Insurance Exam Practice Questions
Pre hospitalization authorization is considered an example of?
Managed care
What Medicare products require use of specific hospitals and physicians for non emergency care?
Medicare Select
Medicare product requires use of specific hospitals and physicians for non-emergency care?
Medicare select
Producer circulating incorrect info about benefit policy is?
Misrepresenting
What must a producer sign when an existing life insurance policy is being reissued w/ a reduction in cash value?
Notice regarding replacement
Reason for backdating policy?
Obtain premium rate based on an earlier age
Informal contract become binding when?
One party makes and offer and the other pay accepts the offer
Part of life insurance policy guaranteed to be true?
Warranty
When is the face amt of whole life policy paid?
When insured dies or at policy maturity date
When must insurable interest be present in order for a life insurance policy to be valid?
When the application is made
Return of premium life policy is?
Whole and increase term
What is the purpose of the MO Life and health insurance guaranty association?
ensure claims filed against insolvent companies will be paid
Life insurance and annuities can be described as?
exchange existing policy for a new one
Long term care -
provide nursing home benefits on an extended basis of at least 12 consecutive months
Time limit on certain defenses -
provision that limits the period during which an insurer can deny a claim based on a misstatement made by the insured
Guaranteed insurability rider -
purchase additional amt of coverage at predetermined times w/o providing evidence of insurability
When does health insurer have an expedited grievance review?
when enrollee life or health is jeopardized
Section of insurance contract which limit coverage?
Exclusions
Combo of whole life and decrease term insurance referred to as?
Family income policy
Disqualifying event that results in the end of continuing COBRA coverage?
Employer terminates all group health plans
Insurers may request a hearing w/ in
20 days if policy is rejected
What is a unfair trade practice?
Coercion
What doesn't require a policy summary to be given?
Credit Life
Federal law allows an insurer to obtain an inspection report on a potential insured?
Fair Credit Reporting Act
What policy must provide coverage for human leukocyte antigen testing for bone marrow transplantation?
Group comprehensive health policies
Medical expense policies exclude coverage for?
Intentional self afflicting injuries
Dividends paid from life insurance policy are?
Issued by the insurer
What is not interest sensitive?
Modified whole life
Periodic health claim payments must be made at least?
Monthly
PPO is less restrictive than a HMO b/c ?
More physicans to choose from
What are the elements of an life insurance policy?
Mortality rate, insurers expenses, interest credit
Characteristic associated w/ large group disability income policy?
No medical underwriting
In MO, all health policies must address diabetes coverage ?
applying the same deductible and copays to cover diabetes supplies as other medical conditions
Without insurable interest...
life insurance policy would be a wagering contract
What is autism spectrum disorder?
medically necessary treatment in accordance w/ treatment plan
Waiver of premium rider -
waives premium for policy if insured becomes totally disabled
What is unfair discrimination?
when insurance companies charge different premiums for insured in same risk classification
Nondisabled indiv is 1st eligible for Medicare Supplement policy at what age?
Age 65
Characteristic of PPO?
Discounted fees for the patient
In MO, A&H policy that's paid on a monthly basis requires a grace period of at least how many days?
10
One becomes eligible for social security after being disabled for?
5 months
Insurer may delay payment of cash value loan or surrender for up to how many months?
6
Credit life doesn't require?
A policy summary be given
A health insurance policy application may only be altered w/ the consent of the?
Applicant
When determining monthly benefit amt for a disability income policy, the factor that limits the amt a prospective insured may purchase is?
Income
What are the sources of underwriting info about an applicant?
Inspection report, credit report, MIB
Who issues Medicare supplement insurance?
Insurance Companies
Variable whole life described as?
Insurance and securities product
Who assign benefits from a group life insurance policy?
Insured
Who signs a Notice Regarding Replacement form when an application is taken for a new life insurance policy that replaces an existing one?
