Final Round
W has a health insurance policy with an 80/20 coinsurance, a $1,000 deductible. If in January W goes into the hospital for an overnight stay, the bill coming to $2,000, what will W pay? A $800 B $200 C $1,000 D $1,200
$1,200
Managed care plan participants are called: A Insurers B Providers C Subscribers D Applicants
Subscribers
All are true of HMO subscribers, except: A Subscribers do not pay a copayment B Subscribers do not receive a bill C Subscribers do not file claims D Subscribers do not pay deductibles
Subscribers do not pay a copayment
Which major medical plan deductible will result in the lowest premium? A $1,500 B $1,000 C $2,500 D $2,000
$2,500
K has a $100,000 traditional whole life policy with $30,000 of cash values and a $10,000 loan outstanding. What is the maximum additional amount she could borrow from the policy at this time? A $40,000 B $30,000 C $60,000 D $20,000
$20,000
Z suffers a total and permanent disability. The policy he has requires a premium payment of $100 per month. He is on claim for 100 months. Initially, how much did Z have to pay before the waiver of premium benefit on his policy started? A $1,800 B $10,000 C $600 D $1,200
$600
XYZ Corporation has 59 employees. The company decides to purchase a group life policy and will pay the total premium. What percentage of employees must participate under this arrangement? A 100% B 75% C 25% D 50%
100%
A viator in Kansas has at least ________ calendar days from receiving the viatical settlement proceeds to rescind the viatical settlement contract. A 3 B 10 C 21 D 15
15
An insured should receive necessary claim forms within _____ days after notice of claim. A 15 B 10 C 20 D 5
15
The Time Limit on Certain Defenses (Incontestable) period is _____ years under individual health and disability contracts. A 2 B 3 C 5 D 7
2
For individual health policies issued in Kansas, the time limit on certain defenses is: A 2 years after the policy has been in force, except for fraudulent misstatements B 5 years after the policy has been in force, except for nonpayment of premium C 2 years after the policy has been in force, except for nonpayment of premium D 5 years after the policy has been in force, except for fraudulent misstatements
2 years after the policy has been in force, except for fraudulent misstatements
COBRA is a federal law requiring employers with _____ or more employees to provide the option of continuing the employee's existing health coverage for dependents for up to _____ months following certain qualifying events such as death of the employee. A 25, 45 B 20, 18 C 20, 36 D 15, 36
20, 36
In a whole life policy, cash value must be made available to borrow against after _____ years. A 3 B 2 C 5 D 4
3
When replacing a life insurance policy in Kansas, the replacing insurer must notify the existing insurer of the replacement within: A 3 working days B 10 working days C 7 working days D 5 working days
3 working days
In Kansas, the free look period for Medicare Supplement and LTC policies is _____ days. A 20 B 15 C 30 D 10
30
A qualified Long-Term Care Policy may exclude losses incurred from preexisting conditions for no longer than ______ months from the effective date of coverage. A 8 B 6 C 12 D 3
6
The Legal Actions provision preserves the insured's right to bring suit against their own insurer, but the insured must wait at least _____ days after filing a proof of loss before pursuing this action. A 90 B 60 C 30 D 45
60
What gives an insurer the authority to operate within this state? A Articles of incorporation filed with the secretary of state B Approval of the National Association of Insurance Commissioners (NAIC) C A certificate of authority D The governor's approval
A certificate of authority
All of the following become part of the entire contract, except: A A copy of the application B The policy itself C Any riders D A copy of the check
A copy of the check
he Commissioner has the authority to suspend the license of all of the following licensees, except: A A licensee who forgot to pay state income tax B A licensee who unknowingly accepts business from an unlicensed producer C A licensee who was convicted of a misdemeanor not relating to insurance D A licensee who does not pay required child support
A licensee who unknowingly accepts business from an unlicensed producer
