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how long would the grace period be under a policy if the insured pays a monthly health insurance premium

10 days

in a noncontributory group policy

100% of eligible employees have to participate

temporary license texas is valid for

180 days

according to the limit on certain defenses provision ,statements or misstatements made in the application at the time of issue cannot be used to deny a claim after the policy has been effective for a minimum of how many years

2 years

a coffee shop owner is under a business overhead expense policy that pays a maximum month benefit of 2,500$ her actual monthly expenses are 3,000$ if the owner becomes disabled the monthly benefit payable under her policy will be

2,500$

resident agent must complete how many house of contributing education every 2 years

24

newborn is covered by parents for how many days

31

under the HMO child immunization cost cannot be charged for children under

6

policy loan request expect loan request for payment of past due premium can be deferred for a period of up to

6 month

Death proceeds from a life insurance policy must be paid to the claimant with receiving proof of insurance death

60 days

texas employer to obtain group health coverage for small employers what percent must be covered

75%

under the mandatory uniform provision of proof of loss the claimant is required to submit proof of loss within what period after the loss

90 days

the corridor deductible applies between

Basic and major medical coverage

an adjustable life policy can assume the form of

Either term insurance or permanent insurance

which fed act defines rules regarding protected health insurance

HIPPA

which act was introduced to lower the cost of healthcare by utilizing preventive care

HMO act of 1973

variable insurance and variable annuities are regulated by

SEC, FINRA, and departments of insurance

what is the purpose to buy sell agreement

To allow the business buyout in case of the owner's death

what guarantees that the information explained in the insurance contract is true

a warranty

which term is used to define the period during annuitant makes payments into an annuity

accumulation period

best describes rebate

agent returning paty of her commissions on her clint as an inducemnt to buy

an insurance provider who conducts instance in texas but whose articles of incorporation are registered on canadas is considered what type

alien

which of the following statements is not true regarding health insurance policy provision

all additional provisions written by insurance providers are cataloged by their respective status

all could qualify as a group to obtain group health insurance except

an association of 35 people

which of the following premium modes would result in lowest overall premium

annual

which of the following signifies the individual upon whose life teh annuity income account is calculated

annulint

an insurer is trying to determine an applicants insurability and decides to obtain medical information from several different sources which has to be notified of the investigation

applicant

which of the following is an acceptable reason for an insurance company to contest the payment of a claim based on statements in the application

application contains material misstatements

an underwriter is reviewing an applicant with the extensive medical history which would provide underwriter a better understanding of the applicants treatment for various illnesses

attending physician's statement

which provision can be added to a permanent life insurance policy at no cost to ensure that the policy will not lapse if there is cash value

automatic premium loan option

which is not a trigger of the payment of accelerated death benefits

being permanently disabled

answers to question in an insurance application are called representations and as such they are

believed to be true to the best of the applicant's knowledge

true regarding drug and alcohol addiction treatment coverage in group health insurance in texas

benefits provided must be the same as benefits for any other physical illness

a dentist has been off work for 4 months because of disability his dental assistant salary would be paid by

business overhead insurance

which is not an indicator of a competent party

business profession

insurance providers cannot conduct insurance business in texas without

certificate of authority

An insured and his spouse recently had a child. Which of the following riders would allow the couple to insure the child for a limited period of time at a specified amount?

children term rider

HMO members pay a small fee when they see their primary care physician the fee is called

co pay

which is not usually an executed clause of disability is an individual disability income policy

complications from pregnancy

an applicant gives his agent a completed applicant and initial premium what can the agent issue him that acknowledges the initial premium payment

conditional receipt

which of following is not correct concerning an insurance policy's consideration clause

considering must be equal on the part of the both the insurance provider and the insured

which of the following distinguished characteristic if the interest adjusted net cost method

considering time value of money in comparing life insurance cost

when the whole life policy is surrendering for reduced paid-up policy the new policy's cash value will

continue to increase

Network Model HMO

contracts independent group physicians provide medical services to subscribers

in an HMO what is the purpose of the gatekeeper

controlling cost

which is true policy conversion from group to individual coverage

conversion need to occur within 31 days

insurance policy is required to have all of the following valid except

countersignature

when filling out and application the applicant makes a mistake what can the applicant do to correct the error if a new application is unavailable

cross out the incorrect answer , write the correct one beside it and initial the new answer

which of the following best describes a major medical expense policy

delivers catastrophic medical coverage beyond basic benefits on a usual customary and reasonable

a major medical expense policy would exclude coverage for all treatments except

drug addiction

HMOs attempt to identify medical problems

early detection through regular check ups

the uniform provision law that prevents an insurance provider from altering oits agreement with a policyholder by referring in the policy is called

