Quiz

All individual health policies in the state of missouri which provide for hospital treatment must also provide coverage for treatment of alcholism litmited to how much damage?

* 30 days* All individual healthpolicies must cover alcoholism on the same basis as any other illiness

In insurance policies, the insured is not legally bound to any particular action in the insurance contract but the insurer is leagally obligated to pay losses covered by the policy.What contract element does this describe?

Unilateral In a unilateral contract, the insured is not leagally bound to do anything. the insurer however must pay losses covered by the policy.

When would a 20 year whole life policy endow?

When the insured reaches age 100. When a limited pay whole life policy just like staright life, endows for the face amount in the insured lives to age 100. The premium is however completly paid off in 20 years.

Which of the following determines whether disability indurance benefits are taxed?

Whether the premium were tax deductible.

Under an individual disability policy, the Minimum schedule of time in which claim payments must be made to an insured is

If a claim involves disability income benefits, the policy must pay those benefits not less frequenty than monthly. In all other cases the company may specify the time period of 45 or 60 days for payments of claims.

Which of the following riders is often used in business life insurance policies when the policyowner need to change the insured under the policy?

Substitute insured rider.

Credit life insurance is usually issued as what type of policies?

Term Life Issued only as individual or group.

The period of time immediately following a disability during which benefits are not payable is?

The elimination period.

Which of the following is NOT covered under Plan A in medigap services?

The medicare part A deductible.

Which of the following statements is true regarding the continuing education requirements for nonresident producers?

The producer does not need to meet Missouri CE requirements if he/she is meeting the home state CE requirements.

All of the following statements are correct regarding credit life insurance except?

In credit life insurance, the creditor is the beneficiary for the amount of benefit equal to the outstanding balance of the loan.

What type of insurance would be used for a return of premium rider

Increasing term The return of premium reider is achieved by using increasing term insurance. When added to a whole life policy it provides that at death prior to a given age, not only is the original face amount payable, but also all premiums previously paid are payable to the beneficary>

The policy owner of an adjustable life policy wants to increase the death benefit. Which of the following statements is correct regarding this change?

The death benefit can be increased by providing evidence of insurability.

The Policyowner of an adjustable life policy wants to increase the death benefit. Which of the following statements is correct regarding this change?

The death benefit can be increased by providing evidence of insurability. The policy owner (insured) would need to prove insurability would be needed to prove insurability for the amount of the increse.

In a disability policy, the elimination or waiting period refers to the period between?

The first day of disability and the day the insured starts recieving benefits. The elimination or waiting period starts at the onset of a disability claim and its the period of time the insured must wait before benefits start.

The insurability clause of a disability policy usually states.

The insurability clause usually on the first page of the policy is the general statment, that defines the insurance agreement and identifies the insured and the insurance company and stats the kind of loss (peril) is covered

When delivering a policy which of the following is an agents responsibilyt?

collect payment at time of delivery the agent has the responsibility to deliver the policy to the insured and to collect any premium that maybe due at the time of delivery.

The policy owner wants to make sure that upon his death, the life policy will pay a portion of the proceeds annually to this spouse but that the principal will be paid to their children when they reach a certain age. Which settlement options should the policy owner choose?

Interest only options.

An applicant for a health insurance policy returns a completed application to her agent, along with a check for the first premium. She recieves a conditional receipt two weeks later. which of the following has the insurer done by this point?

Neither approved the application nor issued to policy When the agent recieves the application and issued the policy.

Each child covered under a non-medicate health carrier plan will be provided coverage for early intervention services up to how much per year?

$ 3,000 per a child, per a policy, per a calendar year.

If an insurance imposes a maximum lifetime benefit for breast cancer treatment using stem cell transplant this limit must be at least?

$100,000 A lifetime benefit maximum of not less than $ 100,000 may be imposed for such treatment.

A long term care shopper's guide must be present at what point?

* Prior to the time of application * A long term care insurance shopper's guide must be provided in the format developed by the National Association of Insurance Commissioner's (NAIC) The shoppers guide must be present to the applicant prior to completing the app.

A producer completed an insurance transaction in 2007. When can the producer dispose of the records for this transaction?

*2010 * Three years available for inspection bt the director.

What is a penalty tax for non qualified distributions from a health savings account?

20%

The Minimum number of credits required for partially insured status for Social security disability benefits is?

6 credits during the last 13 quarter period.

What is the waiting period on a waiver of premium rider in life insurance policies?

6 months most insurers impose a 6 month waiting period from the time of disability until the first premium is waived.

Under the uniform required provisions, proof of loss under a health insurance policy normally should be filed within?

90 days of a loss.

An investor buys a life policy on an elderly person in order to sell it for a life settlement, this is an example of?

A STOLI policy

Under the mandatory uniform provision notice of claim the first notice of injury or sickness covered under an accident and health policy must contain?

A statement that is sufficiently clear to identify the insured and the nature of the claim.

Which of the following is not under a long term care policy?

