 10 days

If an employee terminates their employment and have been covered under a group policy, they have how many days to convert their group coverage to an individual policy without needing to provide evidence of insurability? Select one: a. 30 days b. 29 days c. 14 days d. 31 days

If an insurer issues policies with a guaranteed renewable to age 65 provision, the insurer: Select one: a. may non-renew an insured's policy and continue writing business in Louisiana. b. may charge an increased premium upon renewal. c. may not deny initial coverage to any applicant. d. may single out particular insureds for a rate increase.

If an investigative consumer report is made on an insurance applicant, which of the following laws gives the applicant the right to request a personal interview? Select one: a. Federal Insurance Act of 1976 b. Freedom of information Act c. Fair Credit Reporting Act d. Consumer Protection Act

If the BIG Co. has a contributory group life insurance program, what percentage of its employees must participate in the plan? Select one: a. 100% b. 10% c. 75% d. 50%

If the sponsor of a group health insurance policy opts for a contributory plan, at least what percent of eligible members must participate? Select one: a. 75% b. 100% c. 25% d. 50%

Illustrated dividends presented to consumers must: Select one: a. be done using the current scale. b. be done through the end of the policy term. c. never state that dividends can pay future premiums owed. d. show projections with at least three different interest rates.

In a MET, what defines the relationship between the employer and the trust, and specifies the coverages to which the employer subscribes? Select one: a. Joinder Agreement b. Polyander Agreement c. Subscriber Agreement d. Policy

In a Major Medical policy with a family deductible, a family of six with a $500 individual deductible would need to pay how much for all family members combined? Select one: a. $2,500 b. $1,500 c. $500 d. $3,000

In dental care insurance, prophylaxis treatment will cover: Select one: a. Treatment of gum disease. b. Artificial replacement of teeth. c. Treatment for root canals d. Routine preventive care.

In group insurance policies, the process of using a group's past premium and claims experience to calculate premium rates is what? Select one: a. Expansion Rating b. Group Rating c. Experience Rating d. Community Rating

In order to get his prospect, Matthew, to drop his existing policy in favor of the one he sold, Dean Scamm told Matthew that his current policy would not last more than 10 years, knowing that the policy was with a good company and would last the insured's full life expectancy. Dean's action is an example of: Select one: a. Twisting b. Policy Replacement c. Redlining d. Churning

Individual and Group HMO contracts must contain all of the following EXCEPT: Select one: a. A list of available doctors and hospitals which the enrollee can choose from who are members of the HMO. b. Schedule of all available benefits c. Co-payment and deductible requirements d. Grounds for cancellation or non-renewal

Insurance organizations that organize groups of hospitals, physicians and clinics to provide services at discounted rates, and insureds need to choose a health care provider from within that group is called a(n): Select one: a. POS Plan. b. PPO. c. HMO. d. Producers' Cooperative.

Insurance privacy acts do NOT require: Select one: a. Applicants to be notified if the insurer will use a credit report to gather information about them. b. Applicants to be given an opportunity to review information gathered on them that will be used for marketing purposes. c. Disclosure statements to be made known to the applicant and their signature obtained to signify they were given such notice. d. Applicants to be notified if any information will be used for marketing purposes.

Insurers must file a notice of appointment of an agent with the Commissioner within how many days after an agency contract is signed? Select one: a. 30 days b. 15 days c. 10 days d. 60 days

J has a Medicare Supplement policy and needed an emergency appendectomy while on vacation in Jamaica. This would be covered under: Select one: a. the core benefits of her Medicare Supplement policy. b. none of these choices. c. Medicare Part A. d. Medicare Part B.

J has a disability policy through his place of employment. If premiums for the policy are paid by his employer, what percent of benefits will be income taxable to J if he becomes disabled? Select one: a. 100% b. 30% c. 25% d. 60%

J has full Medicare coverage for both Parts A and B. While she is on a trip to Italy she has an accident and is hospitalized for one week, requiring orthopedic surgery to mend a broken arm. Which of the following is true about her Medicare coverage of the incident? Select one: a. Medicare Part A will pay for the hospital costs as long as Jacqueline has not exceeded 90 days during the current benefit period. b. Medicare Part B will cover the cost of the surgery needed to set the arm, but will not pay for the hospital costs. c. Medicare will pay for 80% of all services combined, after J pays the $100 Part B deductible. d. Medicare will not cover the incident.

Jackie was out of work for six (6) months on disability. She returned to work for three (3) months, but then had to go back on disability. How long will she have disability coverage on her short-term, one (1) year policy according to the six (6) month Recurrent Disability provision? Select one: a. Six (6) months b. 12 months c. Nine (9) months d. Three (3) months

Janet received an abbreviated Policy Summary. What is the death benefit of Janet's life insurance policy? Select one: a. Less than $2,500 b. Less than $8,000 c. Less than $5,000 d. Less than $10,000

Jared, owner of Ace Sports, wants to offer additional benefits to some of his employees, but not all. Under a Group Health plan, he can use all of the following factors to do so except: Select one: a. Salary Grade. b. Sex. c. Length of employment. d. Job Category.

Jill submitted proof of loss to her insurer under an Accident and Health policy. If she has difficulty collecting from the company, what is the maximum time Jill can wait before bringing legal action against her insurer? Select one: a. Two (2) years from the policy inception date b. Three (3) years from the date of loss c. One (1) year from the date of loss d. Three (3) years from the proof of loss submission date

Joan's husband was a licensed insurance producer in Louisiana before he died. For what period of time may Joan receive a temporary license to administer the agency without taking an exam while she looks for someone to buy the business? Select one: a. 180 days b. 45 days c. 365 days d. 90 days

Joseph is a self-employed cabinet maker who must pay 100% of the Social Security tax owed on his income. How much of this is income tax deductible for him? Select one: a. 15.3% b. 100% c. 65% d. 50%

K is enrolled in Medicare Part A. Which of the following may be true of K? Select one: a. Emergency room visits are covered. b. None of the others. c. Skilled nursing care is always covered. d. She is on dialysis.

K is self-employed. If she pays $5,000 in Social Security taxes, how much of the tax can she deduct when she pays her income tax? Select one: a. $750 b. 0 c. $5,000 d. $2,500

Karolee has a Major Medical policy. She will not have coverage for any of the following except: Select one: a. Injuries suffered while serving on active duty in the National Guard. b. Escaping from the police. c. Dental treatment due to an accident. d. Elective cosmetic surgery.

