Comprehensive Exam
An insured should receive necessary claim forms within _____ days after notice of claim. A 15 B 20 C 5 D 10
A 15 According to the Claim Forms Provision (a Mandatory Uniform Provision), the insured should receive the necessary claim forms within 15 days after notice of claim.
The Time Limit on Certain Defenses (Incontestable) period is _____ years under individual health and disability contracts. A 2 B 5 C 7 D 3
A 2 The Time Limit on Certain Defenses (Incontestable) period is 2 years.
Which of the following is a typical benefit period for a group short-term disability benefit? A 52 weeks B 5 years C 2 years D To age 65
A 52 weeks Short-Term Disability Income plans are characterized by maximum benefits for periods of rather short duration, such as 13, 26, or 52 weeks.
If the insured is receiving regular disability income payments, the insurer can require notice of continuance of claim every ______ months. A 6 B 3 C 12 D 9
A 6 If the insured is receiving regular disability income payments, the insurer can require notice of continuance of claim every 6 months.
Which of the following is true of Limited Health Service Organizations? A A person soliciting LHSO coverage must hold either a limited insurance representative's license or a health producer's license B A person soliciting LHSO coverage must hold a limited insurance representative's license C A person soliciting LHSO coverage must hold a health producer's license D A person soliciting LHSO coverage does not need to be licensed
A A person soliciting LHSO coverage must hold either a limited insurance representative's license or a health producer's license A person soliciting LHSO coverage must hold either a limited insurance representative's license or a health producer's license.
Which of the following types of riders would require signed acceptance by the insured if it was added after the base policy is issued? A A rider to reduce coverage under the policy B A rider requested in writing by the insured C A rider designed to exercise a specific, reserved right D A rider needed to avoid duplication of Medicare benefits
A A rider to reduce coverage under the policy Riders or endorsements added to a policy after the date of issue that reduce or eliminate coverage require signed acceptance by the insured.
Which of the following statements is false concerning disclosure requirements? A A soliciting producer's name and signature must be on an individual or group life or health policy B A policy solicited by a producer must identify the name of the firm C A soliciting producer's name and signature must be on an application for individual or group life or health coverage D A policy solicited by a producer must identify the name of the producer
A A soliciting producer's name and signature must be on an individual or group life or health policy A soliciting producer's name and signature must be on an application for individual or group life or health coverage, not on the actual policy.
Which of the following is NOT correct regarding required time periods? A An insurer must provide any necessary claim forms within 30 days B An insurer must give the claimant a reasonable written explanation of the settlement or denial of a claim within 30 days after determining liability C An insurer must reply to all pertinent communications within 15 days D An insurer must pay a claim within 30 days after determining that the loss is covered
A An insurer must provide any necessary claim forms within 30 days An insurer must provide any necessary claim forms within 15 days.
Which of the following is NOT an example of a prohibited practice? A Backdating B Defamation C Misrepresentation D Rebating
A Backdating Backdating the age of an insured by no more than 6 months to save age is not an example of a prohibited practice.
With Long-Term Care Insurance coverage, the longer the _________is, the higher the premium is. A Benefit Period B Waiting Period C Preexisting Period D Elimination Period
A Benefit Period A long benefit period is more costly to the insurer. Therefore, the premium is higher.
_______________ Major Medical insurance coverage combines the features of the Basic Medical Expense policies and a Major Medical policy into a single policy and includes reimbursement for covered expenses on a 'usual, customary, and reasonable' basis. A Comprehensive B Exclusive C Inclusive D Intensive
A Comprehensive Comprehensive Major Medical insurance coverage combines the features of the Basic Medical Expense policies and a Major Medical policy into a single policy and includes reimbursement for covered expenses on a 'usual, customary, and reasonable' basis.
Which type of insurance policy combines Basic Medical Expense Coverage with Major Medical Coverage? A Comprehensive Major Medical B Hospital Expense C Supplemental Major Medical D Surgical Expense
A Comprehensive Major Medical A Comprehensive Major Medical Policy combines the best features of the Basic Medical Expense policies and a Major Medical policy into a single policy that provides the most complete medical expense coverage.
