FL 02-15 Guarantee Exam #1
What are the eligibility requirements for Florida Healthy Kids coverage?
Children over the age of 5 must NOT: 1. Qualify for medicaid 2. reach 19 years old 3. have a family income that exceeds 200% of the federal poverty level.
What source explains the state policies regarding appropriate agent conduct?
Code of Ethics of the Florida Association of Insurance and Financial Advisers
An agent delivers a policy to an applicant, who pays the initial premium but refuses to submit a statement of good health. What term best describes what the applicant has violated?
Consideration
What is the binding force in any contract?
Consideration
A limited health insurance policy that will pay a lump-sum to an insured diagnosed with a heart attack, stroke, or renal failure is known as what?
Critical Illness Insurance
An employee has just started working for a small group corporation and works 25 hours per week. The employee is ___________________________________
Eligible to receive full health coverage
T/F: Applicants who may require a larger death benefit in the future should buy convertible term insurance.
False Convertible Term converts to a cash value policy with the same death benefit
The guaranteed purchase option is also referred to as what?
Future Increase option
What does an annuity protect the contract owner against? What are annuities designed to do?
Living longer than expected Designed to: 1. liquidate an estate 2. protect someone from outliving their money
Does a Major Medical Expense Policy exclude treatment for drug addiction?
NO
With respect to the entire contract clause in health policies, who has the authority to make changes to an existing policy?
Only an executive officer of the company
When may HIV-related test results be provided to the MIB?
Only if the individual is not identified.
Which of the following would make a child over the age of 5 INELIGIBLE for Florida Healthy Kids Coverage?
Qualifying for Medicaid
What does the application of contract of adhesion mean?
Since the insured does not participate in preparing the contract, any ambiguities would be resolved in favor of the insured. take-it-or-leave-it
Insured have the right to do what if they have NOT received the proper claim forms within 15 days of their notice to the insurer of a covered loss under a major medical policy?
Submit the description in their own words on a plain sheet of paper
An annuity has a cash accumulation value of $70,000 of which $30,000 is from premium payments. The annuitant dies during the accumulation phase. The beneficiary will receive how much?`
$70,000 the beneficiary will receive the GREATER of amount of premiums paid into the plan or cash value
When does a Guaranteed Insurability Rider allow the insured to buy additional coverage without proof of insurability?
1. At marriage 2. Birth of a child 3. every 3 years between 25 and 40
What constitutes a policy replacement?
Any transaction in which new life insurance or a new annuity is to be purchased AND it is known (or should be known) to the proposing producer that by reason of the transaction, existing life insurance/annuities have been or will be CONVERTED to reduced paid-up insurance, continued as extended-term, or otherwise reduced in value by the use of nonforfeiture benefits.
Agents in this state are required to promptly report all of the following EXCEPT what? - change in marital status - change of address - administrative actions - use of assumed names
CHANGE IN MARITAL STATUS
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, what will be assumed?
The primary beneficiary died before the insured.
Under the mandatory uniform provision "Notice of Claim", written notice of a claim must be submitted to the insurer within what time parameters?
within 20 Days `
In a replacement situation, all of the following are prohibited practices EXCEPT what? - not listing an existing policy that will be surrendered on the new policy application - submitting a list of replaced policies only after the new policy is delivered - not providing the client with the sales material used in solicitation - borrowing 50% of a policy's cash value to fund a new life insurance contract
- borrowing 50% of a policy's cash value to fund a new life insurance contract
What are some common exclusions of major medical policies?
1. cosmetic surgeries 2. eye refractions 3. dental care
Florida law requires that both individual and group health insurance policies provide coverage for a newborn child of a covered family member, other than the insured, for a period of _____?
18 months
What does dread disease coverage provide?
A specified amount per day if the insured is hospitalized due to a dread disease, like CANCER
What is the purpose of the impairment rider in a health insurance policy?
To exclude coverage for a specific impairment
T/F: Applicants wishing to pay off a mortgage should they suffer a premature death might buy a decreasing term plan.
True
T/F: Employers looking to provide cost effective group life insurance for their employees may choose annual renewable term.
True
HMO contracts may only be sold by a licensed and appointed health insurance agent or a full-time salaried employee or officer who devotes most of his/her services to what?
activities other than soliciting HMO contracts from the public and who receives NO commissions or compensation for procuring such contracts.
all of the following statements regarding the life insurance policy summary are correct EXCEPT what? - it must be given to each new policy owner no later than at policy delivery - it must illustrate all guaranteed cash surrender values - it must illustrate all guaranteed policy dividend values - it must present the generic name of the policy as well as the company's name for it.
it must illustrate all guaranteed policy dividend values --> dividends are NOT guaranteed