Keiko applies for a Guaranteed Insurability rider attached to her Disability Income policy. Which of the following will this rider allow Keiko to do? Select one: a. Keiko can add her children to the policy without proof of insurability. b. She can increase benefit amounts payable under the plan at specified periods of time. c. Keiko will be allowed to purchase Life insurance along with the Disability policy without evidence of insurability. d. She will not have to provide proof of insurability at time of policy application.

L was injured at work when a shelving unit fell on top of him and will not be able to work for at least one year, perhaps permanently. Which of the following policies would BEST cover L's bills as a result of this accident? Select one: a. Disability insurance b. LTC c. Accident Insurance d. Worker's Compensation

L's employer provides group medical coverage for employees. The employer also sponsers dental and/or vision coverage, but L must pay the premium for these coverages. Dental and vision coverage would be considered: Select one: a. blanket policies b. special risk plans c. optional coverages d. worksite plans

LTC policies generally provide coverage for care that is required for at least how many days? Select one: a. 180 b. 15 c. 30 d. 90

Life insurance policy disclosure rules do not require that: Select one: a. A copy of the policy summary must only be given to the insured if it is requested. b. Any reference to policy dividends must state that the dividends are not guaranteed. c. Insurance producers cannot insinuate that they will not receive compensation from the successful completion of a sale. d. Producers must tell prospective customers the full name of the company they represent.

Life insurance replacement regulation applies to which type of insurance? Select one: a. Variable annuities b. Credit life c. Group life d. Whole life

Louie Z, an agent for JFK Insurance, offers Maya a discount on her insurance policy if she will teach his daughter Leah how to play the piano. This is an example of what? Select one: a. Misrepresentation b. Rebating c. Barter d. Redlining

Louisiana allows the backdating of life insurance policies for up to how long before the actual date of application? Select one: a. 3 months b. 6 months c. 60 days d. 1 year

Louisiana insurance regulations require health insurance policies that cover an insured's dependents to cover newborn children from what point? Select one: a. The moment premiums are paid b. 15 days after the newborn's birth c. Birth d. 30 days after the newborn's birth

M has a disability policy through her place of employment. If she pays the premiums for her policy, up to what percent of her income can benefits be if she becomes disabled? Select one: a. 45% b. 50% c. 60% d. 100%

M has a provider care for him 4 days a week for 4 weeks. M's LTC policy has a 30 service days elimination period. How many days of the elimination period have been met? Select one: a. None of these. b. 30 days c. 28 days d. 16 days

M has a worksite plan. Which of the following would not be true about his plan? Select one: a. M determines his own level of protection b. M purchased a life insurance policy c. The cost is paid by the employer d. M's purchased vision and dental coverage

M has already met her health plan's annual deductible. If she requires dental work and does not need to pay another deductible for the dental services, what type of dental/ health policy does she have? Select one: a. Joint b. Integrated c. Basic d. Standard

M needed to have a root canal on one of his teeth. What is the type of dental care that he would require to have it covered by insurance? Select one: a. Oral surgery b. Prophylaxis care c. Prosthodontia Care d. Endodontic care

Managed Care is: Select one: a. A system of delivering health care that includes selectively contracting with specific health care professionals. b. Controlling how policy holders utilize policies through various means. c. Requiring higher deductibles or coinsurance amounts. d. A type of coinsurance where the insured pays the first amount of a claim before the insurer begins payment.

Medicaid is primarily used to: Select one: a. Pay medical aid to those injured as the result of tornadoes or other natural disasters. b. Pay for medical expenses of the needy. c. Pay for medical expenses of the elderly. d. Provide supplemental medical expenses for those on Medicare.

Medical Cost Management is: Select one: a. a system of delivering health care that includes providing for selectively contracting with specific health care professionals b. the requiring of higher deductibles or coinsurance amounts. c. the using of various methods to control how policy holders utilize policies. d. a type of coinsurance where the insured pays the first amount of a claim before the insurer begins payment.

Medical expenses including premium payments that exceed what percentage of the individual's adjusted gross income are tax deductible? Select one: a. 5% b. 2.5% c. 7.5% d. 10%

Medicare Part A does not cover which of the following? Select one: a. Long Term Care b. Home Health Care c. Hospice Care d. Inpatient Hospital Care

Medicare Part D is available to: Select one: a. all individuals with Medicare. b. only individuals with terminal illnesses. c. only individuals with chronic illnesses. d. all individuals under the age of 67.

Medicare Part D pays for all of the following EXCEPT: Select one: a. generic prescription drugs b. standard plan benefits c. name brand prescription drugs d. generic over-the-counter drugs

Medicare Supplement marketing disclosure rules require all of the following EXCEPT that: Select one: a. Such terms as "Medicare supplement" or "Medigap" may not be used in reference to any policy that does not meet the minimum standards for Medicare supplement policies. b. Insureds have 30 days to review the policy after it is delivered to decide if they want to keep it or return it for a full refund. c. A buyers Guide must be given to every accident and sickness policy applicant who is old enough to qualify for Medicare. d. Insurers must provide a record of claims experience and complaints for the past 12 months.

Medicare Supplement policies are offered by: Select one: a. most state governments. b. the federal government. c. private Insurance companies. d. the AMA.

Medicare supplement policies may not exclude or limit benefits for losses due to pre-existing conditions for more than how long from the effective date of coverage? Select one: a. 18 months b. 12 months c. 6 months d. 3 months

Medicare will, under certain circumstances, pay for medical treatment in: Select one: a. the Philippines. b. France. c. Canada. d. the United Kingdom.

Methods dental insurers often use to control costs do not include: Select one: a. Annual and lifetime maximum benefit amounts. b. A broad selection of dentists. c. Payment for silver instead of gold fillings. d. A one year reduction of 50% on certain procedures or exclusion of certain benefits for a certain period of time.

Minors are considered competent to legally contract for annuities or life insurance upon his/her own life or health, or on another individual in whom the minor has insurable interest at what age? Select one: a. 14 years b. 17 years c. 16 years d. 15 years

No insurer selling Health insurance policies in Louisiana may exclude preexisting conditions for more than how long after the policy's effective date? Select one: a. 3 months b. 24 months c. 6 months d. 12 months

None of the following are considered advertisements EXCEPT: Select one: a. General announcements about new group coverage eligibility. b. A sales presentation by an insurance producer in someone's home or office. c. Material in an insurer's internal company communications or not intended for use by the general public. d. Personal communications not intended to produce a sale.