Which of the following best describes the agent's report? A An illustration showing a comparison of all health insurance policies sold by the producer B A personal statement provided by the agent/producer to the insurer clarifying or providing additional information based on the application as part of the underwriting process C A monthly report showing the amount of personal production made by the agent/producer D A statement made by the agent/producer verifying a sale was suitable and that all required disclosures were provided to the applicant
A personal statement provided by the agent/producer to the insurer clarifying or providing additional information based on the application as part of the underwriting process
Which of the following best describes Third-Party Ownership? A A business partner buying a life insurance policy on him/herself B A policy owned by the insured C A key employee buying a life insurance policy on him/herself D A policy owned by one person insuring the life of another person
A policy owned by one person insuring the life of another person
Which of the following best describes a viatical settlement? A A terminally ill insured/owner sells his or her policy to a third party for much needed cash B A policy that is donated to a charitable organization in exchange for certain benefits C Gifting a policy to a non-profit organization in exchange for certain benefits D An insured with 5 years or more life expectancy sells a policy he or she no longer needs for more than its cash value
A terminally ill insured/owner sells his or her policy to a third party for much needed cash
Which of the following riders is used to increase the death benefit if death is the result of an unintended fatal injury, paying a multiple of the face amount? A Accidental Death B Payor Benefit C Disability Benefit D Accelerated Death Benefits
Accidental Death
Which of the following children would not be covered under the parent's individual or group health insurance policy in Kansas? A A newborn child of the enrollee from the moment of birth B A child adopted by the enrollee from the date the adoption petition was filed C An adopted newborn child from the moment of birth if the adoption petition was filed within 45 days of the child's birth D A child placed in the enrollee's home by a child placement agency from the date of placement if the adoption petition is filed within 280 days
An adopted newborn child from the moment of birth if the adoption petition was filed within 45 days of the child's birth
All of the following are true regarding the Life and Health Insurance Guaranty Association, except: A An insurer may use the existence of the Association in advertisements to purchase insurance B It prevents financial loss to policyholders when an insurer becomes insolvent C Other member insurers are assessed to provide money for the claims of an insolvent insurer D The Association is not liable for more than $300,000 in the aggregate for any one life
An insurer may use the existence of the Association in advertisements to purchase insurance
The pay-out period of an annuity is also referred to as the ______ period. A Immediate B Accumulation C Annuity D Deposit
Annuity
Dividends issued by mutual insurance companies: A Represent a share of company profits for stockholders B Are considered guaranteed member benefits C Are taxable distributions to policyholders D Are non-taxable refunds (returns) of unused or surplus premiums
Are non-taxable refunds (returns) of unused or surplus premiums
Whose signature is not required on a life insurance application? A Insured B Policyowner C Producer D Beneficiary
Beneficiary
What type of disability income insurance pays a lump sum enabling certain businesses to cover the cost of purchasing a disabled business owner's interest in the business? A Reducing term B Key employee C Business overhead expense D Business disability buyout
Business disability buyout
By what means does the client acknowledge that an insurer may use services and information provided by third parties to gather information during the underwriting process? A By signing the check given to the producer for the modal premium B By verbally acknowledging that the producer informed him or her about the Fair Credit Reporting Act C By signing the application D By accepting a copy of the Fair Credit Reporting Act brochure from the producer
By signing the application
All of the following are exclusions under an LTC policy, except: A Injury arising due to committing a felony B Chemical dependency on one's own prescription drugs C Nervous or mental disorders that have no demonstrable organic cause D Rest cures
Chemical dependency on one's own prescription drugs *Chemical dependency would not be excluded if it results from the administration of drugs under a physician's prescription and direction.