entire contract provision

the stop loss feature on a major medical policy intent to

establish a maximum out of pocket cost that an insured will have to pay for medical ecpemedews in a calendar year

what is the automatic option when a whole life policy is surrendered for its nonforfeiture value

extended term

a husband and wife both incur cost attributed deducible in their policy which type of deductible do they have

family

an annuity owner received the same guaranteed payment each month what type of annuity is it

fixed

at what point is an automatic premium loan generated

following the grace period

insurer that opportates 1 or more charitable, religious, education, social oe been left proposed for benefit of its members

fraternal insurer

guaranteed purchase option is also known as

future increase option

what provision helps ensure that the insured is protected in the event of an unintentional lapse on the policy

grace period

long term care policies issued in texas must be

guaranteed renewable

medicare supplement plan must have at leats 1 renewable provisions

guaranteed renewable

an insured was diagnosed 2 years ago with kidney cancer he was treated w surgeries and chemotremony and is now in remission he also has a 30 year smoking history the insured is now healthy enough to work and has recently secured a full time job what best describes the health insurance that he will most likely receive

he would be covered under his employer's group health insurance plan without higher premium

when an insured reinstated their major medical policy they were involved in an accident that required hospitalization upon reinstatement of the policy when would this accident be covered

immediately

when an agent suspects a fraudulent insurance act has been committed in texas whom must the agent in from first

in insurance fraud unit of the texas department of insurance

what type of health insurance plan offers board medical expense coverage without requiring an insurance to study a deductible

indemnity

which is true in ACA health care tax credit

individual receiving medicare are not eligible

medicare is a health insurance program for all except

individuals with low assets and low income

to buy insurance policy owner must face prospect of losing money or something of value in the event of loss what is concept called

insurable intrest

which is the primary source of information that an insurance provider uses to evaluate an insured risk for her life insurance

insurance application

all required to sign an application for health insurance except

insurer

which is not true concerning a noncancelable policy

insurer can increase premium above what is stated in policy if claims experience is greater than expected

jacki reviews an agreement on the first page of her policy which contains a list of losses that her insurance provider will cover what is the name of agreement?

insuring claus e

which entity is considered principle

issuing policy

when the policy is issued what happens to the copy of the applicant for health insurance

it becomes part of the entire contract

regarding an ordinary (straight) life policy all of the statement true expcet

it does not have a guaranteed death benefit

regarding an agent report during the policy application process which is true

it provides the agent observations about the proposed insured

which of the following is general enrollment period for medicare part B

jan 1 through march 31 every year

which condition is true when comparing a joint life policy to 2 individual life policies of the same amount on the same insurers

joint life has a lower premium than the total of the two individual policies

if a business wants to ensure it can cover losses due to the disability of its top employee the business should get which type of insurance

key person disability income

For a contract to be enforceable by law, the purpose of the contract must be

legal and not against public policy

an illustration used during the sale of life insurance policy has to include a label stating

life insurance illustration

which of the following statement about medical information bureau correct

med information bureau assist underwriters in evaluating and classifying risk

in an individual health insurance policy all are excluded from coverage except

mental illness

insurance company owned by the policyowners called

mutual insurer

in the event an annuitant dies during the accumulating period and there is a beneficiary names in the annuity the insurer would pay annuity benefits to the

named beneficiary

in a whole life policy cash value guarantees are

nonforfeiture values

texas resident agent looking to sell insurance to clients in another state needs

nonresident license in that state

dividends received on participating life insurance policy are

not taxable because they are a return of unused premiums

which of the best describes unfair trade practice of rebating

offering an inducement of something of value not states in policy

when can HIV related test results be provided to the MIB

only if the person is not identified

what does it mean when insurance contracts are unilateral

only one party makes a promise

sharing of commissions is legal if

other oaty is license for the same lines of insurance as agent

which of the following dividend options is being used when the owner of a participating whole life policy uses the dividend to provide more life insurance coverage

paid-up additions

which of the following is the consideration on the part of an insurance provider

paying a claim

a vertical settlement is a transaction outside the life insurance provider where the owner sells the life insurance policy for which of the following

percentage of policy face amount

an equity indexed annuity will grow based upon

performance of a recognized index

ellen is covered under a health plan provided by her employer she was told that her insurance would pay most of the covered expenses if she chose to see a provider on her plans lst if ellen's chose to be treated by a provider that is not on the list her portion of the bill would be greater ellen is covered under

prefered provider plan

the amount and the frequency of the premium payment are known as

premium mode

the manner and frequency that the policy owner pays the premium is known as

premium mode

what is the difference between a 20 pay whole life policy and a straight life policy