None of the following are considered advertisements EXCEPT: Select one: a. General announcements about new group coverage eligibility. b. Personal communications not intended to produce a sale. c. A sales presentation by an insurance producer in someone's home or office. d. Material in an insurer's internal company communications or not intended for use by the general public.

Paula has a $1,000,000 Comprehensive Major Medical policy with a $10,000 base plan, a $500 corridor deductible, and a 70/30 Co-insurance Clause. Paula was hospitalized, and her covered expenses amounted to $25,000. How much will the insurer pay? Select one: a. $24,500 b. $17,000 c. $20,150 d. $17,150

Policy Design is: Select one: a. controlling how policy holders utilize policies through various means. b. a system of delivering health care that includes providing for selectively contracting with specific health care professionals. c. a type of coinsurance where the insured pays the first amount of a claim before the insurer begins payment. d. the requiring of higher deductibles or coinsurance amounts.

Probate is a term used to describe: Select one: a. An individual who holds a position of public trust and confidence. b. The situation in which someone dies without a will and in which the state laws determine the disposition of property. c. The process of determining the validity of a will in court and carrying out its provisions. d. The laws regulating insurance companies and agents which vary between states.

QRZ Electronics bought a Key Employee life policy on one of its best employees, Raven. When Raven retired QRZ wanted to extend the coverage to Raven's replacement. What rider would allow QRZ to keep the policy with its cash values in force and meet this need at the same time? Select one: a. Change of insured b. Key employee replacement c. No rider allows this. d. Substitute employee

R is 65 and has been enrolled in Medicare part A for one year, since she first became eligible. She has medical insurance through her employer so hasn't enrolled in Medicare Part B, but will retire next month. How long does R have to purchase a Medicare supplement policy that will not deny her coverage because of the heart condition she has? Select one: a. R must buy the Medicare Supplement policy within the next month, before she retires. b. 6 months from the date of enrolling in Medicare Part B. c. R has six months to purchase the policy and cannot be refused coverage, but she could be surcharged for the heart condition because she did not purchase coverage at the time she enrolled in Medicare Part A. d. She must purchase the policy before she is admitted to a skilled nursing facility.

Ray was admitted to a long-term residential nursing facility. Ray had to pay costs at the facility until he had a pre-determined asset amount remaining, and then Medicaid began paying his expenses. What type of insurance policy did Ray own? Select one: a. Medigap b. Long term Care c. Medicare d. Partnership LTC

Removal of wisdom teeth would be covered under which section of a dental insurance policy? Select one: a. Oral surgery b. Prosthodontia Care c. Prophylaxis d. Orthodontia

Renewability of coverage is guaranteed to a specified date/age unless certain events occur under which of the following types of policy? Select one: a. Optionally Renewable b. Conditionally Renewable c. Specifically Renewable d. Guaranteed Renewable

Rhonda noticed an insurance ad that described the premium as a deposit. What does this mean? Select one: a. The premium will be returned in full upon the insured's demand. b. The premium, plus interest will be returned upon the insured's demand. c. The premium will accrue interest and build the policy's cash value. d. The premium, minus expenses, will be returned upon the insured's demand.

Stone, owner of Barrington Sleuths, wants to offer additional benefits to some of his employees. Under a group health plan, he could use all of the following factors to decide who should get benefits EXCEPT: Select one: a. Sex b. Job category c. Salary grade d. Length of employment

Suicide and self-inflicted injuries are examples of policy: Select one: a. Supplemental coverages. b. Non-Forfeiture clauses. c. Exclusions. d. Riders.

Supplementary Medicare policies are used to: Select one: a. Provide medical coverage to those who cannot afford Medicare. b. Provide medical coverage to the needy. c. Provide disability income coverage for those on Medicare. d. Provide benefits not covered by Medicare.

The 10 day free look provision of a Major Medical policy begins at what time? Select one: a. The date the agent receives the policy in order to deliver to the insured b. The date of application c. The date the agent actually delivers the policy to the insured d. The date the insurer actually issues the policy

The Buyers Guide: Select one: a. Explains the policy's guaranteed death benefit. b. Contains the full name and address of the insurance company. c. Describes types of policies and information about replacement of policies. d. Contains the Insurance producer's name and address.

The Comprehensive Omnibus Reconciliation Act allows individuals who leave a group health plan to convert the group plan to an individual one for how long? Select one: a. Up to 18 months b. Until the individual obtains other employment c. Indefinitely d. Up to 12 months

The Fair Credit Reporting Act of 1970 requires which of the following? Select one: a. The insurance company must publish a financial statement for the preceding fiscal year and make it available upon request to all applicants for insurance. b. Medical information must be sent to the applicant if requested. c. If the policy is rejected or rated as a result of false or incomplete information, the applicant can force the inspecting company to change its records. d. Consumer reports cannot contain information on bankruptcies more than 10 years old.

The Fair Credit Reporting Act provides for all of the following EXCEPT: Select one: a. Applicants have the right to file their opinion on the issue with the reporting credit company if a policy is rated or rejected as a result of the report. b. Insurance companies must send medical information directly to the insured. c. Consumer reports cannot contain information about an arrest that is 7 years old. d. Consumer reports cannot contain information about bankruptcies over 14 years old.

The Fair Credit Reporting Act requires that an: Select one: a. insurance company notify an applicant of the results of personal interviews with neighbors, friends and others b. agent provide a prospect with a notarized statement that a credit investigation will be conducted c. agent be responsible for obtaining information about an applicant's credit rating d. applicant have the right to question the validity of a credit report

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 protects the health insurance coverage for workers when they have a new dependant if they have already been covered for how many months before the change? Select one: a. 9 months b. 6 months c. 12 months d. 18 months

The Louisiana Commissioner may suspend, revoke, refuse to issue or renew, or place on probation the license of any individual who has done any of the following except for: Select one: a. failure to notify the commissioner within 30 days of the producer's license revocation in another state. b. indictment for a felony. c. conviction of a fraudulent act. d. forging an applicant's name on documentation related to an insurance application.

