texas life and health
Grace period for month premiums of a health insurance policy is _ days.
10
In a noncontributory plan, _% of *eligible* employees must participate
100
How many days does a viator have to rescind a vatical settlement after receiving the proceeds?
15
Part B coinsurance is _%.
20
Written notice of claim must be submitted to the insurer within _ days.
20
A notice of claim must be given to the insurer/agent by the insured no longer than _ days.
20, unless incapacitated
An insurer must notify the costumer in writing of an investigative consumer report has been requested within _ days of the initial request.
3
When must nonforfeiture benefits begin?
3 years
Cease and Desist orders to be challanged must be requested within _ days.
30
A newborn baby will automatically be covered under a parent's health insurance plan for _ days.
31
The commissioner must evaluate an insurer's financial condition and ability to comply with state laws every _ years.
5
How many days do you have to exercise your cobra right after you become terminated?
60
An insured must wait _ days but no longer than _ years after prove of loss for legal action to be taken against a health insurer to recover on a policy.
60 days and 3 years
_% of eligible employees must be covered for a small employer health insurance plan.
75
A temporary license is considered valid for _ days.
90
The claimant must submit proof of loss within _ days.
90
_ care is for meeting personal needs such as assistance in eating, dressing, or bathing, provided under a doctor's orders but NOT administered by noncertified personnel.
Custodial care
What is the insuring clause? (4)
On the first page of the policy and lists: insured insurance company what kind of losses are covered how much the losses would be compensated
The insurance part of a universal life policy is always _.
annually renewable term
When are the agents required to provide an outline of coverage to an applicant for individual LTC policy?
at the time of policy delivery
Corridor deductible applies between _ and _.
basic and major
_ Sums are percentages of _ sums.
capital principal
3 non forfeiture options:
cash reduced paid up = policy cash value is used to purchase a single premium permanent policy with a reduced face amount extended term = convert to term insurance for the same face amount - this is the automatic one
6 dividend options: these are only for mutual insurance company!
cash reduction of premium accumulate at interest paid up addition = purchases a single premium policy in addition to the face amount of the perm policy; increase death benefit paid up option = dividend collects interest and uses dividend and interest and cash value to pau the policy early 1 year term
What is included on the first page of a medicare supplement policy?
company's right to change premiums renewal provisoin continuation provision
One of the reasons someone purchases life insurance is because it...
creates an immediate estate
When the insure relinquishes control of the policy via mail, the policy is considered _.
delivered
The free look period begins when the policy was _.
delivered not issued
Medicare supplemental policy *does/does not* cover part A deductible.
does not
When must policy outline of coverage be given to the applicant for a LTC policy?
during solicitation
What is mandatory under the Uniform Provisions Law as applied to accident and health policies? (3)
entre contract physical exam and autopsy time limit on certain defenses
What is an impairment rider in a health insurance policy?
excludes coverage for a specific impairment
When a deductive is for two or more family members the deductible is considered a _ deductible.
family
Difference between fixed period and fixed amount?
fixed period - picking a number of years
The guranteed purchase option is also referred to as the _
future increase option
LTC policies issued in this state must be _.
guranteed renewable
is there a waiting period for reinstated health policies?
i chose no
What is the primary source of information that an insurer uses to evaluate an insured's risk for life insurance?
insurance application Why not agent's report?
_ is occasional nursing and rehabilitative care that is ordered by a physician and provided by skilled medical personnel for such things as changing bandage or administering medication
intermediate care
Benefits from BOE insurance *is/is not* taxable.
is benefits are taxable!
Converting coverage from group to individual *is/is not* considered policy replacement.
is not
A whole life policy is surrender fora reduced paid up. What happens to the cash value?
it continues to build/increases
What type of insurance company institutes participating policies?
mutual insurers, NOT stock
Difference between network model HMO and group model HMO?
network usually contracts with 2 or more groups of physicians
Is the owner of a business eligible for coverage under key person?
no
2 death benefit options for universal?
option a = level death benefit option b = increasing death benefit
Who are 3rd party policies written to cover?
policy owners minor children or business associates not nessicarily policy owners who are not insured
The coordination of benefits provision is to...
prevent overinsurance
Which nonforfetiure option gives you longest coverage? the most coverage?
reduced paid up because its whole life extended term (annually renewable; same death benefit)
_ is a maximum out of pocket expense that an insured will have pay for medical expenses in a calendar year?
stop loss
Key person disability income benefits are _.
tax free
The _ has the option of including optional provisions in a health insurance contract?
the insurer
Who doesn't have to sign a health insurance policy?
the insurer insured, applicant, and producer/agent must
What constitutes acceptance when the applicant submits a premium with the application?
the underwriter approves the application
What is the purpose of a benefits schedule??
to state what and how much is covered by the plan
_ life insurance is characterized by a flexible premium.
universal
_ type of life insurance is characterized by use of a separate account.
variable
When must an agent collect a premium?
when the agent delivers the policy
Can joint life and survivorship policies cover more than one life?
yes