final
Which of the following statements is NOT correct concerning the COBRA Act of 1985? a)It covers terminated employees and/or their dependents for up to 36 months after a qualifying event. b)It applies only to employers with 20 or more employees that maintain group health insurance plans for employees. c)COBRA stands for Consolidated Omnibus Budget Reconciliation Act. d)It requires all employers, regardless of the number or age of employees, to provide extended group health coverage.
It requires all employers, regardless of the number or age of employees, to provide extended group health coverage.
On a participating insurance policy issued by a mutual insurance company, dividends paid to policyholders are a)Paid at a fixed rate every year. b)Taxable as ordinary income. c)Guaranteed. d)Not taxable since the IRS treats them as a return of a portion of the premium paid.
Not taxable since the IRS treats them as a return of a portion of the premium paid
Which of the following statements is INCORRECT concerning Medicare Part B coverage? a)Participants under Part B are responsible for an annual deductible. b)Part B will pay 80% of covered expenses, subject to Medicare's standards for reasonable charges. c)It is a voluntary program designed to provide supplementary medical insurance to cover physician services, medical services and supplies not covered under Part A. d)Part B coverage is provided free of charge when an individual turns age 65.
Part B coverage is provided free of charge when an individual turns age 65.
In respect to the consideration clause, which of the following is consideration on the part of the insurer? a)Offering a secondary policy to the applicant b)Offering an unconditional contract c)Explaining policy revisions to the applicant d)Promising to pay in accordance with the contract terms
Promising to pay in accordance with the contract terms
The Affordable Care Act requires all U.S. citizens and legal residents to have qualifying health care coverage. This is known as a)Safe Harbor mandate. b)Special enrollment. c)The individual mandate. d)The Insurance Marketplace.
The individual mandate.
Which of the following is NOT a goal of risk retention? a)To increase control of claim reserving and claims settlements b)To fund losses that cannot be insured c)To minimize the insured's level of liability in the event of loss d)To reduce expenses and improve cash flow
To minimize the insured's level of liability in the event of loss
Which type of misrepresentation persuades an insured, to his or her detriment, to cancel, lapse, or switch policies from one to another? a)False advertising b)Rebating c)Twisting d)Switching
Twisting
How soon following the occurrence of a covered loss must an insured submit written proof of such loss to the insurance company? a)As soon as possible b)Within 20 days c)Within 60 days d)Within 90 days or as soon as reasonably possible, but not to exceed 1 year
Within 90 days or as soon as reasonably possible, but not to exceed 1 year
Which of the following will NOT be considered unfair discrimination by insurers? a)Assigning different risk classifications to applicants based on gender identity b)Discriminating in benefits and coverages based on the insured's habits and lifestyle c)Charging applicants with similar health histories different premiums based on their ethnicity d)Cancelling individual coverage based on the insured's marital status
Discriminating in benefits and coverages based on the insured's habits and lifestyle
Which of the following entities is not an insurer but an organization formed to provide insurance benefits for members of an affiliated lodge or religious organization? a)Reciprocal association b)Fraternal benefit society c)Mutual company d)Stock company
Fraternal benefit society
How is the amount of Social Security disability benefits calculated? a)It is based on age, number of quarters worked in the last 25 years (minimum of 80) and the number of health claims made during that period of time. b)It is based on age, number of quarters worked in the last 20 years (minimum of 60) and the number of health claims made during that period of time. c)It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years. d)It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 30 years.
It is based upon the worker's Primary Insurance Amount (PIA), which is calculated from their Average Indexed Monthly Earnings over their highest 35 years.
Which of the following is true regarding a term health policy? a)It is nonrenewable. b)It is conditionally renewable. c)It is guaranteed renewable. d)It is noncancellable.
It is nonrenewable
Which of the following would be a typical maximum benefit offered by major medical plans? a)$1 million b)$10 million c)$50,000 d)$500,000
$1 million
Which of the following statements is most correct concerning the changing of an irrevocable beneficiary?a)They can be changed only with the written consent of that beneficiary. b)They may be changed at any time. c)They can never be changed. d)They may be changed only on the anniversary date of the policy.