The Policy Summary must be given to the applicant no later than what time? Select one: a. The date the application is signed b. The date of the sales presentation c. The date the policy is delivered d. The date the application is accepted

The full core benefits of Medicare plans are not found in which plans? Select one: a. K & L b. A & B c. all Medigap plans except Plan A. d. A & F

The maximum amount of total insurance that an insurer can issue is based upon: Select one: a. There is no limit to the amount of insurance that can be issued. b. Policy reserves. c. A fixed number of insured persons which varies in each state. d. A percentage increase in the number of applicants per year.

The medical expense policy provision that requires the insurer to pay 100% of covered expenses over a certain specified amount after the insured has paid the policy deductible is called the: Select one: a. Stop-gap. b. Co-insurance maximum. c. Policy umbrella. d. Stop-loss.

The monitoring and evaluation process that attempts to insure that the patient's stay in the hospital is adequate for treatment, but of the shortest duration possible, is called: Select one: a. conditional review b. cost containment c. mandatory review. d. concurrent review

The open enrollment period in a group insurance policy is how long? Select one: a. 31 days b. 70 days c. 50 days d. 45 days

The purpose of Supplementary Medicare policies is to: Select one: a. provide medical coverage to those who cannot afford Medicare. b. provide disability income coverage for those on Medicare. c. provide medical coverage to the needy. d. provide benefits not covered by Medicare.

The scope and limits of coverage is identified in which clause of the insurance policy? Select one: a. The Coverage Identification Clause b. The Insuring Clause c. The Benefit Identification Clause d. The Entire Contract Clause

The term "capital sum" in an Accidental Death and Dismemberment policy refers to: Select one: a. The death benefit for death caused by a disease that was accidentally contracted. b. A lump sum payment for an accidental dismemberment. c. A lump sum payment for the loss of a leg due to cancer. d. The amount of cash accumulation built up in the policy.

The type of dental care more fully covered than any other on dental plans is: Select one: a. Orthodontia. b. Prophylaxis. c. Endodontic Care. d. Periodontal.

The year of cessation must be identified in policy illustrations if policy coverage ends before this age. Select one: a. 90 b. 100 c. 75 d. 95

Tia is a staff person at Agent D's office. Which of the following statements must be true for Agent D to legally give Tia a bonus based on the number of policies the office issues each month? Select one: a. Tia must be a licensed producer. b. Tia must have all work approved by Agent D. c. Tia may get a bonus only on the polices she helped to process. d. Tia must have worked at D's office for a minimum of 5 years.

To avoid adverse selection, an insurance company may not do which of the following? Select one: a. Charge very high premiums for Jewish history teachers. b. Decide to increase premium rates for a whole class of people. c. Employ underwriters. d. Look at an applicant's credit report.

To avoid adverse selection, an insurance company may not do which of the following? Select one: a. Employ underwriters. b. Charge very high premiums for Jewish history teachers. c. Look at an applicant's credit report. d. Decide to increase premium rates for a whole class of people.

Tricare coverage is for: Select one: a. Retired military personnel not eligible for Medicare. b. Retired firefighters and their dependents. c. Retired schoolteachers and their dependents. d. Retired policemen not eligible for Medicare.

Tricare coverage is for: Select one: a. Retired policemen not eligible for Medicare. b. Retired schoolteachers and their dependents. c. Retired firefighters and their dependents. d. Retired military personnel not eligible for Medicare.

Tricia, who has group health coverage through her employer, had a baby yesterday. How many days from today does Tricia have to notify the insurer of the birth before coverage will terminate? Select one: a. 30 days b. 44 days c. 31 days d. 29 days

Under a Guaranteed Renewable Accident and Health policy, an insurer can do which of the following? Select one: a. Increase an individual's premium due to excess claims in the past year b. Decrease coverage for an entire class of insureds, but guarantee some benefits c. Increase premiums for an entire class of insureds d. Cancel coverage for an entire class of insureds

Under federal law, if a member of a group policy terminates their membership in a group of 20 or more employees, they have the right to purchase a temporary plan covering them individually up to 18 months after they leave the place of employment, at a maximum premium of how much more than their previous premium? Select one: a. 2% b. 5% c. 4% d. 3%

Unfair insurance trade practices include each of the following EXCEPT: Select one: a. Monopoly in the insurance business. b. Misappropriation of funds. c. Boycotts. d. Intestacy.

V is 62 years old and wants to retire. All of the following statements about his health insurance are false except: Select one: a. He will automatically be enrolled in Medicare. b. Medicare part A will charge no premium after age 65 if V worked at least 10 or more years in Medicare covered employment. c. He will need to pay a premium for Medicare part B until age 65, at which point in time coverage will be automatic. d. He will receive a permanently reduced benefit.

V requires care in a nursing home, and his LTC policy pays the expenses associated with that care. Which of the following statements is NOT correct about the tax treatment of benefits V receives? Select one: a. V must pay income tax on benefits he receives through his policy that exceed actual expenses he incurs at the nursing facility. b. V must pay income tax on any benefits the insurer pays under his policy. c. V does not need to pay FICA tax on benefits he receives from his LTC policy. d. V does not need to pay income tax on benefits he receives, whether it is he himself or his employer who paid the policy premiums.

W is part of a group dental policy through his employer. If he is in a biking accident and loses four teeth, his policy will cover a bridge to replace the missing teeth. What percentage of the actual cost of the bridge is taxable as income to W? Select one: a. 12.5% b. 0% c. 8.65% d. 7.65%

What document must be issued by the Insurance Commissioner to any insurer transacting business in Louisiana? Select one: a. Insurance license b. Insurance Sellers Certificate c. State Binder of Insurance d. Certificate of Authority

What is a Certificate of Authority required for? Select one: a. A Certificate of Authority is required for any person or company to insure any other person or company. b. A Certificate of Authority is required for anyone who wants to act as a Managing General Agent. c. A Certificate of Authority is required by any non-resident, appointing the Commissioner to act as the non-resident's legal agent in the state. d. A Certificate of Authority is required for any person to act as a general lines agent.

What is a deductible carryover? Select one: a. It is an optional rider in an individual disability insurance policy that allows the insured to continue receiving benefits in a second calendar year if the full deductible was met during the first year. b. It is a provision in a group health insurance contract that allows an insured to count payments made during the last quarter of one year as being made toward the deductible of the following calendar year if the deductible was not met during the first year. c. It is a provision in an individual health insurance contract that allows an insured to count payments toward a deductible for two different years of the contract. d. It is a required provision in a group health insurance policy that allows the insured to count any payments made in the last quarter of one year toward both the first and second year's deductible.

