2

In order to reduce the premium to the lowest monthly amount on his disability income policy, the insured could choose 1. A shorter elimination period and a longer benefit period. 2. A longer elimination period and a longer benefit period. 3. A shorter elimination period and a shorter benefit period. 4. A longer elimination period and a shorter benefit period.

A longer elimination period and a shorter benefit period.

Which of the following persons would qualify for Medicare Part A?1. Anyone living in the United States over age 65 2. Anyone who has permanent kidney failure 3. Medicaid recipients 4. Veterans

Anyone who has permanent kidney failure

An agent accepts the premium payment 35 days after it is due, telling the insured that the policy will continue to remain in force. This is an example of what type of agent authority? 1. Implied 2. Apparent 3. Express 4. Fiduciary

Apparent

HMOs operate on what basis? 1. Capitated 2. Stop-loss 3. Community rating 4. Deductible

Capitated

Which of the following is true regarding commission sharing by insurance agents? 1. Commissions can only be shared with a person authorized and licensed in the same line of authority. 2. Commissions can only be shared among agents appointed by the same insurer. 3. An agent can share commissions with any person who helped solicit or negotiate the insurance contract. 4. An agent can never share a commission with another agent.

Commissions can only be shared with a person authorized and licensed in the same line of authority.

Which of the following types of health insurance options will generally cover any sickness or accidents? 1. Government medical plan 2. Franchise insurance 3. Accident-only policy 4. Comprehensive policy

Comprehensive policy

Under which of the following circumstances may the uniform individual accident and sickness policy provisions be changed? 1. If the change is more favorable to the policyholder 2. If the change is signed by both the agent and the policyholder 3. If approved by the company's board of directors 4. Under no circumstances.

If the change is more favorable to the policyholder

The Time Limit on Certain Defenses provision is the same as which of the following? 1. Reinstatement 2. Free look 3. Incontestability 4. Grace period

Incontestability

Which of the following principles describes restoring the insured to his or her original financial status after a loss? 1. Indemnity 2. Warranty 3. Utmost good faith 4. Reasonable expectations

Indemnity

Which of the following is NOT a metal level plan available on the insurance exchange? 1. Silver 2. Bronze 3. Iron 4. Gold

Iron

Which of the following types of health policies cover medical and hospital expenses, and have deductibles, coinsurance and high maximum limits? 1. HMOs 2. Basic medical policies 3. Major medical policies 4. Indemnity policies

Major medical policies

Who are the owners of a mutual insurance company? 1. Fraternal benefit societies 2. Shareholders 3. Policyholders 4. Brokers

Policyholders

An insured owns a disability policy and is in an accident which leaves him permanently blind. Which of the following provisions in a disability policy would qualify the insured for benefits, even if the insured is able to resume working? 1. Any Occupation 2. Rehabilitation Benefit 3. Presumptive Disability 4. Residual Disability

Presumptive Disability

HMOs help reduce the cost of health care by providing 1. Major medical services. 2. Preventive care. 3. Limited health services. 4. Primary care.

Preventive care.

What are the terms used to define the amount of benefit paid in a disability policy that contains an Accidental Death and Dismemberment (AD&D) rider? 1. Double indemnity and triple indemnity 2. Complete benefit and partial benefit 3. Principal sum and capital sum 4. Primary sum and secondary sum

Principal sum and capital sum

Statements made by an applicant for an insurance policy that are true to the best of the applicant's knowledge are referred to as 1. Material information. 2. Indemnity. 3. Warranties. 4. Representations.

Representations.

Long-term care (LTC) coverage may be provided by any of the following EXCEPT 1. Group LTC policy. 2. Rider to life insurance. 3. Rider to Medicare Part A. 4. Individual LTC policy.

Rider to Medicare Part A.

For which of the following reasons can the Department of Financial Services issue a temporary license? 1. Servicing existing business 2. Partnering with a licensed agent 3. Licensing a business entity 4. Soliciting new business

Servicing existing business

To be eligible for coverage under the Health Insurance Marketplace, an applicant must meet all of the following qualifications EXCEPT 1. Not be currently incarcerated. 2. Have been previously insured by a private insurer. 3. Live in the United States. 4. Be a U.S. citizen, national, or be otherwise lawfully present.

The pool of risks covered by a policy form.