)They can be changed only with the written consent of that beneficiary.
An insured pays a monthly premium of $100 for her health insurance. What would be the duration of the grace period under her policy? a)7 days b)10 days c)31 days d)60 days
10 days
S is a sole business proprietor who owns a medical expense plan. What percentage of the cost of the plan may he deduct? a)25% b)50% c)75% d)100%
100%
What is the maximum period of time that a temporary license may last? a)60 days b)30 days c)180 days d)90 days
180 days
Following hospitalization because of an accident, Bill was confined in a skilled nursing facility. Medicare will pay full benefits in this facility for how many days?a)80 b)3 c)20 d)100
20
Following an injury, a policyowner covered under Medicare Parts A & B was treated by her physician on an outpatient basis. How much of her doctor's bill will she be required to pay out-of-pocket? a)20% of covered charges above the deductible b)80% of covered charges above the deductible c)All reasonable charges above the deductible according to Medicare standards d)A per office visit deductible
20% of covered charges above the deductible
Within how many days of requesting an investigative consumer report must an insurer notify the consumer in writing that the report will be obtained? a)3 days b)5 days c)10 days d)14 days
3 days
Changes in address must be reported to the Commissioner within a)180 days. b)90 days. c)30 days. d)10 days.
30 days
#3. Employer health plans must provide primary coverage for individuals with end-stage renal disease before Medicare becomes primary for how many months? a)12 months b)24 months c)30 months D)36 months
30 months
Under the Age Discrimination in Employment Act, if the obligation of the employer to provide retiree health benefits, what will an individual younger than 65 receive in benefits each year? a)The minimum established by the employer b)One-fourth of the benefits required under the Social Security Act c)At least $10,000 d)At least the value of the Social Security benefits
At least the value of the Social Security benefits
When must the Medicare Supplement Buyer's Guide be presented? a)Within 30 days of policy delivery b)When the prospective policyholder inquires about a policy or at the time of application, depending on which occurs first. c)At the time of application d)When the policy is delivered
At the time of application
Which of the following is NOT required to be stated in the outline of coverage provided with a long-term care policy?a)Basic information about the insurance company b)Basic information about supplementary policies c)The policy number d)The right to return the policy for a refund
Basic information about supplementary policies
All of the following are true regarding Key Employee Disability Income insurance EXCEPT a)The employer owns the policy. b)Benefits are paid to the employer to retrain a new person. c)Premiums are not tax deductible for the employer. d)Benefits are taxable to the employer.
Benefits are taxable to the employer.
To be eligible for tax credits under the ACA, individuals must have income that is what percent of the Federal Poverty Level? a)Between 100% and 400% b)Higher than 300% c)Less than 10% d)Between 10% and 100%
Between 100% and 400%
Which of the following is true regarding inpatient hospital care for HMO members? a)Care can be provided outside of the service area. b)Care can only be provided in the service area. c)Services for treatment of mental disorders are unlimited. d)Inpatient hospital care is not part of HMO services.
Care can be provided outside of the service area
Because an insurance policy is a legal contract, it must conform to the state laws governing contracts which require all of the following elements EXCEPT a)Consideration .b)Legal purpose .c)Offer and acceptance. d)Conditions.
Consideration
What is an important feature of a dental expense insurance plan that is NOT typically found in a medical expense insurance plan? a)A broad coverage area b)A low monthly premium c)Low cost deductibles d)Diagnostic and preventive care
Diagnostic and preventive care
In disability income insurance, the time between the onset of an injury or sickness and when benefits begin is known as the a)Enrollment period. b)Probationary period. c)Elimination period. d)Qualification period.
Elimination period
All of the following may be excluded from coverage in a Major Medical Expense policy, EXCEPT a)Coverage provided under workers compensation. b)Emergency surgery. c)Custodial care. d)Cosmetic surgery.
Emergency surgery.
In long-term care (LTC) policies, as the benefit period lengthens, the premium a)Remains unchanged. b)LTC premiums are not based on benefit periods. c)Decreases. d)Increases.