Which of the following is not a Mandatory Uniform Provision? A Reinstatement B Payment of Claims C Conformity with State Statutes D Physical Exam and Autopsy
Conformity with State Statutes
Insurers include provisions in contracts to help reduce unnecessary claims and the overpayment of claims. Which of the following is not one of those provisions? A Emergency Services B Mandatory Second Surgical Option C Consideration Clause D Concurrent Review
Consideration Clause
All of the following CE requirements are correct, except: A 18 hours for life and/or health B 4 hours for title C 18 hours for property, casualty, or personal lines D Continuing education courses are required every 4 years
Continuing education courses are required every 4 years
When an individual is covered by more than one health plan and is injured, what provision determines which plan is that person's primary coverage? A Extension of Benefits B Conversion Privilege C Continuation of Coverage D Coordination of Benefits
Coordination of Benefits
An insured in Kansas is covered under a group health plan through their job and has secondary coverage as a dependent under their spouse's group plan. Which of the following benefits would the secondary plan pay once the primary plan has paid its benefits? A Premiums paid during the period of hospitalization B Copayment required under the primary plan C 5% of the total benefits paid under the primary plan D Nothing, as there is primary coverage
Copayment required under the primary plan
In Kansas, all of the following must first be obtained by a viatical settlement provider when entering into a new viatical settlement contract, except: A Copy of the viator's most recent federal tax return B Statement from a physician stating that the viator is of sound mind and under no constraint or undue influence to enter into a viatical settlement contract C The insured's consent to the release of medical records D Viator's consent to the viatical settlement contract
Copy of the viator's most recent federal tax return *A copy of the viator's most recent federal tax return is not required to be obtained before entering into a viatical settlement contract.
If questions are incomplete on an application and the insurer issues the policy, a claim is: A Covered only after the first 2 years B Not covered if discovered during the Incontestability period C Not covered and the policy is canceled due to fraud D Covered since the insurer issued the contract based on an incomplete application
Covered since the insurer issued the contract based on an incomplete application
All states have adopted the Uniform Individual Accident and Sickness Policy Provision Law. If an insurer changes any of these provisions, it must make sure that the change does not: A Violate legal precedent B Nullify the law of large numbers C Weaken its grounds to void the policy D Create a meaning that is less favorable to the insured than the original wording
Create a meaning that is less favorable to the insured than the original wording
Group Accidental Death and Dismemberment premiums are _______ by the company paying the premiums as a business expense. A Tax-Free B Taxable C Deductible D Tax-Deferred
Deductible
A producer who makes a derogatory statement about a competing insurer's financial statement is guilty of: A Coercion B Twisting C Defamation D Intimidation
Defamation
In a policy summary all of the following must be shown as being guaranteed, except: A Interest rates B Premiums C Dividends D Cash values
Dividends
___________ are not taxable because they are considered a return of excess premium. A Death Benefits B Dividends C Cash Values D Policy loans
Dividends
In Kansas, the accelerated benefit provision becomes effective for losses due to accidents on which of the following dates? A Anniversary date B Effective date of the policy or rider C 90 days after the effective date of the policy or rider D 30 days after the effective date of the policy or rider
Effective date of the policy or rider
Once issued, if the application is attached to the policy itself, it then becomes part of the ___________. A Insuring Clause B Entire contract C Consideration Clause D Incontestability Clause
Entire contract
Which annuity product offers interest rates linked to the positive performance of the S&P 500? A Equity-indexed annuity B Indexed Universal Life C Variable annuity D Variable Universal Life
Equity-indexed annuity
The Commissioner of Insurance must examine the financial condition of each producer or insurer at least once: A Every year B Every 2 years C Every 10 years D Every 5 years
Every 5 years
The nonforfeiture option that provides the most amount of coverage is: A Reduced Paid-Up B Extended Term C Cash surrender value D Automatic Premium Loan
Extended Term
When a policy lapses due to nonpayment of premium, which nonforfeiture option is the automatic option? A Reduced paid-up B Automatic premium loan C Extended term D Cash surrender value
Extended term
Which Settlement Option pays a specified dollar amount until benefits are exhausted? A Life Income B Life Income with Period Certain C Paid-Up Option D Fixed Amount
Fixed Amount
Which Settlement Option pays for a specified period, regardless of who may receive the payments? A Fixed Amount B Paid-Up Additions C Life Income with Period Certain D Fixed Period
Fixed Period