What is a group called in which several employers pool their risks and self-insure? Select one: a. Multiple Employer Trust b. Combined Risk Pool c. Small Business Blanket Organization d. Multiple Employer Welfare Association

What is a written or oral contract made by an agent which puts a policy temporarily into effect until accepted or cancelled by the insurance company, and which includes all the terms of the policy? Select one: a. Compact b. Peril c. Binder d. Covenant

What is it called if an agent writes an application on his own life or personal property? Select one: a. Controlled business b. Self insuring c. Redlining d. Rebating

What is the Equivalent Level Annual Dividend? Select one: a. A level amount per $1,000 of death benefit which if paid at the beginning of each policy year and accrued at 5% interest would be equal to allowing dividends to accumulate at 5% interest to the end of the 5th and 10th years. b. A level amount per $10,000 of death benefit which if paid at the beginning of each policy year and accrued at 5% interest would be equal to allowing dividends to accumulate at 5% interest to the end of the 10th and 20th years. c. A level amount per $10,000 of death benefit which if paid at the beginning of each policy year and accrued at 5% interest would be equal to allowing dividends to accumulate at 5% interest to the end of the 5th and 10th years. d. A level amount per $1,000 of death benefit which if paid at the beginning of each policy year and accrued at 5% interest would be equal to allowing dividends to accumulate at 5% interest to the end of the 10th and 20th years.

What is the free look period of a life insurance policy transaction when it involves replacing one policy with another? Select one: a. 20 days b. 60 days c. 30 days d. 10 days

What is the initial enrollment period (IEP) for Medicare? Select one: a. Individuals who are eligible for Medicare at 65 can sign-up during a 7 month period that begins 3 months before turning 65. b. Individuals who are eligible for Medicare at 63 can sign-up during an 8 month period that begins 6 months before turning 63. c. Individuals who are eligible for Medicare at 65 can sign-up during a 12 month period that begins 3 months before turning 65. d. Individuals who are eligible for Medicare at 67 can sign-up during an 8 month period that begins 3 months before turning 67.

What is the insured required to pay coinsurance on in Medicare Part A under the Home Health Care section? Select one: a. Nothing, Part A covers all approved costs. b. Health care c. Wheel chair d. Medication

What is the maximum amount of time in which an insured must supply written proof of loss to the insurance company? Select one: a. 120 days b. 30 days c. 90 days d. 15 days

What is the maximum number of full-time employees an employer may have to participate in an HSA? Select one: a. There is no maximum number. b. 150 c. 75 d. 100

What is the maximum percentage of commissions an insurance producer may earn on controlled business before violating Louisiana's regulations on such business? Select one: a. 10% b. 50% c. 25% d. 33%

What is the penalty for using HSA funds for non-medical purposes? Select one: a. 35% b. 25% c. 15% d. 20%

What is the prior authorization required by many insurers for non-emergency services called? Select one: a. Approved service b. Accredited coverage c. Pre-scheduled coverage d. Pre-determination of benefits

What is the producer license maintenance fee in Louisiana for a Life and Health license or Property and Casualty License? Select one: a. $100 every two years b. $50 every year c. $100 every two years d. $50 every two years

What is the purpose of the deductible carryover? Select one: a. It allows an insured to carry any unmet portion of the deductible that the insured runs up in the last quarter of the year over to the next year. b. It allows an insured to use the deductible paid for one family member to also count toward another family member. c. It allows a group to have a decreased deductible amount if benefits are kept below a certain amount during a calendar year. d. It allows the insured to accumulate deductible payments between family members so that a maximum of three family members pay a deductible.

What is the result of a producer not completing continuing education during the required time? Select one: a. Voluntary license termination b. Involuntary license termination c. A hearing with the Commissioner to determine the producer's aptitude. d. A warning from the Insurance Commissioner

What method of determining the needed amount of life insurance assumes that the principal sum will be kept, only interest or investment earnings will be dispersed, and allows payments to continue indefinitely? Select one: a. Capital liquidation b. Capital retention c. Capital conservation d. Capital restriction

What rider allowed Don to not pay money to keep his Health policy in force once he became ill? Select one: a. Waiver of Premium rider b. Consideration rider c. Impairment rider d. Indemnity rider

What will happen if an insured allows his whole life policy to lapse and does not tell the insurer what to do with the cash value in the policy? Select one: a. The insurer can convert the cash value of the policy to its capital assets account if the money is not claimed within three years. b. The insurer will send a check for the entire amount minus any outstanding loans to the insured. c. The insurer will use the cash value as a single premium payment to purchase a paid-up whole life policy for the amount of insurance that the cash value will buy. d. The insurer will convert the policy to a term policy with a face amount equal to the original policy's face amount with the term of the policy as long as will be bought by the original policy's cash value.

When a corporation is both the owner and the beneficiary of a Key Employee Disability policy, benefits are: Select one: a. taxable to the employee. b. not taxable to anyone because the employee paid the premiums. c. taxable to the employer. d. not taxable to the employer.

When an HMO limits the number of health care providers its subscribers can use, the HMO subscribers must choose their physician from those within: Select one: a. the capitation network. b. the admitted provider network. c. the open panel. d. the closed panel.

When an agent submits an application for insurance to an insurer, he or she is acting as: Select one: a. A representative of the state. b. An independent contractor. c. A representative of the applicant. d. A representative of the insurer.

When an employer pays the entire premium for a group disability plan, any benefit received by an employee is: Select one: a. not coordinated with any Worker's Comp benefits the employee may be eligible to receive. b. received only for short-term disabilities. c. deductible income to the employer. d. taxable as income to the employee.

When an insurer issues a policy that replaces a policy of another company, which of the following does the replacing insurer NOT need to do? Select one: a. The replacing insurer must give the insured an expanded free look provision of 20 Days. b. The replacing insurer must send a Buyers Guide to the applicant. c. The replacing insurer must send the existing insurer a notice of intent to replace the existing policies describing the insured and the intended policies to be replaced. d. The replacing insurer must send a policy comparison to the insured, showing the similarities and differences between the existing policy and the replacement policy.