Increases.
Which type of a hospital policy pays a fixed amount each day that the insured is in a hospital? a)Indemnity b)Surgical c)Blanket d)Medigap
Indemnity
A policyowner is reading a statement on the first page of his health insurance policy, which says "this is a limited policy." What is the name of this statement? a)Policy Limitation Notice b)Statute of Limitations c)Limited Benefit Statement d)Limited Policy Notice
Limited Policy Notice
in cases where a covered employee is eligible for Medicare benefits to treat end-stage renal disease (ESRD) with dialysis or kidney transplant, which of the following is correct? a)Medicare is primary for the first 12 months of treatment and the employer group insurance is secondary. b)Medicare is the secondary payer during the first 30 months of treatment. c)Medicare and the employer group insurance plan will share the cost equally. d)Because Medicare does not cover treatment of ESRD, the group plan will pay 100%.
Medicare is the secondary payer during the first 30 months of treatment.
An insured is involved in a car accident. In addition to general, less serious injuries, he permanently loses the use of his leg and is rendered completely blind. The blindness improves a month later. To what extent will he receive Presumptive Disability benefits? a)Full benefits until the blindness lifts b)No benefits c)Full benefits d)Partial benefits
No benefits
Premium payments for personally-owned disability income policies are a)Not tax deductible. b)Eligible for tax credits. c)Tax deductible. d)Tax deductible to the extent that they exceed 10% of the adjusted gross income of those itemizing deductions.
Not tax deductible.
Which of the following is the most common time for errors and omissions to occur on the part of an insurer? a)Policy delivery b)Policy renewal c)Underwriting d)Application process
Policy delivery
If an individual is covered by a policy that includes an Accidental Death & Dismemberment rider, what term describes the maximum benefits he will receive if he loses sight in both eyes as a result of a fire? a)Principal sum b)Reciprocal amount c)Capital sum d)Percentage of full amount
Principal sum
Which type of insurance is based on mutual agreements among subscribers? a)Mutual insurance b)Limited liability c)Reinsurance d)Reciprocal insurance
Reciprocal insurance
In comparison to consumer reports, which of the following describes a unique characteristic of investigative consumer reports? a)They provide additional information from an outside source about a particular risk. b)They provide information about a customer's character and reputation. c)The customer has no knowledge of this action. d)The customer's associates, friends, and neighbors provide the report's data.
The customer's associates, friends, and neighbors provide the report's data.
An insured wants to transfer his personal insurance policy to a friend. Under what conditions would this be possible? a)The insured will need a written consent of the insurer. b)It is impossible to transfer a policy. c)The insured would have to surrender his policy to the insurer, and his friend could then ask to buy it. d)The insured can transfer the policy to his friend and then notify the insurer of the change.
The insured will need a written consent of the insurer.
An insured who has an Accidental Death and Dismemberment policy loses her left arm in an accident. What type of benefit will she most likely receive from this policy? a)The principal amount in a lump sum b)The capital amount in monthly installments c)The principal amount in monthly installments d)The capital amount in a lump sum
The principal amount in a lump sum
An insured notifies the insurance company that he has become disabled. What provision states that claims must be paid immediately upon written proof of loss? a)Incontestability b)Physical Exam and Autopsy c)Legal Actions d)Time of Payment of Claims
Time of Payment of Claims
Under what condition are group disability income benefits received by an employee NOT taxable as income? a)When the benefits received are equal or less than the employee's percentage of the contribution. b)When the employer makes all the premium payments. c)When the employee is 59 ½. d)When the amount of the benefit is equal or less than the amount of contributed by the employer.
When the benefits received are equal or less than the employee's percentage of the contribution.
An agent offers his client free tickets to a sporting event in exchange for the purchase of an insurance policy. The agent is guilty of a)Coercion. b)Twisting. c)Controlled business. d)Rebating.
rebating
Under a health insurance policy, benefits, other than death benefits, that have not otherwise been assigned, will be paid to a)Beneficiary of the death benefit. b)The spouse of the insured. c)The insured. d)Creditors.
the insured
