Pennsylvania xcel final

In long term care policy, the right to examine period is

30 days

In accident and health plans, premiums paid less frequent than monthly require a minimum grace period of at least

31 days

Under Pennsylvania statute, first year commission for long-term care insurance may not be greater than

50% of the first year premium

In Pennsylvania, an insurer may backdate policy issue not more than how many months from the date of a life insurance application?

6 months

If a health insurance claim is not promptly paid, legal action may be taken against the insurer after

60 days from the date proof of loss is furnished

In Pennsylvania, HIPAA laws require that an individual's prior creditable coverage may reduce the maximum pre-existing condition exclusion period that a new group health plan can apply. This rule is applicable as long as there has been no gap in creditable coverage for a period greater than

63 days

In Pennsylvania, what's the requirement for a minor to receive proceeds from a death benefit?

A guardian must be appointed

A Modified Endowment Contract (MEC) is best described as

A life insurance contract which accumulates cash values higher than the IRS will allow

A plan in which an employer pays insurance benefits from a fund derived from the employer's current revenues is called

A self-funded plan

Which of these is considered to be a Living Benefit option in a life insurance policy?

Accelerated death benefit

A long-term care policy typically provides all of the following levels of cares except

Acute care

A policyowner may change two policy features on what type of life insurance?

Adjustable Life

An underwriter's primary responsibility to an insurer is to protect against

Adverse selection

How does life insurance create an immediate estate?

After first premium is paid, the face amount may be available to the beneficiary

What amount will be paid under a policy where the insured misstated his/her age?

An amount the premium would have purchased at the correct age

Which of the following is considered to be the period when the accumulated value in an annuity is paid out

Annuitization phase

According to life insurance contract law, insurable interest exists

At the time of application

An accident and health insurer has just received written proof of loss from one of its insureds. The insured must now wait 60 days before

Bringing legal action against the insurer

How are health plans classified according to the Affordable Care Act?

Bronze, Silver, Gold, Platinum

In which of the following relationships would there not be insurable interest?

Business owner to business customers

Which of these is not considered a form of insurance advertisement?

Buyer's guide

Ted has a health insurance plan that requires him to pay a specific sum out of pocket before any benefits are paid in a calendar year. Which of these does his health plan have?

Calendar-year deductible

An order issued by the commissioner that prohibits a specific practice listed in the order is called a

Cease and desist order

Which of the following is not part of an insurance contract?

Certificate Authority

Which of the following is not a required provision in an accident and health insurance policy

Change of occupation

A policy that allows a policyowner to temporarily give up ownership rights to secure a loan is called a

Collateral assignment

A health insurance policy where the insurer has the right to terminate the policy for reasons other than the insured's health is called

Conditionally renewable

A form of medical health insurance covering the treatment and care of gum disease is called

Dental expense insurance

A hospital or medical expense policy will typically cover dental treatment expenses under which circumstance?

Dental treatment is needed to repair an injury

Lisa has recently bought a fixed annuity. Which of these is considered to be a disadvantage of owning this type of annuity?

During periods of inflation, annuitants will experience a decrease in purchasing power of their payments

Which prohibited act involves a producer spending a client's insurance premiums for his/her own personal use?

Embezzlement

Which of these would limit a company's liability to provide insurance coverage?

Exclusion

Fraternal Benefit Society has each of the following characteristics EXCEPT

Exist For profit

A life insurance rider that allows an individual to purchase insurance as they grow older, regardless of insurability, is called a

Guaranteed insurability rider

Barbara's policy includes a rider which allows her to purchase additional insurance at specific dates or events without evidence of insurability. This rider is called a

Guaranteed insurability rider

Tom has a rider on his disability income policy that guarantees the right to increase his benefits without a medical exam. What kind of rider is this?

Guaranteed insurability rider

What is the required Renewability status of all Medicare supplement policies?

Guaranteed renewable

Which of the following is not included under a health benefit plan

Hospital indemnity plan

Which of the following provisions protects a Pennsylvania policyowner from an innocent mistake made on the application over 2 years ago

Incontestability provisions

A policyowner is prohibited from making any changes to the policy without the beneficiary's written consent under which beneficiary designation?

Irrevocable beneficiary

Violating Pennsylvania insurance law may result in which of the following Insurance Department actions?

Issuance of a cease and desist order after a hearing

Which of the following statements is true about medicaid?