An insurer authorized to do business in State A, which was incorporated in State B, is considered what type of insurer in State A? A Stock B Alien C Domestic D Foreign
Foreign
Which of the following regarding Medicare Part B is true? A Generally pays 80% of covered physician, surgeon, and outpatient hospital expenses, with a monthly premium and annual deductible B Provides coverage for inpatient services C It is free for those who qualify D It covers routine dental checkups
Generally pays 80% of covered physician, surgeon, and outpatient hospital expenses, with a monthly premium and annual deductible
Which of the following statements regarding life insurance policy exclusions is TRUE? A The status clause states that coverage is provided to individuals with military status B Generally, aviation is excluded, except for fare-paying passengers on a commercial flight C Hazardous occupations are usually covered at a reduced benefit if death is the result of an insured's occupation D The war clause states coverage is provided if death is the result of war
Generally, aviation is excluded, except for fare-paying passengers on a commercial flight
If the insured dies while the _______ period is in effect, the death benefit paid is the face amount, minus the premiums due. A Incontestability B Grace C Reinstatement D Settlement
Grace
When advertising health insurance policies in Kansas, insurers must: A Use words like "only" or "merely" to describe restrictions or exclusions B Have a 6-month gap between enrollment periods C Never use statistics D Obtain confirmation of testimonials used more than 3 years after they were originally given
Have a 6-month gap between enrollment periods
A Tertiary Beneficiary is the person who receives a death benefit payment in which of the following scenarios? A If the Contingent Beneficiary dies before the insured B If the Primary Beneficiary dies before the insured C If the insured dies before the Primary Beneficiary D If the primary and contingent beneficiary die prior to the insured
If the primary and contingent beneficiary die prior to the insured
Attaching a(n) ___________ rider excludes coverage for a condition that would otherwise be covered. A Rehabilitation benefit B Waiver C Impairment D Lifetime benefit
Impairment
One of your clients just reinstated an Accident and Health policy. When is coverage effective? A Immediately for both accident and sickness B In 30 days for sickness, immediate coverage for accidents C In 10 days for accident and in 48 hours for sickness D In 10 days for sickness and immediately for accidental injuries
In 10 days for sickness and immediately for accidental injuries
The Modified Endowment Contract (MEC) rules were put into place because: A Life insurance companies needed to become more competitive with other financial institutions B The federal government needed a new source of tax revenue C Individuals were overfunding life insurance policies and using them as tax-free investment vehicles instead of a way to protect survivors against the financial cost of one's death D Too many consumers were being sold life insurance when they thought they were buying annuities
Individuals were overfunding life insurance policies and using them as tax-free investment vehicles instead of a way to protect survivors against the financial cost of one's death
Which of the following documents used for underwriting can be completed by talking to the proposed insured over the phone? A MIB B APS C Agent's report D Inspection report
Inspection report
Mandatory uniform provisions found in health insurance policies are designed to protect the: A Insured B Insurer C Agency D Producer
Insured
Optional uniform provisions found in health insurance policies are designed to protect the: A Insured B Agency C Producer D Insurer
Insurer
What is an insurer permitted to do if and when it discovers during the underwriting process that a proposed insured has AIDS? A Insurers may refuse to issue a policy to individuals based on positive HIV test results B The insurer can share information discovered during the underwriting process with the Center for Disease Control as well as state and local health authorities C Insurers can share the test results with the insured's immediate family members and any health professionals listed on the application D Insurers can discriminate between individuals of the same class in underwriting for the risk of AIDS
Insurers may refuse to issue a policy to individuals based on positive HIV test results
If a copy of the application, which led to a life insurance policy being issued, is attached to the policy: A It is a way for the insurer and policyowner to evidence who the producer was at the time of application B It can be used by the insurance company later on if the insured wants to increase their coverage instead of using a new one C It is provided merely as a convenience to the policyowner so that they will have a record of the transaction D It is considered part of the entire contract
It is considered part of the entire contract
Of the following listed choices, which is true as it pertains to Medicare Part A? A Provides coverage for outpatient services B It covers all prescription drugs C It is prepaid through FICA taxes and is automatic when that worker qualifies for Social Security retirement benefits ('fully insured') D All recipients pay a monthly premium