premium payment period

which is not included on 1 page of medicare supplement policy

premium rates

what is the primary purpose of the coordination of benefits provision in group insurance

prevent over insurance

medicare part A services do NOT include which

private duty nursing

jake retirement plans meets all fed requirements and entitles him to certain tax benefits as the plan owner what term best describes jakes retirement plan

qualified

a person buys a life insurance policy and list his parents as the beneficiaries he can change beneficiaries at any time the policy has what type of beneficiary designation

revocable

an agent delivers a life policy she explains a policy change and ask the applicant to sign a statement acknowledging that she explained the changed the agent sasy the premium has not been paid and needs to be paid before the policy goes into effect she collects a statement of good health , relinquishes the policy and leaves what did she do wrong

she left the policy with the insured without collecting the premium

an insured has an individual disability income policy with a 30 day elimination period she becomes disabled on june 1 for 15 days when will she collect on her disability income payments

she won't collect anything

what is the meaning behind a contract of adhesion

since insured does not take part in preparing the contract any ambiguities would be resolved in the insured's favor

a whole life policy that will generate immediate cash value is a

single premium policy

which of the following forms of care are daily nursing and rehabilitation catre that can only be delivered by medical personnel under the direction of a physician

skilled care

which of the following statements is right

socialisation of insurance cannot be associated with the fed gov

when differentiating mutual insurance from stock insures true

stock insures non participating policies own by shareholders

under a major medical policy , policy owners have the right to do which if they have NOT received the necessary claim forms within 15 days of their open works on a plan sheet of paper

submit the description in their own words on a plain sheet of paper

Upon payment of a loss, the insured is obligated to surrender to the insurer the right to sue a negligent party. This is called?

subrogation

if the benefits of a basic medical insurance plans are exhausted what type of plan will begin covering those losses

supplementary major medical

a life insurance policy can provide which

survivor protection

Which is incorrect?

testimonials used in advancement may or may not apply to the advertised policy

who is obligated to ensure that every question is answered and all necessary signatures are collected on the application

the agent

whose responsibility is it to ensure that the application for health insurance is accurate and complete

the agent

life insurance creates an immediate estate which best explains

the face value of the policy is payable to the beneficiary upon the insured's death

in a health insurance policy which entity has to option of including optional provision

the insurance provider

which is incorrect

the insurance provider does not have the right to conduct an autopsy

Under the Payment of Claims provision, to whom will the insured's benefits be paid if the insured is deceased?

the insured's primary beneficiary

the reduction of premium option uses the dividend to reduce

the next year premium

as it pertains to life settlements the term owner means

the owner of the original life policy

regarding the premium in a 10 year level premium policy which is true

the premium will remain level for 10 years

According to the Common Disaster clause, if the insured and primary beneficiary are killed in the same accident and it cannot be determined who died first, which of the following will be assumed?

the primary beneficiary died before the insure

the guaranteed insurability rider allows the owner to buy additional amounts of life insurance without proof of insurability at all of the following except

the purchase of a new home

what is accurate of dividends from a life insurance policy

they are not taxable and are not guaranteed

what is the purpose of key person insurance

to cover decreasing business revenues as a result of a key employees death

in a health insurance policy what is the purpose of the impairment rider

to exclude coverage for a specific impairment

in the application process what is the purpose of the agent's report

to give additional information about the applicant to the underwriters

what is purpose of a policy's benefit schedule

to state what and how much is covered in the plan

regarding the definition of total disability which is incorrect

total disability is the inability to perform practical duties of any occupation for which an individual's is suited because of education

2 individuals of the same age , health statue , and life expectancy apply for individual insurance coverages when the same insurer issues the coverage premium rates are different based on insured's race what practice is this

unfair discrimination

which of these can be described as a flexible premium adjustable life policy

universal life

which service is not provided by an HMO

unlimited coverage for drug rehabilitation treatment

due to an injury an insured has been unable to work for 8 months when her life insurance premium came due she could not pay yet the policy remained in force this policy includes

waiver of premium rider

when an insured's membership in a group is terminate the insured can convert to

whole life without proof of insurability

if an insured is not entirely satisfied with an issued policy the insured may return it to the insurance company and receive a refund of their entire premium paid at which of the time

within 10 day of when the policy was delivered

under the mandatory uniform notice of claim provision policy owners must submit written notice of a cami to the insurance providers within what time

within 20 days

an employee that becomes ineligible for group coverage due ti termination of employment or a change in status must exercise an extension of benefits under COBRA

within 60 day

the commissioner can issue a temporary agents license to an applicant who is under consideration for appointment as an agent by another agent an insurance company or a health maintenance organization (HMO)

without a written examination


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