Which of the following is a Managed Care Provision used by insurers to monitor hospital stays? A Concurrent Review B Retrospective Review C Prospective Review D Precertification
A Concurrent Review Once an insured is admitted to the hospital, the insurer monitors the insured's hospital stay to make certain that everything is proceeding on schedule through the Concurrent Review Provision.
Which of the following is NOT an unfair claims practice? A Failure to instruct an insured in how to file a claim B Neglecting to investigate a claim fully before denying it C Requiring duplicate submissions of proof of loss documentation D Failing to adopt claims settlement standards
A Failure to instruct an insured in how to file a claim An insurer is not required to notify or instruct an insured on when or how to file a claim.
To be eligible for Social Security disability the insured worker must be: A Fully insured B Eligible for Workers' Compensation C Paralyzed D Partially disabled
A Fully insured To be eligible for Social Security disability, the insured worker must be fully insured. Some Social Security benefits are payable to a worker that is currently insured, but the other choices do not apply to Social Security.
All are types of service plans, except: A Indemnity Plans B POSs C HMOs D PPOs
A Indemnity Plans HMOs, PPOs, and POSs are all types of service plans (i.e., those in which the insurer contracts with service providers in advance to control costs). An indemnity plan not a service plan.
Which of the following statements is false with regard to marketing practices? A It is an unfair practice to refuse to issue a policy due to an applicant's occupation B An insured's misrepresentation will void a policy only if the misrepresentation was intended to deceive the insurer or materially affects the acceptance of the risk C Misrepresenting a policy's terms, benefits, or dividends is punishable by a fine of $100 to $5,000 D It is an unfair practice to imply that a governmental agency guarantees or approves an insurer
A It is an unfair practice to refuse to issue a policy due to an applicant's occupation Refusing to issue a policy due to an applicant's occupation is an acceptable practice.
Any policy designed to provide coverage for not less than 12 consecutive months for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than an acute care unit of a hospital is the definition of: A Long-Term Care B Custodial Care C Home Convalescent Care D Residential Care
A Long-Term Care The question gives the definition of Long-Term Care.
Which of the following is a common exclusion in a medical expense plan: A Loss due to Workers' Compensation B Minor surgical procedure C Loss due to an accident D Office visit expense
A Loss due to Workers' Compensation Typical exclusions include preexisting conditions, intentionally self-inflicted injuries, war or any act of war, elective cosmetic surgery, medical expenses payable under Workers' Compensation, military service and overseas residence, coverage payable under a governmental plan, and losses due to the commission or attempt of a felony.
Precertification, Mandatory Second Surgical Opinion, and Concurrent Review are provisions in health insurance policies known as: A Managed Care Provisions B Extra-Legal Actions Provisions C Miscellaneous Provisions D Oversight Provisions
A Managed Care Provisions They are included as Managed Care Provisions or sometimes referred to as Cost Containment Provisions.
Which provision is an Optional Uniform Provision? A Misstatement of Age B Payment of Claims C Physical Examination D Claim Forms
A Misstatement of Age Misstatement of Age is an Optional Uniform Provision. All of the other answers are Mandatory Uniform Provisions.
Which statement is incorrect concerning Part B of Medicare? A Part B covers prescription drugs up to $1,500 annually B Part B will cover vaccines and preventive screenings C Part B has an annual deductible and requires a copayment D All Part B recipients pay a monthly premium
A Part B covers prescription drugs up to $1,500 annually Medicare Part B does not cover prescription drugs at all. Part A would cover them but only while hospitalized. All other possible answers are correct concerning Medicare Part B.
Which provision is an Optional Uniform Provision? A Relation of Earnings to Insurance B Physical Examination C Claim Forms D Payment of Claims
A Relation of Earnings to Insurance Relation of Earnings to Insurance is an Optional Uniform Provision. The other choices are Mandatory Uniform Provisions.