When delivering a policy to a client, an agent should do all of the following except: Select one: a. Review all benefits the policy offers. b. Collect any premiums due. c. Obtain the insured's signature for any changes made to the policy. d. Reveal the reasons and sources for any substandard ratings.

When discussing coinsurance clauses, a number such as 70/30 would mean what? Select one: a. The insurer will begin full payment of costs after the insured has paid an amount that can vary depending on circumstances. b. The insured pays 70% of total costs and the insurer pays the other 30%, to a set amount. c. The insurer will begin full payment of costs after the insured has paid a certain set amount. d. The insurer pays 70% of total costs and the insured pays the other 30%, to a set amount.

When is it necessary for insurable interest to exist under an Accidental Death and Dismemberment policy? Select one: a. During the two (2) year waiting period b. At the time of claim settlement c. At the inception of the policy d. At the time the policy is issued

Where is an agent's authority to waive the provisions of an insurance contract limited? Select one: a. The Waiver of Authority provision b. The Non-Forfeiture provision c. The Time Limit on Certain Defenses provision d. The Entire Contract provision

Which federal law pertains to inspection reports? Select one: a. The Fair Trade Act b. The Fair Credit Reporting Act c. The Unfair Sales Practice Act d. The Sherman Anti-trust Act

Which insurance delivery systems provides both the insurance and the health care service to the insured? Select one: a. HMO b. PPO c. POS systems d. Traditional Insurers

Which is NOT true of the NAIC? Select one: a. It determines the types of insurance policies that can be sold. b. Directors are responsible for passing legislation regarding insurance in their states. c. All state insurance directors belong to the NAIC. d. It investigates consumer complaints against insurers and agents.

Which is not a characteristic of Medicare Part A? Select one: a. Inpatient hospital care includes 60 lifetime reserve days. b. There is no co-insurance for a skilled nursing facility stay for the first 120 days. c. There is a 20% co-insurance for wheelchairs with home health care. d. Private rooms are covered.

Which is not guaranteed under COBRA? Select one: a. Premiums b. Any of these c. Renewability d. Benefits

Which mode of paying the insurance policy premium is generally the least expensive? Select one: a. Bank check plan b. Quarterly c. Annual d. Monthly

Which of the following Medicare supplement policies does not cover the Part A deductible? Select one: a. Plan A. b. Plan F. c. Plan K. d. Plan B.

Which of the following constitutes misrepresentation? Select one: a. Promoting a competitor's company b. Presenting the audited financial statements to gain the trust of a client c. Making disparaging remarks about another agent or policy d. Stating that the state or federal government guarantees funds in any way

Which of the following could sell insurance in this state? Select one: a. state resident who has passed the state producer exam. b. staff employee of a licensed producer, under the producer's supervision. c. non-resident licensed producer. d. fully licensed claim adjustor.

Which of the following dental services would be most likely to have separate deductible and coinsurance amounts from the rest of the policy coverages? Select one: a. Endodontic Care b. Orthodontia c. Prosthodontia Care d. Prophylaxis

Which of the following expenses are covered by Medicare Part A? Select one: a. Surgical expenses b. Long-term care expenses c. Physician office expenses d. Hospital room and board

Which of the following is NOT correct about Louisiana's Insurance Commissioner? Select one: a. The commissioner may hold hearings and impose appropriate penalties. b. The commissioner can establish administrative regulations in order to carry out existing insurance statutes put into place by the state legislature. c. The commissioner makes insurance laws as appropriate to the needs of the state. d. The commissioner is elected by LA voters for a four-year term.

Which of the following is NOT covered by LTC insurance? Select one: a. Intermediate nursing care b. Adult day care c. Care given for a five-week stay in a hospital. d. Help given to allow home caregivers a break

Which of the following is NOT required by most states that have privacy acts? Select one: a. The company must not gather information from certain sources if the applicant tells them not to do so. b. The company must inform applicants if credit reports will be obtained. c. Applicants are to be given notice if any information will be used for marketing purposes. d. Applicants must sign disclosure statements.

Which of the following is a correct statement concerning group health insurance plans? Select one: a. Plans issued by stock insurance companies usually provide for refunds on an experience-rating basis. b. Group health plans are generally non-participating. c. Dividend refunds are guaranteed in a group insured by a mutual insurer. d. If a group policy is experience-rated, any premium reductions are not retroactive.

Which of the following is allowed by advertising regulations? Select one: a. Creating the impression that availability of a policy is limited in order to encourage consumers to act quickly. b. Suggesting that dividends will pay up a policy's premiums, as long as the conditions and benefits that pertain to such a feature are also described. c. The use of testimonials that are taken out of context. d. Using words or symbols similar to those of a government agency.

Which of the following is an example of a deductible carryover? Select one: a. S has a $500 deductible and paid $450 during the first quarter but had no medical claims during the rest of the year. S only needs to pay $50 the next year to meet that year's deductible. b. K has a $500 individual deductible for her family with a maximum three individual payment. K has 5 family members and three of the meet the deductible this year, so the other two do not need to pay money toward the deductible. c. C has a $500 deductible and paid $700 this year with the deductible and coinsurance. C can carry over $200 towards any deductibles needed next year. d. P has a $500 deductible and had no medical claims in the first part of the year, but ran up $350 worth of claims in November. P only needs to pay $150 the next year to meet that year's deductible.

Which of the following is an example of redlining? Select one: a. YLR Insurance charges people in Metropolis an $800 premium for life insurance if they live in homes valued at $150,000, but $1,800 for people who live in homes less than that amount. b. An admitted insurer decides it wants to offer insurance to HIV patients for a premium of $10,000 when a surplus lines producer currently offers a similar policy for only $3,000. c. An insurer decides not to offer term insurance to any of its customers. d. Agent Francesco gives a cell phone to anyone who buys a life insurance policy from him.

Which of the following is correct about the taxation of group health benefits? Select one: a. The portion of disability for which the employee pays premium is not subject to income tax. b. Benefits received for group hospital or medical usually are subject to income tax. c. Employers can deduct the full contributory cost of premiums from taxes. d. Benefits received for group disability benefits are always subject to income tax.

Which of the following is not a Common Dental Plan Exclusion? Select one: a. Injuries covered by Workers Compensation. b. Cosmetic services required because of a biking accident in which the insured lost three teeth. c. Replacement of dentures four year after the policy starts. d. Service on braces put in place two months before policy inception.