Acute care in a hospital. A long term care policy may provide coverage for home health, care adult day care, hospice care, or respite care.

Group health insurance is characterized by all of the following EXCEPT?

Adverse selection.

Which of the following would be considered a non medical insurance application?

An application on which the medical information is completed by the applicant and the agent only. An application on which all of the questions, including medical history questions, do not need to be complete by medical professionals and may be complete by the agent and the applicant.

Which provisions allow the policyholder a period of time, while coverage is in force to exaime a health insurance policy and determine whether or not to keep it?

Free look period 10 days after the policy is delevered return the policy recieves a full refund.

Which of the following is NOT required to be stated in the outline of coverage provided with a long term care policy?

Basic information about supplementary policies. The outline of coverage must follow the standard format included in the insurance reguations. It must provide information about the insurance company, the policy number, important features of the policy and explain the right to return policy for a refund.

Which of the following statements are correct reguarding credit life insurance Except?

Benefits are paid to the borrows beneficiary.

The act of trying to discourage a policyholder from dropping his/ her policy is called.

Conservation Effort

An insurer neglects to pay a legitimate claim that is covered under the terms of the policy. Which of the following insurance principle has the insurer violated?

Consideration The binding force in any contracr is consideration. Consiteration on the part of the insured is the payments of and the health representations made in the application. Consideration on the part of the insurer is the promise to pay in the event of loss.

Contracts that are prepared by one party and summated to the other party on a take it or leave it basis are classified as?

Contracts of adhesion Insurance policies are written by the insurer ans submitted to the insured and take it or leave it basis. The insured does not have any input into the contracts, but simply adheras to the contract.

Which of the following terms describes a specific dollar amount of the cost of care that must be paid by the member?

Copayment

According to the entire contract provision what document must be made part of the insurance policy?

Copy of the original application.

A waiver of premium provision may be included with which kind of health insurance policy?

Disability income

What is the goal of the HMO?

Early detection through regular check ups.

Which of the following entities has the authority to make a change to an insurace policy?

Executive office of the company (insurer's)

Which policy component decreases in decreasing term insurance?

Face Amount decreasing term policies feature a level premium and a death benefit that decreases each year over the duration of the policy term.

An insured is involved in an accident that renders him permanently deaf, although he does not sustain any other major injuries. The Insured is still able to perform his current job. To what extent will he recieve presumtive disability benefits?

Full benefits loss of two limbs total and permament blidness loss of speech, hearing even if able to work.

Which of the following statements is correct?

HMO's may pay for services not covered by medicare.

The benefits received by the business in a disability buy sell policy are?

Income tax free

A guaranteed renewable disability insurance policy.

Is renewable at the insured's option to a specific age. Guaranted renewable means that the insured has the right to keep the policy until a specific age, however while the insurer cannot increase the rates on an individual basis, can increase the rates by class.

Whenever it appears that a producer or an insurer is violating an insurance Law of Missouri, the director will do which of the following?

Issue a cease and desist order Whenever it appers that any person is violating an insurance law, the director can issue a cease and desist order and schedule a hearning into the matter.

An insured purchased a disability income policy with a 10 year benefit period. The policy stated a 20 day probationary period for illness. If the insured is hospitalized with an illnesses 2 weeks after the policy was issued, How much will the policy pay?

Nothing illness is not covered during the first twenty days of the contract. Not covered if it occurs during the probationary period.

Under which of the following organizations are the practicing providers compensated on a fee for service basis?

PPO

Something of value exchanged between the insurer and the insured is considered an?

consideration

Which of the following statements about a suicide clause in a life insurace policy is true?

suicide is excluded for a specific period of years and covered thereafter.

An employee is insured under her employers group life plan. If she terminates her group coverage which of the following statements is Incorrect?3

the Insured may choose to convert to term or permanent individual coverage. When group coverage is converted to an individual policy, the insurer will determine the type of coverage, usually permanent insurance.

Insuerers may change which of the following on a guaranteed renewable health insurance policy?

Rate by class.

Which of the following is TRUE about credit life insurance?

Creditor is the policy-owner In credit life insurance, the creditor is the policyowner and the beneficiary the debator is insured.

A health insurance policy that pays a lump sum if the insured suffers a heart attack or stroke is called?

Critical illness

Twin brothers are starting a new business. They know it will take several years to build the business to the point that they can pay off the debt incurred in the start of the business. What type of insurance would be the most affordable and stil provide death benefits?

Joint life premiums are based on an average age. death benefit only at the first death.

R has a life insurance policy that specifically excludes his death from being covered should it occur in act of war. Where must this be spelled out in the policy?

On the face of the policy This provision stipulates that life insurance policies must include a notice of any war of aviation exclusions. The notice must be prominently displayed on the face of the policy and clearly name and explain the exclusions.

Which of the following documents provides a disclosure of a medicare supplement policy?

Outline of coverage in order to provide complete disclosure, insuers are required to provide an outline of coverage upon policy application The outline must include a desription of the benefits and coverage a statement of renewal provisions and a statement identfies the outlines of coverse.