A long-term care policy is prohibited from: A Terminating due to the insured's age or deterioration of the insured's health B Requiring a prior institutional stay of 30 days as a condition for receiving non-institutional benefits C Excluding coverage for up to 6 months for a pre-existing condition for which medical advice or treatment was recommended by or received within 6 months before the effective date of coverage D Providing the same coverage for skilled nursing facility care as for lower levels of care
A Terminating due to the insured's age or deterioration of the insured's health A long-term care policy is prohibited from providing more coverage for skilled nursing facility care than for lower levels of care; excluding coverage for more than 6 months for a pre-existing condition for which medical advice or treatment was recommended by or received within 6 months before the effective date of coverage; or requiring a prior institutional stay of more than 30 days as a condition for receiving non-institutional benefits.
Which of the following is NOT correct regarding Premium Fund Trust Accounts? A The premium fund trust account must be with any U.S. financial institution B Any prohibited withdrawals from the account constitute misappropriation of funds C Producers maintaining a premium fund trust account must pay or credit any return premiums to the insured within 15 days after receipt D The premium fund trust account must be maintained for 7 years
A The premium fund trust account must be with any U.S. financial institution The premium fund trust account must be with a financial institution in Illinois.
Which of the following is not a Mandatory Uniform Provision of an Accident and Health policy? A Waiver of Premium B Proof of Loss C Time Limit on Certain Defenses D Payment of Claims
A Waiver of Premium The other choices are Mandatory Uniform Provisions. Waiver of Premium is a provision that may or may not be included.
An evaluation of Simon's past earnings reveals his average earned monthly income to be about $4,000. The greatest amount of benefit that Simon will likely be able to purchase under a Disability Income Policy, in order to reduce malingering in the event of a claim, is: A $4,000 monthly B $2,500 monthly C $2,000 monthly D $1,000 monthly
B $2,500 monthly Benefits are usually determined as a percentage of the insured's current earnings, normally 60 to 70%. Simon would be unlikely to obtain 100% of his income as a disability benefit.
The right of return (free look) provision for individual health policies allows for a full refund of premium if the insured cancels the policy for any reason, within how many days? A 30 B 10 C 5 D 20
B 10 The individual policy must state a right of return for full premium for any reason (Free Look) within 10 days.
COBRA applies to employers with: A 10 or fewer employees B 20 or more employees C 2 to 50 employees D 51 or more employees
B 20 or more employees COBRA states that employers with 20 or more employees must provide a health coverage continuation option to all covered employees and dependents.
In Illinois, the Continuing Education requirement is: A 16 hours every year B 24 hours every 2 years C 32 hours every 2 years D 12 hours every year
B 24 hours every 2 years In Illinois, 24 hours of approved CE courses are required, 3 of which must consist of classroom instruction on ethics.
Coverage of dependent children will continue under federal law until the child reaches the limiting age of: A 18 B 26 C 21 D 29
B 26 Federal law requires that every policy providing coverage for a dependent child extends coverage up to age 26 (through age 25).
A producer whose license has been suspended may not reapply for: A 15 years B 3 years C 6 months D 1 year
B 3 years An individual whose license is denied or revoked may not reapply for a license for 3 years.
A Long-Term Care plan may deny coverage for preexisting conditions for no more than how many months after the effective date of coverage? A 24 B 6 C 12 D 0
B 6 A Long-Term care policy may not deny coverage for preexisting conditions for more than 6 months after the effective date of coverage.
In a Medicare Supplement replacement sale, if the original policy has been in force for less than ______ months, the replacing insurer shall waive any time periods applicable to preexisting conditions to the extent that they have already been satisfied under the original policy. A 9 B 6 C 12 D 3
B 6 In a Medicare Supplement replacement sale, if the original policy has been in force for less than 6 months, the replacing insurer shall waive any time periods applicable to preexisting conditions to the extent that they have already been satisfied under the original policy.