What is the required minimum notice to the producer for a hearing regarding a violation of the rules of unfair methods of competition? 1. 7 days 2. 10 days 3. 15 days 4. 20 days

10 days

If an insurer pays compensation to an agent for the sale of a Medicare supplement policy, the first-year commission CANNOT exceed what percentage of the renewal commission for servicing the policy in the second policy year? 1. 10% 2. 50% 3. 100% 4. 200%

200%

Under the Affordable Care Act (ACA), what is the maximum age for a child of an insured to be covered under the insured's plan? 1. 18 2. 20 3. 23 4. 26

26

The maximum period of time an employee may be entitled to benefits through the New York State Disability Program is 1. 5 months per year. 2. 26 weeks during 52 consecutive calendar weeks. 3. 2 years. 4. 60 days during 12 consecutive months

26 weeks during 52 consecutive calendar weeks.

What is the minimum required annual benefit level increase in long-term care policies to protect the insured from inflation? 1. 2% 2. 3% 3. 5% 4. 8%

5%

How long is a temporary license valid in New York? 1. 30 days 2. 90 days 3. 6 months 4. 1 year

90 days

Which of the following is a requirement for standard Medicare supplement plans? 1. Plan A is optional. 2. All plans must offer the core benefits. 3. Core benefits are only required in Plan A. 4. Plans A through N are mandatory.

All plans must offer the core benefits.

If both parents have family coverage on their respective group health plans, and both of the plans include a coordination of benefits clause, which of the following methods would be used to split a claim payment for a covered child? 1. Gender rule 2. Pro-rata 3. Birthday rule 4. Equal shares

Birthday rule

Which of the following types of group health insurance is characterized by not naming the covered persons on the application or the policy? 1. MEWA 2. Blanket 3. Association 4. Credit health

Blanket

Which of the following disability policies will cover business' rent or employee salaries following the owner's disability? 1. Business overhead expense policy 2. Key-person disability policy 3. Disability buy-sell policy 4. Short-term disability policy

Business overhead expense policy

All of the following features of a medical plan are expressed as a set dollar amount EXCEPT 1. Copay. 2. Deductible. 3. Stop-loss 4. Coinsurance.

Coinsurance.

Which of the following statements is true regarding common exclusions from health coverage? 1. If a person is injured while committing a crime, the health plan will only cover emergency room care. 2. Pre-existing conditions are permanently excluded from group health policies. 3. Injuries incurred at a workplace will be paid by the insured's health plan. 4. Cosmetic dental surgery may be paid by health insurance if the surgery is necessary due to an accident.

Cosmetic dental surgery may be paid by health insurance if the surgery is necessary due to an accident.

When can an employee join a group health plan without providing evidence of insurability? 1. During a probationary period 2. Any time, as long as the employee is not adding dependents 3. Twice a year, during a 30-day enrollment period 4. During an open-enrollment period

During an open-enrollment period

An insured has a disability policy. After becoming disabled, the insured must wait 90 days before qualifying for benefits. This timeframe is called the 1. Elimination Period. 2. Gap Period. 3. Benefit Period. 4. Probationary Period.

Elimination Period.

Which of the following standards is used to determine premium rates under the Affordable Care Act (ACA)? 1. Alcohol use 2. Family composition 3. Medical history 4. Employment

Family composition

What provision allows a person to pay an insurance premium after it is due? 1. Consideration 2. Automatic premium extension 3. Late payment 4. Grace period

Grace period

All of the following are characteristics of group health insurance EXCEPT 1. Individual insureds receive certificates of insurance. 2. Groups may be formed for the purpose of purchasing insurance. 3. A group contract is between an insurer and a group sponsor. 4. Only one policy is issued for the entire group.

Groups may be formed for the purpose of purchasing insurance.

Under which of the following provisions does the insured have the right to renew the policy for the life of the contract, while the insurance company may increase the premiums on a class basis only? 1. Guaranteed irrevocable 2. Comprehensive 3. Noncancellable 4. Guaranteed renewable

Guaranteed renewable

In order to qualify for Medicaid, the applicant must 1. Have dependents. 2. Be over the age of 65. 3. Have a specified illness or disability. 4. Have income below the Federal Poverty Level.

Have income below the Federal Poverty Level.