It is funded by federal, state, and local taxes

What happens to interest earned if the annuitant dies before the payout start date

It is taxable

Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA?

It would be considered taxable income to the employee

Which type of life insurance is normally associated with payor benefit rider

Juvenile insurance

The authority granted to a licensed producer is provided via the

Law of Agency

In Pennsylvania, completion of continuing education is required upon license renewal for which of the following?

Licensed individuals qualified in major lines of insurance

An insurance company may only pay commission to a

Licensed producer appointed by the insurer

Low frequency diseases can be exclusively covered by what kind of health insurance policies?

Limited policies

The IRS states that a taxpayer's medical expenses that exceed 7.5% of their adjusted gross income is tax deductible. Which of these is considered a medical expense under this rule

Long term care insurance premiums

An employer is issued a group medical insurance policy. The single contract is know as

Master policy

An employer is issued a group medical insurance policy. This single contract is know as

Master policy

Which of these gaps in Medicare coverage is addressed with Medicare supplemental insurance?

Medicare in-hospital deductible

During the first two years a life insurance policy is in force, the insurer may contest a policy for all of the following reasons except

Misstatement of age in the application

A beneficiary has just received a claim payment for a life insurance policy. Which of the following is TRUE regarding the federal income tax liability owed?

No federal income tax is owed on life insurance proceeds

The document that describes policy features, benefits, exclusions and riders in a long-term care policy is known as the

Outline of Coverage

Which clause defines total disability as being unable to perform the major duties of the insured's regular occupation?

Own occupation clause

What is know as the immediate specific event causing loss and giving rise to risk?

Peril

In what form do disability income policies typically pay benefits

Periodic income

Which of these is considered to be a document that describes the critical segments of a life insurance policy

Policy summary

During the accumulation period, who can surrender an annuity?

Policyowner

Replacement regulation is designed to protect the interests of

Policyowners

All of the following are functions of an insuring clause except

Primarily describes the free-look period

The branch of dentistry which deals with replacement of missing parts

Prosthodontics

The branch of dentistry which deals with the replacement of missing parts is called

Prosthodontics

How are survivorship life insurance policies helpful in estate planning

Provide funds to help pay taxes

What is the primary reason for buying an annuity?

Provide future economic security

When hmo to a ppo, the ppo

Provided a greater choices of providers

The Commissioner is responsible for all of the following EXCEPT

Recommending insurers

Which of the following is an example of a producer's fiduciary duty?

Recording receipt and remittance of premiums due to the insurance company

All of the following are considered to be nonforfeiture options available to a policyowner except

Reduction of premium

A policyowner may exercise which of these dividend options that uses the dividend to pay all or part of the next premium due?

Reduction of premium dividend option

An annuitant dies during the distribution period. What kind of annuity will return to a beneficiary the difference between the annuity value and the income payments already made?

Refund annuity

According to the affordable care act, what metal tier is required to have an actuarial value of 70% with covered individual paying 30% through deductibles, co-pays, and other cost sharing features

Silver plan

A life insurance producer licensed in commonwealth of Pennsylvania is authorized to

Solicit, receive and forward applications to the insurer

An insurer has the right to recover payment made to the insured from the negligent party. These rights are called

Subrogation

Which of these is not a characteristic of accelerated death benefit option

The benefit can be offered as a rider at a specific extra cost or may be at no cost

What does the word "level" in level term describe?

The face amount

In which of the following situations would the insurer be liable for a loss

The insured suffered an injury as an innocent bystander during a bank robbery

A partial surrender is allowed in which of the following life policies?

Universal Life

Craig submits a $500 claim for medical expenses. With a past due premium of $100, the insurer pays $400. Which of the Uniform Optional Provisions covers this situation?

Unpaid premium

Which type of policy combines the flexibility of a universal life policy with investment choices?