Which of the following statements is false regarding required provisions for Medicare supplement policies? A If a Medicare supplement policy is terminated by a group policyholder and is not replaced, the insurer must offer certificate holders an individual Medicare supplement policy B A Medicare supplement policy may not deny coverage for preexisting conditions for more than 12 months after the effective date of coverage C Medicare supplement policies must be guaranteed renewable D An insurer may not cancel or nonrenew a Medicare supplement policy solely based on the insured's health status
B A Medicare supplement policy may not deny coverage for preexisting conditions for more than 12 months after the effective date of coverage A Medicare supplement policy may not exclude pre-existing conditions for more than 6 months from the effective date of coverage. The policy or certificate may not define a pre-existing condition more restrictively than a condition for which medical advice was given or treatment was recommended or received from a physician within 6 months before the effective date of coverage.
The following license fees are required in Illinois, except: A A temporary producer license: $50 (one-time fee) B A business entity license: $150 annually C A limited line producer license: $50 annually D An insurance producer license: $180 payable every 2 years
B A business entity license: $150 annually The business entity license of $150 is payable biennially.
A temporary license may be issued for 180 days when necessary to service existing insurance business to all of the following, except: A The surviving spouse of a deceased producer B A college student who does not have time to take the prelicensing exam C The designee of a producer entering active duty in the U.S. Armed Forces D An employee of a business entity when the designated producer becomes disabled
B A college student who does not have time to take the prelicensing exam A temporary license is issued for the purpose of preparing to sell the business, allow time for a producer to recover from a disability and return to work, to provide time for hiring and training licensed personnel, or for a temporary period while the producer is on active duty.
The Director may take all of the following actions, except: A Make reasonable rules and regulations to enforce the Insurance Code B Amend the insurance code as needed C Issue a Cease and Desist order D Subpoena witnesses
B Amend the insurance code as needed The Director may write new rules and regulations, but changes in the Code are a change in law and must be done by the Legislature.
The Director is: A Elected through public nominations B Appointed by the Governor C Appointed by the State Senate D Appointed by the President of the NAIC
B Appointed by the Governor The NAIC does not appoint any insurance directors. The State Senate does not appoint government officials. The Director is not elected, but is appointed by the Governor.
All of the following qualifications are required for a producer license, except: A Pass an examination, unless exempt B Be at least 21 years of age C Complete a prelicensing course D File a bond, unless exempt
B Be at least 21 years of age An individual must be at least 18 years of age.
If the premium is paid at the time of application, the agent will provide the applicant with a: A Free look notice B Conditional receipt C Claim form D Statement of good health
B Conditional receipt The agent will provide a conditional receipt if the premium is paid by the applicant at the time of application.
producer may be placed on probation or have their license revoked or suspended by the Director for which of the following? A Unknowingly accepting business from an unlicensed individual B Failing to pay court-ordered child support C A minor traffic violation D Demonstrating trustworthiness and financial responsibility in the conduct of business
B Failing to pay court-ordered child support Failing to pay court-ordered child support is grounds for being put on probation, license revocation, suspension, or nonrenewal.
A nonprofit corporation without capital stock formed solely for the benefit of its members is a: A Unauthorized insurance association B Fraternal benefit society C Stock insurer D Mutual company
B Fraternal benefit society A fraternal benefit society is a nonprofit organization formed solely for the benefit of its members and transacts insurance only for its members.
All of the following are accurate statements, except: A The group must be a natural group B Group insurance normally covers occupational injury or disease C In group insurance, the contract is between the employer and the insurer D In group insurance, the employer receives a Master Policy and each employee receives a Certificate of Insurance
B Group insurance normally covers occupational injury or disease Group insurance normally covers nonoccupational injury or disease. Workers' Compensation Insurance is designed for occupational injury and disease.
Sylvia is a participant in a Preferred Provider Organization and finds that if she opts to use a provider outside the network: A Her PPO will cover any charges in full B Her PPO will pay a reduced amount with Sylvia paying the balance C Her PPO will not pay at all D Her PPO will pay only if the circumstances for care were precipitated by an emergency
B Her PPO will pay a reduced amount with Sylvia paying the balance Sylvia's PPO will provide the maximum benefit when she uses in-network providers.