It is prepaid through FICA taxes and is automatic when that worker qualifies for Social Security retirement benefits ('fully insured')
What type of disability income insurance pays a benefit to a business to help in the search, cost, and hiring of a replacement when an employee becomes disabled and is unable to work for the company? A Buy-sell B Reducing term C Business overhead expense D Key employee
Key employee
Producer W filled out an application on client X. Before submitting the application to the insurer, W notices that there was one question left unanswered and another one was answered incorrectly based on the information provided. Since X lives over an hour away from the office, W should do which of the following? A W can make these necessary administrative changes with X's verbal consent B As a licensed professional, W can answer the question and correct any mistakes on behalf of X C Make arrangements to meet X in-person to obtain the missing information and correct the incorrect response D Immediately submit the application as is written and hope that the home office does not notice
Make arrangements to meet X in-person to obtain the missing information and correct the incorrect response
If X has a life insurance policy that is no longer wanted or needed and is considering selling their policy, how much might X receive if the premiums are $10,000 annually, the cash value is $200,000, and the face amount is $1,000,000? A $200,000 B Less than $200,000 C Nothing, because selling the policy is a prohibited transaction D More than $200,000 but less than $1,000,000
More than $200,000 but less than $1,000,000
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 One half of normal benefit B Nothing C Amount scheduled D Full claim, less the deductible
Nothing
Which of the following is not covered with Medicare Part A? A Outpatient hospital care B Post-hospital skilled nursing care C Semiprivate hospital room D General nursing and hospital services
Outpatient hospital care
All of the following are TRUE regarding qualified plans, except: A Employer contributions are not taxable to the employee until withdrawn B Plans can discriminate in favor of highly compensated employees C Employer contributions are immediately tax-deductible D Distributions taken prior to age 59 1/2 are subject to tax and a tax penalty
Plans can discriminate in favor of highly compensated employees
The Insuring Clause under an individual A&H policy would contain all the following, except: A The name of the insured and insurer B The length of the policy period C Premium or rate calculations D What perils are covered
Premium or rate calculations
Which is NOT typically covered under HMOs? A Chiropractic services B Medical equipment C Physical therapy D Private hospital rooms
Private hospital rooms
If a producer offers any special favor in dividends or other benefits to an insured, the producer is guilty of which of the following marketing practices? A Twisting B Defamation C Rebating D Intimidation
Rebating
The main purpose of requiring a Gatekeeper is to: A Reduce costs within the plan B Charge a higher rate for preventive services C Enforce exclusions D Determine premiums
Reduce costs within the plan
The __________ provision specifies what an insured must do, if a policy has lapsed, in order to put it back in force. A Reconsideration B Reissuance C Renewal D Reinstatement
Reinstatement
Which provision is an Optional Uniform Provision? A Physical Examination B Payment of Claims C Claim Forms D Relation of Earnings to Insurance
Relation of Earnings to Insurance
All of the following are essential elements of a legal contract, EXCEPT: A Competent Parties B Representation C Consideration D Legal Purpose
Representation
A(n)________ is an added benefit attached to a life insurance policy for which an additional premium is generally paid. A Extension B Rider C Reduction D Exception
Rider
All of the following are modes of premium payment for health insurance, except: A Annually B Quarterly C Single pay D Monthly
Single pay
Harry's father purchases a life insurance rider with a Payor Benefit Rider on his 12-year old son Harry. If Harry's mother dies, A The Payor Benefit rider will pay the full premium until Harry reaches the age of adulthood and then only the mortality costs B The Payer Benefit rider will pay the premium until Harry reaches the age of adulthood and then stop C The Payor Benefit rider will pay the premium as long as Harry lives D The Payor Benefit rider will pay nothing
The Payor Benefit rider will pay nothing
The Mode of Premium provision addresses: A The method of premium payment B When premiums can be skipped C The frequency of premium payment D Whether or not the insurer or producer will accept cash
The frequency of premium payment
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 insurer must add a 10% penalty to any amount eventually paid B The claim is automatically denied C The claim is automatically accepted D The insured can submit written proof of the loss
The insured can submit written proof of the loss
What is the risk to the purchaser in a viatical settlement transaction? A The purchaser paid too little for the policy B The check given to the seller does not clear the bank C The insured does not die within the time period anticipated D The insured dies sooner than expected
The insured does not die within the time period anticipated