Which of the following is not a common exclusion to health and disability policies? Select one: a. Vision Correction b. Suicide c. Pre-Existing Conditions d. Pregnancy Complications

Which of the following is not a reason for which a Medicare supplement policy may be terminated? Select one: a. Non-payment of premium b. Material misrepresentation c. All of these are reasons a Medicare supplement policy may be terminated. d. The insured's health status

Which of the following is not a requirement to obtain an insurance producer license? Select one: a. Required fees must be paid. b. Complete the required pre-licensing education. c. Pass a state examination for each line of authority for which the applicant applies. d. The applicant must be 21 years of age or older.

Which of the following is not a situation in which a Consumer Report would be furnished? Select one: a. A company wants to market products to people that fit a certain profile b. Employment purposes c. Underwriting of insurance policies for the consumer d. A pending credit transaction with the consumer

Which of the following is not an example of a fee-for-service plan? Select one: a. Producer cooperatives b. PPO c. HMO d. Traditional InsurersD.

Which of the following is not an example of misrepresentation? Select one: a. Making disparaging remarks about another agent b. Confirming that the company is guaranteed by a federal of state governmental agency c. Presenting the audited financial statements to gain the trust of a client d. Overstating the company's assets

Which of the following is not considered to be one of the non-forfeiture options in a life insurance policy? Select one: a. Reduced Paid-up Insurance b. Extended Ordinary Life Option c. Cash Surrender Value Option d. Extended Term Option

Which of the following is not correct about the Louisiana Health Insurance Association? Select one: a. People previously covered by the Association whose policies were cancelled during the past 12 months because the individual did not pay previous premiums are not eligible for coverage through the Association. b. Individuals must live in Louisiana for twelve consecutive months before being eligible for coverage through the Association. c. Maximum lifetime benefits available through the Association must be at least $500,000/covered person. d. The Association provides health or accident insurance to LA citizens who cannot secure through an individual or group policy because of health conditions

Which of the following is not correct about the regulation of variable products in Louisiana? Select one: a. Insurers may not keep variable product funds separate from the insurer's common account. b. Producers must have a life insurance producer license in order to sell variable products. c. Producers must have an NASD securities license in order to sell variable products. d. Insurers must obtain written approval from the Commissioner before transacting variable product business in Louisiana.

Which of the following is not part of the Policy Summary? Select one: a. Buyer's Guide b. Cost comparison indexes for 10 and 20 years c. The policy's generic name and that of each rider d. The annual premium for the basic policy and all riders for the first five policy years and representative years thereafter.

Which of the following is part of Medicare Part A? Select one: a. All of these b. Inpatient Hospital Care c. Home Health Care d. Hospice Care

Which of the following is responsible for monitoring the financial stability of insurance companies? Select one: a. The NASD b. The state's insurance commissioner/director c. The state's attorney general d. The Federal Exchange Commission

Which of the following losses would be covered by Disability insurance? Select one: a. A disability suffered by a fall on the job b. Residual Disability c. A disability suffered while making a delivery in the employer's truck d. Long-term care

Which of the following must be communicated to applicants in order to comply with insurance privacy acts? Select one: a. They must be told whether any information will be used for marketing purposes. b. Insurance privacy acts do not concern applicants, only insurers. c. All of the different options, riders, etc., must be made known to the applicant. d. Applicants must be notified of changes made to their pending policy.

Which of the following policies would NOT provide occupational coverage? Select one: a. Group Major Medical b. Business Overhead Expense c. Workers Compensation d. Group Accidental Death and Dismemberment

Which of the following provisions in LTC policies is NOT designed to protect coverage for someone confined in a residential nursing home? Select one: a. Pre-existing condition provisions b. Guaranteed renewability c. Non-cancelable policy d. Waiver of Premium Rider.

Which of the following regarding a Limited Health Services Organization is NOT correct? Select one: a. An LHSO is similar in organization to an HMO. b. LHSOs provide both the medical care and the insurance coverage. c. LHSOs are called such because of the limited geographical area in which they offer services. d. LHSOs offer coverage for only limited types of health services, such as vision and dental?

Which of the following requirements of LTC policies is INCORRECT? Select one: a. Hospice care includes a family counseling benefit. b. Every LTC policy must contain a renewal provision no less favorable than Annually Renewable. c. Coverage for Alzheimer Disease cannot be excluded from LTC benefits. d. Long-Term Care policies must provide a 30-day free look from the date of policy delivery.

Which of the following rights was NOT given by the Fair Credit Reporting Act of 1970 to persons applying for an insurance policy? Select one: a. The right to have medical information sent to his or her own physician b. The right to add explanatory notes or seek to correct information within the report c. The right to the name and address of the inspecting company if a policy is rated or rejected as a result of the report d. The right to be given notice of certain activities that the insurer will perform in gathering information about them for underwriting purposes

Which of the following statements about LTC policies is correct? Select one: a. If one LTC policy is replacing another, the replacing policy must waive any pre-existing conditions that were already satisfied by the existing policy. b. LTC insurance covers non-residential nursing care. c. LTC policies must provide a 10-day free look from date of policy delivery. d. LTC policies may not be non-cancelable.

Which of the following statements about Point-of-Service limited health service contracts is not true? Select one: a. POS limited health service organizations may offer different maximum lifetime benefits for both in-plan and out-of-plan services, b. POS limited health insurance plans may not offer orthodontic services out-of-plan that are not also offered in-plan. c. POS limited health service organizations may require a higher co-payment for out-of-plan benefits than for in-plan benefits. d. The plans may not exclude certain members of a group from coverage.

Which of the following statements about a group health plan's Summary Plan Description (SPD) is not correct? Select one: a. All plan participants must be notified of any changes in the SPD. b. The SPD describes the benefits that plan participants have through the plan. c. The SPD explains the rights of plan participants. d. The SPD is not given to plan participants, but is kept by the plan administrator.

Which of the following statements is correct about the differences between Individual and Group Health insurance? Select one: a. There is no difference between Group and Individual health plans. b. Adverse selection is less in Individual policies than in Group plans. c. Group plans do not cover pregnancies, but Individual policies must cover them. d. Group plans have lower premiums per person than do comparable Individual policies.

Which of the following statements is correct regarding the tax situation of an employee who has non-participating group AD&D coverage through his/her employer? Select one: a. The employee must pay income tax on any benefits that exceed the actual amount of medical expenses. b. The employee may deduct the cost of the premium from income taxes. c. The employer must report all benefits received by the employee to the IRS. d. 75% of employees must participate in the plan.