One of your clients just reinstated an Accident and Health policy. When is coverage effective? A In 10 days for accident and in 48 hours for sickness B In 10 days for sickness and immediately for accidental injuries C In 30 days for sickness, immediate coverage for accidents D Immediately for both accident and sickness
B In 10 days for sickness and immediately for accidental injuries Upon reinstatement, accidents are covered immediately, and sickness is covered after 10 days.
Which clause in a contract would state that Jim is covered by XYZ insurer for a monthly benefit of $2,000 in the event of disability? A Entire Contract B Insuring Clause C Consideration Clause D Free Look Provision
B Insuring Clause The Insuring Clause states who is covered, by whom, for how much, for what period, and against what peril.
The Insuring Clause under an individual A&H policy would contain all the following, except: A What perils are covered B Premium or rate calculations C The length of the policy period D The name of the insured and insurer
B Premium or rate calculations Premiums or rates would be part of the Consideration Clause. All of the other answers would be part of the Insuring Clause.
If a change or correction must be made on the application for insurance, which of the following applies? A A change cannot be made once the application is signed B The Producer can make the change and have the insured initial the change C The producer can make and initial the change at any time prior to submitting the application D The change must be made in red ink
B The Producer can make the change and have the insured initial the change If a mistake is made on the application, the producer can make the change and have the applicant initial that change. The producer cannot make changes on the application without the applicant's knowledge or initials.
With a Business Overhead Expense Policy, all of the following are claims that are covered, except: A Utilities B The salary or profit of the business owner C Employee labor D Office rent
B The salary or profit of the business owner A Business Overhead Policy does not pay the owner's salary or profit. Virtually all other financial aspects of running a business are covered.
Notice of claim is required within _____ days of loss. A 10 B 15 C 20 D 90
C 20 Under the Notice of Claim Provision (a Mandatory Uniform Provision), the insured is required to notify the insurer, in writing, within 20 days of any loss.
Which of the following correctly describes the difference between a HMO and a Limited Health Service Organization (LHSO)? A Group contracts must provide health services for at least 12 months B The complaint process C A LHSO provides limited health care plans D The risk that is borne
C A LHSO provides limited health care plans The complaint process, the risk that is borne, and the 12-month coverage requirement are similarities between a HMO and a LHSO. The difference is that a LHSO provides limited health care plans.
Which of the following statements is false regarding examinations by the Director? A The Director must disclose an examination report to the examinee before making the report public B The examinee must pay all expenses for the examination C A person who adjusts losses is not subject to examination D Anyone violating a written order as a result of an examination may be fined up to $10,000
C A person who adjusts losses is not subject to examination A person who adjusts losses is subject to examination by the Director.
Which of the following is correct regarding a temporary license? A A temporary license may be issued for up to 180 days after successfully completing the licensing examination B The duration of a temporary license may not exceed 80 days C A temporary license may be issued to the surviving spouse of a disabled or deceased producer D A temporary license may not be extended
C A temporary license may be issued to the surviving spouse of a disabled or deceased producer The duration may be for up to 180 days without an examination, and a temporary license may be extended for an additional 180 days.
Which of the following types of coverage must provide at least 80% of the charges for semi-private room accommodations, or $100 per day? A Accident Only B Basic Medical-Surgical Expense C Basic Hospital Expense D Major Medical
C Basic Hospital Expense Basic Hospital Expense coverage must provide at least 80% of the charges for semi-private room accommodations, or $100 per day.
Which of the following is not a Mandatory Uniform Provision? A Payment of Claims B Physical Exam and Autopsy C Conformity with State Statutes D Reinstatement
C Conformity with State Statutes Conformity with State Statutes is an Optional Uniform Provision.
Which of the following is considered a qualified expense from a Flexible Spending Account? A Long-term care coverage B Amounts covered under another plan C Dental expenses D Insurance premiums
C Dental expenses Insurance premiums, long-term care coverage, and amounts covered under another plan are not qualified expenses.