In an HMO policy, one of the main responsibilities of the primary care physician (PCP) as a gatekeeper is to do which of the following? 1. Keep regular office hours 2. Seek alternative treatments for patients 3. Help run the HMO 4. Help control costs

Help control costs

Which of the following is NOT covered under Medicare Part B? 1. Hospital room and board charges 2. Outpatient services 3. Ambulance fees 4. Physician services

Hospital room and board charges

All of the following statements regarding Medicare Supplement insurance are true EXCEPT 1. There is an open enrollment period of 6 months after the applicant signs up for Medicare Part B. 2. Medicare Supplement policies A-N must offer the core benefits. 3. Medicare Supplement policies require premiums for additional benefits. 4. Insurers use the traditional risk rating of preferred, standard, and substandard in underwriting.

Insurers use the traditional risk rating of preferred, standard, and substandard in underwriting.

Which of the following is true about Medicaid? 1. It is administered by the Centers for Medical Services. 2. It is health insurance for the elderly. 3. It is funded by the state and the federal government. 4. It includes Medicare Part A and Part B only.

It is funded by the state and the federal government.

The term "subscriber" is most commonly associated with which type of medical plan? 1. Managed care 2. Major medical 3. Limited health 4. Community rated

Managed care

All of the following are common exclusions in health insurance policies EXCEPT 1. Medically necessary cosmetic surgeries. 2. Injuries incurred at a workplace. 3. Active military duty. 4. Medicare-eligible expenses.

Medically necessary cosmetic surgeries.

A surgeon developed a disability and can no longer perform surgeries. However, he is able to teach medicine at the university. He is most likely to collect disability benefits if his disability policy uses which definition of disability? 1. Own occupation 2. Key-person disability 3. Any occupation 4. Workers compensation

Own occupation

Which of the following is a characteristic of PPOs? 1. PPOs provide care on a prepaid basis. 2. Plan members who use the services of an in-network facility will pay a lower amount. 3. Plan members must use the facilities in their assigned PPO. 4. Plan members are required to select a primary care physician.

Plan members who use the services of an in-network facility will pay a lower amount.

What is a primary difference between an HMO and a traditional insurance company? 1. The HMO is financed primarily through the government, while traditional companies receive their funding from premium payments. 2. Traditional companies receive their funding from a combination of premiums and government subsidies. 3. HMOs receive their funding from a combination of premiums and government subsidies. 4. The HMO provides both the financing and patient care for its members, while traditional companies provide the financing only.

The HMO provides both the financing and patient care for its members, while traditional companies provide the financing only.

When an insured chooses the indemnity method of benefit payment, the insurer will pay 1. Up to 80% of the usual and reasonable daily rate. 2. The amount of the actual expenses incurred. 3. The fixed benefit amount, regardless of the actual charge. 4. Up to 100% of the usual and reasonable daily rate.

The fixed benefit amount, regardless of the actual charge.

Which of the following is true regarding Guaranteed Renewable health insurance policies? 1. Rates may be changed individually only. 2. They must be renewed if the insured pays the premium. 3. Rates may never be changed. 4. They are renewable indefinitely

They must be renewed if the insured pays the premium.

When does the free-look period begin in insurance policies? 1. When the policy is delivered 2. When the insured pays the first premium 3. When the underwriters approve the application 4. When a signed application is submitted to the insurer

When the policy is delivered

If an employee is injured on the job, which of the following will NOT be a standard benefit through Workers Compensation? 1. Rehabilitation benefits 2. Caregiver benefits 3. Death benefits 4. Medical benefits

Caregiver benefits

All of the following characteristics are required in order to establish a group health plan for an association EXCEPT 1. The plan must be contributory. 2. The group must have been active for at least 2 years. 3. Group members must hold annual meetings. 4. The group must have at least 100 members.

The plan must be contributory.

In insurance policies, the entire contract is made up of which of the following? 1. The policy and a copy of the application, stapled together 2. The policy, and copies of the sales presentations 3. Parts 1 and 2 of the application, and the agent's report 4. The policy and the outline of coverage

The policy and a copy of the application, stapled together

The community rating in health insurance is based on 1. Morbidity and mortality. 2. The pool of risks covered by a policy form. 3. The age and gender distribution of a covered group. 4. The age and health status of the members of a community.

The pool of risks covered by a policy form.

What type of consideration does the proposed insured offer to an insurance company? 1. Competent parties and the premium 2. The premium and a legal purpose 3. Insurable interest plus the premium 4. The premium plus the statements in the application

The premium plus the statements in the application