Which of the following statements is not correct about group health insurance? Select one: a. An employer is able to deduct premiums it pays from its income tax liability. b. Each insured individual holds a copy of the policy. c. The master policy holder helps process claims, negotiates premiums, and answer questions that group members have. d. Contributory plans require 100% of employees to participate in the plan.

Which of the following statements is not true of service organizations? Select one: a. Benefits are available only for individuals working for nonprofit agencies. b. They are also called producers' cooperatives. c. Benefits are paid directly to the producer rather than the subscriber. d. They were initially started to guarantee payment to physicians and hospitals.

Which of the following statements is untrue of Medicare? Select one: a. Part B has a yearly deductible of $135 in 2009 b. People with permanent kidney failure are eligible for Medicare. c. It usually does not pay for treatment outside the USA. d. It was started in 1935.

Which of the following statements regarding an insurance producer's responsibilities in a life insurance policy replacement transaction is NOT correct? Select one: a. The applicant must sign a statement that the sale involves a replacement. b. The agent must sign a statement that the sale involves a replacement. c. The agent must send the existing insurer a notice of intent to replace the existing policies, describing the insured and the intended policies to be replaced. d. The agent must sign and give the applicant a "Notice Regarding Replacement of Life Insurance or Annuity".

Which of the following types of companies does NOT underwrite health insurance? Select one: a. Life insurance companies. b. Annuity companies c. Casualty companies d. Mono-line companies

Which of the following types of policies replacing another policy in Louisiana needs to follow replacement regulations for life insurance policies? Select one: a. Group annuities b. Credit life c. Whole life d. Home service policies

Which of the following would be considered discrimination? Select one: a. A person who works as a race car driver has a higher life insurance premium than that of his neighbor who is an insurance agent. b. An insurance company decides to increase the premium charge on life insurance policies issued to non-Catholics because of difference in beliefs. c. An insurance company charges women lower premiums than men because women generally live longer. d. A life insurance company charges obese people a higher premium when it can prove actuarially that obese people have a greater risk for heart disease and will therefore die sooner than others.

Which of the following would be considered discrimination? Select one: a. An insurance company charges women lower premiums than men because women generally live longer. b. An insurance company decides to increase the premium charge on life insurance policies issued to non-Catholics because of difference in beliefs. c. A person who works as a race car driver has a higher life insurance premium than that of his neighbor who is an insurance agent. d. A life insurance company charges obese people a higher premium when it can prove actuarially that obese people have a greater risk for heart disease and will therefore die sooner than others.

Which of the following would not be a reason for the Louisiana Insurance Commissioner to suspend or revoke an insurance producer's license? Select one: a. Having another individual take the license candidate's insurance licensing exam b. Providing materially correct information on an application for a producer's license c. Replacing the policy summary of one policy with another when explaining the policy in an insurance sales situation d. Signing another person's name on an insurance document

Which of the following would not be considered a limited coverage health policy? Select one: a. long term care policy b. hospital indemnity policy c. credit disability policy d. accident policy

Which of the following would not be covered by Tricare? Select one: a. Medical supplies provided on a military base b. Hospitalization c. Drug rehabilitation centers d. Outpatient medical care

Which of the following would not be included in the illegal practice of misrepresentation? Select one: a. Comparing two or more policies with incomplete explanations b. Using policy names which do not accurately reflect the true nature of the policy c. Making misleading statements about the terms, benefits, or dividends of a policy d. Charging different premiums on a non-actuarial basis

Which of these situations does not represent a common exclusion from dental plans? Select one: a. Christi falls down some stairs at work and chips two teeth. b. Tony requires a crown on one of his teeth just 11 months after he buys the plan. c. Rowena started orthodontia treatment one year ago, and her new employer offers orthodontia care. d. Alex requires new dentures three years after he takes out his dental policy.

Which organization does not usually cover medical fees incurred by services rendered outside the network? Select one: a. FIO b. PPO c. POS d. HMO

Which statement describes a likely requirement if S does not enroll in her employer's group dental plan when first eligible and later decides to enroll? Select one: a. S may be able to receive only half the benefit others in the plan receive for the first year she is enrolled. b. S will not be able to enroll in the dental plan, to avoid adverse selection. c. S will be subject to a 10% increased premium. d. S will need to wait until the general enrollment period, January 1-March 31 of the following year, to be added to the group plan.

Which statement is correct regarding qualified Long Term Care policies? Select one: a. Premiums for nursing home coverage are ineligible for a deduction from income tax. b. LTC premiums are not deductible for income tax purposes. c. LTC benefits are generally not taxable as income. d. Skilled and intermediate nursing care are the only options available for LTC patients under qualified plans.

Which type of HMO is allowed to limit the number of health care providers its subscribers can use to those in the selected group? Select one: a. Capitation b. Limited Health Services Organization c. Closed Panel d. Open Panel

Who/What is it that decides what to do in the event of an insurer insolvency? Select one: a. The commissioner/director of insurance b. The SEC c. The NASD d. The state governor

William purchased a Medicare supplement policy that was delivered on March 31. What is the last date that William could return the policy with a full return of premium? Select one: a. April 20 b. May 30 c. April 30 d. April 10

Within how many days must an insurance agent notify the commissioner of a change in address? Select one: a. 10 days b. 15 days c. 30 days d. 45 days

Within how many days must an insurer give claims forms to an insured after receiving notice of a health claim? Select one: a. 60 b. 90 c. 15 d. 30

XYZ Insurers worked out an agreement with a business customer that the customer would not allow any other insurers to sell insurance to the company because of a business loan that XYZ made to the company. What is this an example of? Select one: a. Improper Claims Practices b. Unreasonable restraint of trade in the business of insurance c. Unfair discrimination. d. Monopoly in the business of insurance

Zack was found guilty of indirectly encouraging the making of maliciously critical comments regarding the financial condition of one of his competitors. Of what was Zack found guilty? Select one: a. Discrimination b. Rebating c. Defamation d. False Advertising

_____________ is always available under group health plans. Select one: a. Workers Compensation b. AD&D c. Maternity coverage d. Disability income coverage

primary care physician in an HMO is called the what? Select one: a. Gatekeeper b. Steward c. Guardian d. Administrator

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