Which of the following is NOT an unfair claims practice? A Misrepresenting pertinent policy facts or provisions to claimants B Requiring an insured to sue by offering less than the amount due C Failing to inform a claimant about appealing arbitration awards D Attempting to settle claims on the basis of an altered application
C Failing to inform a claimant about appealing arbitration awards 'Failing to inform a claimant about appealing arbitration awards' is not an unfair claim practice. All other answers are unfair claim practices.
The National Association of Insurance Commissioners (NAIC): A Enacts legislation and policy B Requires only 30 Commissioners to be members at any time C Has no legal authority over insurance regulation D Requires each legislature to accept recommendations
C Has no legal authority over insurance regulation The NAIC does not have legal authority over insurance regulation, but promotes uniformity in the interpretation of insurance legislation and regulation.
Which of the following does Medicare Part A help pay for? A The first 3 pints of blood B Outpatient services C Inpatient hospitalization D Routine physical exams
C Inpatient hospitalization Medicare Part A provides coverage for up to 90 days of inpatient hospitalization per benefit period.
Optional uniform provisions found in health insurance policies are designed to protect the: A Producer B Agency C Insurer D Insured
C Insurer Optional Uniform Provisions are designed to protect the insurer.
The Insurance Director: A Is appointed by the Legislature B Is elected to a 4-year term C Is appointed by the Governor D Is elected to a 2-year term
C Is appointed by the Governor The Insurance Director is appointed by the Governor.
The Director may revoke, suspend, or refuse to renew a license for all the following, except: A Had a license suspended or revoked in another state B Been convicted of a felony C Issued insufficient coverage to a customer through apparent authority D Acted as an insurance agency through persons not licensed as producers
C Issued insufficient coverage to a customer through apparent authority If a licensee issues insufficient coverage to an individual through apparent authority, this is not grounds for license suspension, non-renewal or revocation. Being convicted of a felony, having a license suspended or revoked in another state and acting as an insurance agency through persons not licensed as producers are all grounds for license suspension, non-renewal or revocation.
All of the following are true regarding the Life and Health Insurance Guaranty Association, except: A The Association is not liable for more than $300,000 in the aggregate for any one life B Other member insurers are assessed to provide money for the claims of an insolvent insurer C It covers HMOs D It prevents financial loss to policyholders when an insurer becomes insolvent
C It covers HMOs The Life and Health Insurance Guaranty Association does not cover HMOs.
What is an impairment rider? A It pays out an additional benefit if the insured cannot perform 2 of the 5 specified functional activities B It guarantees the insured's future insurability C It excludes specific conditions that normally would cause the entire policy to be declined D It pays out an additional benefit in cases where the cause of loss is a result of an accident
C It excludes specific conditions that normally would cause the entire policy to be declined An impairment rider is a rider added to a policy that will exclude specific conditions that would normally cause a policy to be declined. The use of this rider allows an insured to qualify for a policy with the exclusion attached, where they would otherwise be declined altogether.
A licensed producer may do all of the following with respect to the line of authority for which they are licensed, except: A Solicit and negotiate an insurance contract B Provide advice regarding the benefits of a policy C Pay claims D Counsel an insurance applicant by explaining the advantages and disadvantages of a policy
C Pay claims A licensed producer may sell, solicit, or negotiate insurance, but it's the insurance company that actually pays claims.
An insurer has the right to request a physical exam or an autopsy to determine its liability to pay benefits. This request may be made under which provision? A Intoxicants and Narcotics B Proof of Loss C Physical Exam & Autopsy D Proof of Disability or Death
C Physical Exam & Autopsy According to the Physical Exam and Autopsy Provision (a Mandatory Uniform Provision), the insurer, at its own expense, has the right to request a physical exam or autopsy where not prohibited by law
The principal objectives of a HMO include all of the following, except: A Reducing the average number of days per hospital visit B Keeping patients well with preventative medicine C Providing only inpatient medical care D Reducing unnecessary hospital admissions
C Providing only inpatient medical care The principal objectives of an HMO are to reduce medical expenses by emphasizing preventive medicine, reducing the number of unnecessary hospital admissions, reducing the average number of days per hospital visit, reducing duplication of benefits, and saving on administrative costs.