Producer and Applicant
What does suitability information include?
age, annual income, and financial history
Medicare supplement policy covers -
allowable amts under Medicare part A- N
Conversion privilege -
allows an individual to leave the group term policy and continue insurance w/o providing evidence of insurability
When the director of insurance finds that a licensee has violated the insurance code, the director cant issue?
an warrant for arrest
Hospital indemnity policy -
coverage that pays a sated amount per day of a covered hospitalization
Underwriting process involves -
credit report, risk classification, and application
Personal life insurance premiums aren't
deductible for federal income tax
Why would the director in insurance examine the records of insurance companies?
determine solvency of the company
Inspection report -
info obtained by a telephone call to the proposed insured
What is credit life?
insurance issued on a debtor to cover outstanding balances on installment loans
What must a producer sign when an existing life insurance policy is being reissued w/ a reduction in cash value?
notice regarding replacement
At the time of application, major medical health plans are required to?
offer coverage for prosthetic devices
What is rebating?
offering a client something of value not stated in the contract in exchange for business
50% of excise tax rate the IRS imposes
on indiv's 70 ½ or older who don't take the required min distribution from retirement plan
To obtain a resident producer license for Missouri you must?
pay $100 license fee
Variable annuity -
pays benefits based on units rather than stated dollar amounts
Licensee must complete _____ hours of continuing education every 2 years
16
What the min benefit period that must be offered by a long term care policy issued in MO?
12 months
Applicant for insurance license denied. You must request a hearing with in how many days after receipt of the denial?
30 Days
What is the required free look period in a medicare supplement policy?
30 Days
Producer must report any personal felony charges w/ in
30 days of a pre trial hearing
CE provider must report to the director a licensee earned credits w/in?
30 days of course completion
Entire contract provision -
application & policy contains all provision and constitute the entire contract
Coverage for low protein modified food products for treatment of PKU or any other inherited disease require coinsurance not exceed what percentage of the cost of the formula or food products?
50%
When insured received chiropractic service, co payment may not exceed what percentage of the total cost of providing the service?
50%
Insurer may exclude pre existing conditions coverage on a medicare supplement policy for up to?
6 months
Maximum fixed interest rate for life insurance policy?
8%
What is not a required provision in the group life policy?
Accidental death and dismemberment
When must a producer deliver a notice regarding replacement of life insurance?
At the time of the application
. A ____ of authority permits an insurance company to transact business in MO?
Certificate
Whose life is covered on life insurance policy that contains a payor benefit clause?
Child
Health coverage for the administration of anthesia and hospital charges for dental care must be provided to?
Children under the age of 5
Applicant for a nonresident producer license must be?
Producer in good standing in their home state
Existing whole life policy converted to reduced paid up insurance while immediately taking a new life policy is considered?
Replacement
Statement made by insured in an insurance application that must be true to the best of ones knowledge and becomes part of the contract?
Representation
Disability elimination period is described as?
Time deductible
What's the elimination period of an indiv disability policy?
Time period disabled must wait before benefits are paid
Life insurance policy were investment acct is separate from general acct?
Variable life
In MO, a long term care policy must?
be guaranteed renewable
Each life insurance applicant in MO is expected to be provided with?
buyers guide and policy summary
Health insurance plans that cover physical therapy visits may not impose a copay that?
greater than the copay for primary care office visits
PPO -
group of doctors & hospitals in a designated area contract w/ an insurer to provide service at prearranged cost
Probationary period -
period of time b/w effective date of a policy and the date of coverage before sickness
Characteristic of a conditionally renewable health insurance policy -
premium may increase at time of renewal
Single (intermediate) premium annuity -
purchased with single lump sum payment and guaranteed income for life
Subrogation -
reimbursement of benefits for the treatment of a beneficiary injuries caused by 3rd party
After being properly appointed by the insurer, producer can do what?
sell insurance for an insurer
Prior to producing license being revoked, a hearing must be held. Prior to the hearing the Director of Insurance is required to do what?
send a written notice to producer
Director of insurance is authorized?
to enforce state laws relating to insurance
