Guarantee Exam
An elimination ( waiting period) may not have to be satisfied for a disability in which of the following? a) an insured suffers a relapse of a prior disability within 6-months of the initial covered disability b) an insured suffered the disability from the results of active duty with the US armed forces c) an insured is disabled from a work-related accident d) an insured contracts an incurable disease
A
What is the max amount that the Guaranty Association would have to pay on a life insurance death benefit? a) 300,000 b) 400,000 c) 500,000 d) 750,000
A
Which of the following is not normally an excluded case of disability in an individual disability income policy? a) complications from pregnancey b) injury resulting from illegal activity c) sucide d) war
A
under the mandatory uniform provision legal actions, an insured is prevented from bringing a suit against the insurer to recover on a health policy prior to a-60 days after written proof of loss is submited b-90 days after written proof of loss has been submitted c-one year after the occurrence of a disability d - 30 days after the loss
A
A probationary period is
A specified period of time that a person joining a group has to wait before becoming eligible for coverage
All of the following would be classified as "limited insurance coverage" except? a) accidental death and dismemberment policy b) supplemental social security coverage c) travel insurance policy d) dread disease policy
B
In group insurance the primary purpose of the coordination of benefits provision is to? a) encourage hospitals to keep their charges reasonable b) prevent overinsurance c) prevent lawsuits between insurance companies involved in the claim d) ensure the payment of claims by al policies that are in effect at the time of the claim
B
A major medical expense policy would exclude coverage for all of the follow treatments except a) dental care b) cosmetic care c) drug addiction d) eye refractions
C
All of the following are characteristics of group health insurance plans except. a) employers may require the employees to contribute to the premium payments b) the benefits under a group plan are more extensive than those under individual plans c) The parties that hold a group health insurance contract are the employees and the employer d) the cost of insuring an individual is less than what would be charged for comparable benefits under an individual plan
C
An agent received a 1,000$ commission on the sale of a long-term care policy. However, the agent has violated the LTC regulations during policy solicitation. The agent may be required to pay a fine in what amount? a) 1000 b) 3000 c) 10,000 d) 30,000
C
How many solicitors may a producer legally have? a) 0 b) 1 c) 2 d) 3
C
Medicare part B covers all of the following except a) home health visits b) outpatient hospital services c) long term care services d) doctors services
C
Riley reads an agreement on the first page of their policy, which includes a list of losses that will be covered by her insurer. what is the name of this agreement? a) statement of loss coverage b) consideration clause c) insuring clause d) coverage provision
C
Under the payment of claims provision, to whom will the insured's benefits be paid if the insured is deceased? a) the insured's beneficiary's first choice b) to any remaining debtors the insured owes c) the insured's primary beneficiary d) the insured's estate even if a beneficiary is living
C
Under the relation of earning to insurance provision, an insurer is allowed to limit an insured's benefits to his or her average income over the last two years. What is the minimum benefit amount that can be provided A) 50$ a month B) 100$ a month c) 200$ a month d) 400$ a month
C
Which of the following is not true regarding a noncancellable policy? a) the guarantee to renew coverage usually only applies until the insured reaches age 65 b) insured has a unilateral right to renew the policy for the life of the contract, and may discontinue paying premiums to cancel it. c) insurer can increase the premium above what is stated in the policy if claims experience is greater than expected d) insurer cannot cancel policy
C
regarding the consideration clause, which of the following is not correct? a) the insurers consideration consists of providing coverage B) the insured's consideration consists of providing information on the application, as well as agreeing to pay the premium. c) Consideration of the insurer and insured must be equal d) Consideration is defined as the exchange of values
C
Long-term care policies sold in this state must include a free-look provision that last for how many days? a) 10 b) 15 c) 20 d) 30
D
The guaranteed purchase option is also referred to as the a) multiple indemnity rider b) impairment rider c) evidence of insurability rider d) future increase option
D
What is the purpose of the benefit schedule? A) to include the average charges for procedures b) to provide the dates for the payment of benefits c) to list the insured's copayments and deductibles. d) to state what and how much is covered in the plan
D
What is the purpose of the gatekeeper in an HMO? a) making sure that patients do not go to physicians outside of the HMO region b) establishing strong preventative care c) making sure that services are properly prepaid d) controlling costs
D
Which party can expect to incur the cost of a hearing? a) the taxpayer b) the commissioner's office c) the key witness d) the party against whom findings were made as a result of the hearing
D
an underwriter is reviewing an applicant with an extensive medical history. which of the following would give the underwriter a better understanding of how the applicant has been treated for various illnesses? a) MIB report b) policy application c) medical exam d) attending physicians statement
D
An agent did a lot of things. What did he not do.
He left the policy with the insured without collecting the premium
in addition to participation requirements, how does an insurer guard against adverse selection when underwriting group health? a) by obtaining mib reports on each enrollee b) by imposing case management provision c) by requiring that the insurance be incidental to the group d) by having each enrollee undergo a paramedical examination
c) by requiring that the insurance be incidental to the group
Which of the following describes the relationship between a capital sum and a principal sum?
capital sums are percentages of principal sums
an insurer is attempting to determine the insurability of an applicant and decides to obtain medical information from several different sources. Which of the following would be notified of the application? a- the MIB b- the state department of insurance c-the medical examiner d-the applicant
d
Elaine's basic hospital expense policy has a 500$ per day limit for room and board in a hospital for a maximum of 5 days. Elaine got sick and had to spend 3 days in the hospital at 650$ a day. How much will Elaine have to pay to cover the rest of her room and board charges? a - 0 b - 150 c - 350 d - 450
d - 450
All of the following must sign an application for health insurance except producer insurer proposed insured applicant
insurer
on an accidental death and dismemberment AD&D policy, the death benefit payable is known as the a-face amount b-capital sum c-policy limit d-principal sum
principal sum