Medicare is available to individuals who have been receiving ______________ benefits for 24 months. A Workers' Compensation B Medicaid C Social Security Disability D Long-Term Care
C Social Security Disability Medicare is available to individuals regardless of age if they have received Social Security disability benefits for 24 months.
What is the result of an insured not receiving a claim form within the time period allotted after submitting a notice of claim? A The claim is automatically accepted B The claim is automatically denied C The insured can submit written proof of the loss D The insurer must add a 10% penalty to any amount eventually paid
C The insured can submit written proof of the loss The claim form must be received by the insured from the company within 15 days after notice of claim. If forms are not furnished, the insured may submit written proof of occurrence, character, and extent of loss.
High Deductible Health Plans (HDHPs) are characterized by which of the following? A Once the deductible is paid, the plan pays at 100% B To qualify as a HDHP, the plan must have an HSA associated with it C The premiums are significantly lower than other plans D Medical expenses are available as first dollar coverage
C The premiums are significantly lower than other plans The premiums payable for a HDHP are significantly lower than other plans, but the insured is responsible for paying more out-of- pocket.
A Group Health plan may deny coverage for preexisting conditions for no more than how many months after the effective date of coverage? A 24 B 0 C 6 D 12
D 12 A group health plan may impose a preexisting condition exclusion for a period of not more than 12 months (or 18 months in the case of a late enrollee) after enrollment, reducible by any applicable creditable coverage (prior coverage which ended less than 63 days before the enrollment date of the new policy).
A licensee must report being convicted of a felony to the Director within: A 10 days after the judgment's entry date B 90 days after the judgment's entry date C 60 days after the judgment's entry date D 30 days after the judgment's entry date
D 30 days after the judgment's entry date A licensee must report being convicted of a felony to the Director within 30 days after the judgment's entry date.
Which of the following is the correct number of days in the grace period for each premium mode? A 10 days for weekly, 15 days for monthly, 31 for all others B 10 days for weekly, 15 for all others C 7 days for weekly, 10 days for monthly, 28 for all others D 7 days for weekly, 10 days for monthly, 31 for all others
D 7 days for weekly, 10 days for monthly, 31 for all others According to the Grace Period Provision (a Mandatory Uniform Provision), this is the correct response.
Which of the following statements is true with respect to the Illinois Health Insurance Portability and Accountability Act (HIPAA)? A Group plans are optionally renewable B A group health plan may impose a preexisting condition exclusion for a period of not more than 18 months C Pregnancy and genetic information are considered preexisting conditions D A preexisting condition exclusion period is reduced by any creditable coverage that ended less than 63 days before the enrollment date of the new policy
D A preexisting condition exclusion period is reduced by any creditable coverage that ended less than 63 days before the enrollment date of the new policy A group health plan may impose a preexisting condition exclusion for a period of not more than 12 months (18 months only in the case of a late enrollee). Pregnancy and genetic information may not be classified as preexisting conditions. Group plans are guaranteed renewable.
In the event a policy is delivered by an agent to the insured, and the premium payment is to be collected at the time of this delivery, normally what else must the agent obtain to make the delivery complete? A Postage and handling fees B Additional payment reflecting lost interest C An affidavit from the applicant D A statement of good health
D A statement of good health It is the agent's responsibility to deliver the policy and verify that the insured has remained in good health.
Which of the following is NOT a general power of the Director? A Make rules and regulations as necessary B Subpoena and examine witnesses under oath C Institute any action or legal proceeding to enforce insurance laws D Adjust claims
D Adjust claims The Director does not have the power to adjust claims.
Other than the applicant, which signature is required on an application? A Beneficiary B Insurance commissioner C Executive officer of the insurer D Agent
D Agent The applicant and the agent are required to sign and application for insurance. If the insured is not the applicant and is not a minor, a signature is also required.