Which of the following provisions would prevent an insurance company from paying a reimbursment claim to someone other than the policy owner?

Payment of claims

Which of the following is correct concerning the taxation of premiums in a key person life insurance policy?

Premiums are not tax deductible as a business exspense.

On its advertisement a company claims that is has funds in its possesion that are, in fact NOT available for the payment of losses or claims the company is guilty of.

Misrepresentation issuing or circulating any sale materials that is false or misleading would be considered misrepresentation and is illegal.

An insured purchased an insurance policy 5 years ago. Last year, she recieved a dividened check from the insurance company that was not taxable this year she did not recieve a check from the insurer?

Mutual

Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss?

Notice of claim The notice of claim provision spells out the insured's duty to provide the insurer with reasonable notice in the event of a loss.

Which of the following is not among the lines of authority for which an insurance producer may qualify in the state of Missouri?

Group health insurance.

Which of the following is NOT true regarding equity indexed annuities?

They earn lower interest rates than fixed annuities. Equality indexed annuities invest on an aggressive basis in order to yield

The Missouri life and health insurance guaranty association was created to protect all of the following EXCEPT?

Insurers, the Missouri life and health insurance guaranty associaton was created to protect policyowners, beneficiaries, and insureds.

In which of the following situations is it legal to limit coverage based on marital status?

It is never legal to limit coverage based on marital status. Availability of insurance benefits or coverage may not be denied based on sex, marital status. Marital status may be considered for the purpose of defining persons eligible for dependent benefits.

An individual obtained a life insurance policy in March, but 3 months later was deemed clinically insane by the state of Missouri. Five months later the insured takes his own life. What type of death benefits will the policy beneficiary recieve?

No benefits will be received because the policy was not in effect for at least one year, however all premium payments will be returned. Insurer is responsible for a

Methods used to pay the death benefits to a beneficiary upon the insured's death are called?

Settlement options

How long must an insurer retain an advertisement for its long term care policies?

Three years The insurance company must retain all advertisments for at least three years from the data that the advertisement was first used.

When does credit life insurance coverage take effect?

The date the debtor becomes obligated to the creditor. The insurer requires evidence of insurability and that evidence is provided 30 days after the date the debtor becomes obligated to the creditor the term of the insurance begins on the date the company determines the evidence of insurance.

In the event of loss, after a notice of claim is submitted to the insurance, who is responsible for providing claims forms and to which party?

Insurer to the insured upon a receipt of a notice of claim, the company must supply claims forms to the insured within a specific numbers of days.

Which of the following provisions in universal life policies stipulates that a written notice of the termination of coverage must be sent to the policyowner?

Grace period and lapse provision requires that a written notice of the termination of coverage must be sent to the policy owner at least 30 days prior to the termination after policy lapse a grace period of at least 30 days must be provided.

Who makes up the medical information bureau?

Insurers Companies can compare the information they have collected on a potential insured with information other insuers may have discovered.

An insured purchased a life insurance policy. The agent told him that depending upon the company's investments and exspense factor, the cash values could change from those shown in the policy at issue time. the policy is?

Interest sensitive whole life.

Which of the following does not have to be disclosed in a long term care (LTC) policy.

The aggregate amount of premium due ALL LTC policies must disclose and exsplain the renewibility provisions, with regard to life insurance policies that provide an accelerated benefit for (LTC) the policy must include a statement to the effect that receipt of the accelerated benfits may be taxable and that the insured should seek assistance from a personal tax advisor.

Which of the following is true about the requirements regarding HIV exams?

The applicant must give prior informed written consent. A seperate written consent form must be obtained prior to an HIV exam results may be disclosed to underwritters but not to agents.

The primary beneficiary of her husbands life policy found that no settlement option was stated in the policy on the date of her husbands death. Who will select the settlement option in this case?

The beneficiary if a settlement option is not selected by the policyowner before the insured dies, then the beneficiary can choose the option.

What is the purpose of a disclosure statement in life insurance policies?

To explain features and benefits of a proposed policy to the consumer.

Which of the following is NOT required to cover early intrevention services for children?

Medicaid All health carrier and health benefit plans are required.

Under the fair credit reporting act, individuals rejected for insurance due to information contained in a consumer reprt?

Must be informed of the source of the report.

All of the following statements concerning the use of life insurance as an executive bonus are correct? EXCEPT

The policy is owned by the company The policy is owned by the emplyee.

Which of the following is True about nonforfeiture value?

They are required by state law to be included in the policy A table showing the nonforfeiture values for the next 20 years.

All of the following are legitimate reasons for a group health insurance policy Nonrenewal except?

Any misrepresentation by the plan sponsor on the application for insurance. Only fraud of intentional misprepresentation of a material fact will be grounds for policy discontinuance or nonrenewal. In addition, the group plan sponsor must pay timely premium and conply with the with the minimum participant and employer contribution requirements from group health plans.

Under a health Insurance policy, benefits other than death benefits, that have not otherwise been assigned will be paid to?

The Insured