Variable universal life policy

All of these statements concerning whole life insurance are false except

When a whole life policy is surrendered, income taxes may be owed

For Pennsylvania Insurance Code violations, the Commissioner may assess a(n)

administrative penalty

People with higher loss exposure have the tendency to purchase insurance more often than those at average risk. This is called

adverse selection

Fixed period settlement options are considered to be a form of a(n)

annuity

Bill requires some nursing care and supervision but NOT full-time care. Which of these nursing home options would best serve him?

assisted living

A type of group that has a constitution and bylaws and has been organized for purposes other than obtaining insurance is called a

association or labor group

The commissioner has the right and duty to

audit insurer financial reports and conduct market studies

An insured dies from what appears to be accidental causes. When confirming the cause of death, which of these actions by the insurer takes precedence?

autopsy

Under a group life policy, the insurer will issue an individual _____ to the policyowner for delivery to each person insured.

certificate

Life insurance policies will normally pay for losses arising from

commercial aviation

A waiver of premium rider allows an insured to waive premium payments if the insured is

completely and permanently disabled

Field underwriting performed by producer involves

completing the application and collecting initial premium

In order for a contract to be valid, it must

contain an offer and acceptance

Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n)

conversion

All of these are standard exclusions found in a life insurance policy EXCEPT

disability

Benefits provided by a Medicare Supplement policy must NOT

duplicate Medicare benefits

Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the

employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan

The limited period of time given to all members to sign up for a group health plan is called the

enrollment period

A professional liability for which producers can be sued for mistakes of putting a policy into effect is called

errors and omissions

A producer is meeting with a client to determine whether an annuity would be suitable for purchase. Which of the following topics needs to be discussed with this client?

financial objectives

When collecting insurance premiums from a client, a producer must

forward premiums to the insurer on a timely basis

Fixed annuities provide each of the following except

hedge against inflation

For licensing purposes, if an applicant has a home or office location in the state of Pennsylvania, this would be consistent with which of the following?

home state

Sharing 50% of a producer's commission with the insured is an example of

illegal inducement

Which type of beneficiary should be named if the insured wants to give explicit directions on how the policy proceeds should be paid?

individual

Who assumes the investment risk with a fixed annuity contract?

insurer

An example of a primary care physician would be a

internist

Non-admitted Insurer

is not afforded protection by the guaranty fund

A life insurance policy written on one contract for two people in which it is payable upon the first death is called

joint

A common exclusion with Vision plans is

lasik surgery

Commissions may be shared by

licensed and appointed Producers

Someone needing custodial care at home would require which type of coverage?

long term care

Which of the following is considered to be a point of service (POS) plan)

managed care plan

An insurer would be committing Unfair Discrimination if coverage was denied based upon

marital status

In contrast to a guaranteed renewable policy, a noncancellable policy

may never raise premiums

A guaranteed issue insurance policy has no

medical underwriting

A beneficiary change can occur

normally at any time during the policy term

A nonparticipating policy will

not pay dividends

How are contributions made to a Roth IRA handled for tax purposes?

not tax deductible

Which of the following is not an example of utilization review?

ongoing inspection of accident prone individuals

A clause that allows an insurer the right to terminate coverage at any anniversary date is called a(n)

optional renewability clause

A policyowner suffers an injury that renders him incapable of performing one or more important job duties. Any decrease in income resulting from this injury would make him eligible for benefits under which provision?

partial disability

States that have "no loss no gain" laws require a replacing policy to

pay for ongoing claims under the policy it replaces

The federal employees benefit program consists of two types of health plans for federal civilian employees. The two plans are fee-for-service and

prepaid

Who can receive an insurance commission?

producer

What is the automatic continuance of insurance coverage referred to as?

renewal

Under the subrogation clause, legal action can be taken by the insurer against the

responsible third party

Long term care policies may provide coverage for claims arising from

senile dementia

Which of the following is the Pennsylvania insurance department not responsible for?

shareholders

Health insurance involves two perils, accident and?

sickness

Continuous 24-hour care provided by licensed medical professionals under the direct supervision of a physician is called

skilled nursing care

A policyowner can receive an immediate payment before the insured dies by using a(n)

viatical settlement contract

Shawn, Mike, and Dave are brothers who have a $100,000 "first to die" joint life policy covering all three of their lives. If Mike dies first, the policy proceeds

will no longer provide insurance protection

Kate has a Major Medical Plan with a 75/25 coinsurance and a deductible of $25. How much will she have to pay if she, not having met any of her deductible, visits the doctor and receives a bill for $125?

$50

An insured may return their accident and health policy within ____ days of policy delivery

10 days

Kathy pays a monthly premium on her health insurance policy. How long is her grace period?

10 days

The typical long-term care insurance policy is designed to provide a minimum of ___ years of coverage

1 year