Sandra owns a Medical Expense Plan that contains a 60/40 Participation (Coinsurance) Provision and a $200 deductible. How much will Sandra and the insurer each pay under the coinsurance provision if Sandra's first medical claim for the year totals $10,200? A The insurer would pay $6,000, and Sandra would pay $4,200 B The insurer would pay $4,000, and Sandra would pay $6,200 C The insurer would pay $4,200, and Sandra would pay $6,000 D The insurer would pay $6,200, and Sandra would pay $4,000
The insurer would pay $6,000, and Sandra would pay $4,200
If a child is covered under more than one group health insurance plan how is it determined which carrier is primary? A The date of birth of the child that is closest to either parent becomes primary B The younger parent's plan will become primary C The parent whose date of birth is closest to the end of the year determines which is primary D The plan covering the parent whose birthday occurs first in the calendar year will be the children's primary coverage
The plan covering the parent whose birthday occurs first in the calendar year will be the children's primary coverage
Who retains all of the rights in a life insurance policy? A The insurer B The insured C The policyowner D The beneficiary
The policyowner
What information must appear on the policy summary provided to a life insurance client? A The producer's agency's name and address B A copy of the producer's license C The producer's name and address D The producer's name and home address
The producer's name and address
Which of the following best describes the consideration on the part of an insurer? A The acceptance of the contract B The offer of the contract C The purpose of the contract must be legal D The promise to pay in the event of a covered claim
The promise to pay in the event of a covered claim
When the receipt for the initial premium of an individual life policy is written in Kansas, all of the following are correct, except: A The receipt may void the coverage if the application contains a material misrepresentation or was fraudulently completed B The receipt may void coverage if a check or draft for the premium is not honored when presented C The receipt may not exclude coverage for suicide D The receipt may limit coverage by specifying the amount and type of temporary coverage
The receipt may not exclude coverage for suicide
In which of the following circumstances was the small business owner able to deduct the premiums they paid for insurance? A The sole proprietor buys a policy on him or herself B The employer buys a key employee policy on their top sales executive C The partners purchase a policy to fund a buyout plan D The sole proprietor of a small firm buys an overhead expense policy
The sole proprietor of a small firm buys an overhead expense policy
The insurer's consideration is __________ while the applicant's consideration is ________. A Issuing the policy / Submitting the application B Providing claim forms / Submitting proof of death C Hiring and training a producer / Listening to the sales presentation D Their promise to pay the claim / The application and premium payment
Their promise to pay the claim / The application and premium payment
First-to-die and last-to-die life insurance policies have in common all of the following, except: A They are both issued by an insurance company B They both require premiums to be paid on time C They both continue in force after one of the named insureds dies D Generally they cover the lives of two people, typically husband and wife
They both continue in force after one of the named insureds dies *With first-to-die, the policy ends with a death claim after the first insured dies. With last-to-die, the policy remains in force until the last named insured dies.
How do PPOs save consumers money? A They waive their charges in cases of emergency care B They charge minors less than adults C They offer senior discounts D They charge patients utilizing providers contracted with the PPO less than those who are not contracted with the PPO
They charge patients utilizing providers contracted with the PPO less than those who are not contracted with the PPO
What is the primary purpose of the free look period? A It is a marketing strategy of major insurers to get applicants to sign up for a policy B It is a way to offer a legal rebate, 10-30 days of 'free' insurance C It forces producers to deliver policies in person to resell the policy to reduce returns and early policy lapses D To allow the applicant time to reconsider their purchase decision and to see if the policy was issued as applied for
To allow the applicant time to reconsider their purchase decision and to see if the policy was issued as applied for
An example of ___________ is charging a lower rate to one individual who lives in a certain geographic location in which others are charged the correct higher rate. A Unfair discrimination B Rebating C Twisting D Boycott
Unfair discrimination
The insurer generally assumes the investment risk in all of the following annuities, except: A Variable B Fixed C Indexed D Guaranteed
Variable
When is a cross purchase buy-sell agreement plan used? A When the entity does not have the funds necessary to pay for policies on each of the owners B When insurability is an issue C When parties purchase life insurance on each other D When individual tax deductions are needed
When parties purchase life insurance on each other