Which of the following statements is false concerning HMO grievance procedures? A An HMO must respond to a complaint received by the Department within 21 days after receiving notice B An HMO must keep a record of each filed grievance for at least 3 years after its resolution C An HMO must have a complaint resolution procedure D An HMO must submit its grievance process to the Director upon request
D An HMO must submit its grievance process to the Director upon request An HMO must submit its grievance process to the Director for pre-approval.
All individual and group health insurance policies providing coverage for the insured's dependents must provide coverage for adopted children: A After providing evidence of insurability B 31 days after being placed for adoption C 31 days after birth D From the date of placement of adoption
D From the date of placement of adoption Adopted children are covered at the date of placement for adoption.
Under the Fair Credit Reporting Act, which of the following statements is correct? A The reporting company can provide confidential information to anyone requesting it B The Act is designed to protect reporting agencies from the public C The reporting agency has no responsibility to investigate inaccurate information D If an individual is denied coverage, they can request a copy of the report
D If an individual is denied coverage, they can request a copy of the report The FCRA is designed to protect the public and requires the reporting agency to investigate disputed information. The applicant has the right to request a copy of the report from the reporting agency. This act protects confidential information.
All of the following are classes of insurance requiring a producer's license except: A Life B Accident and health C Motor vehicle D Mutual farm
D Mutual farm Mutual farm is a limited line of insurance.
If Mr. Stanley is injured while attempting to escape from the police after committing a bank robbery, his A & H coverage will probably pay: A Full claim, less the deductible B One half of normal benefit C Amount scheduled D Nothing
D Nothing Since Mr. Stanley is injured while committing an illegal act, the Illegal Occupation/Act Provision (an Optional Uniform Provision) provides the insurer's right to deny liability.
Which of the following is not a requirement for licensure as an insurance producer? A Passing the license exam (unless exempt) B Taking a prelicensing course C Paying the license fee D Possessing a high school diploma or equivalent
D Possessing a high school diploma or equivalent Aside from prelicensing and continuing education, there is no education requirement.
Which of the following is required to sign the application for insurance? A Producer only B Insurer only C Producer and the insurer D Producer and the applicant
D Producer and the applicant The producer and the applicant must sign the application. If the applicant and insured are different, then both must sign as well as the producer.
Which is not a qualifying event for the continuation of dependent coverage under the Consolidated Omnibus Budget Reconciliation Act? A Death of the employee B The employee's eligibility for Medicare benefits C Divorce or legal separation D Termination of the employee for theft
D Termination of the employee for theft This would be termination for gross misconduct and neither the employee nor his/her dependents would be eligible for continuation under COBRA.
Which of the following must an advertisement describing Medicare disclose? A That the insurer and agent are connected with the Medicare program B The source of any statistical information about the policy C That a failure to respond will jeopardize Medicare coverage D That it is an insurance advertisement
D That it is an insurance advertisement An advertisement describing Medicare must prominently state that the insurer and agent are not connected with the Medicare program, disclose that it is an insurance advertisement, identify the insurer's actual address, indicate that a failure to respond will not jeopardize Medicare coverage, and state if one of the insurer's representatives shall deliver any material or information in person.
Which of the following statements is NOT correct with regard to replacement requirements for individual health insurance? A An application must determine whether coverage is intended to replace another health policy in force B The insurer must give the applicant a Notice Regarding Replacement, before issuing or delivering the policy C The Notice Regarding Replacement states that certain factors may affect the protection available under a new policy, including preexisting conditions D The insurer must give the applicant a Notice Regarding Replacement, after issuing or delivering the policy
D The insurer must give the applicant a Notice Regarding Replacement, after issuing or delivering the policy The insurer must give the applicant a Notice Regarding Replacement, before issuing or delivering the policy.
Withdrawals may be made from the Premium Fund Trust Account only for the following, except: A To pay net premium to the insurer B Return of premiums to an insured C Commissions to the producer D To pay claims
D To pay claims Withdrawals from the Premium Fund Trust Account to pay for claims are not allowed.
