Insurance licensing test prep
Prohibits payments for regularly covered services if provided by non-network providers.
A Medicare SELECT policy
Time Limit on Certain Defenses Clause
A health insurance policy clause that prevents an insurance company from denying payment of a claim after a specified period of time is known as the
Prior to the time of the application
A long-term care shopper's guide must be presented at what point?
Children born after the inception of the contract
A man purchased a health policy to provide coverage on himself, his wife, and their two children. All of them would need to prove insurability EXCEPT
The insurance through his company is primary
A man works for Company A and his wife works for Company B. The spouses are covered by health plans through their respective companies that also cover the other spouse. If the husband files a claim,
Automatic Premium Loan
A policyowner fails to pay the premium due on his whole life policy after the grace period passes, but the policy remains in force. This is due to what provision?
The spouse of a retired producer
A temporary license may NOT be issued to
Adjust the claim benefit to reflect the woman's true age
A woman misstated her age on an application for an individual health insurance policy. The insurance company found the mistake after the contestable period had expired. The insurance company will take which of the following actions regarding any claim that has been issued?
Full benefits
Alden is involved in a small plane accident that renders him permanently deaf, although he does not sustain any other major injuries. Alden is still able to perform his current job. To what extent will he receive Presumptive Disability benefits?
The plan is funded by permanent insurance only
All of the following are true of Key Person insurance EXCEPT
The payable premium amount steadily declines throughout the duration of the contract.
All of the following are true regarding a decreasing term policy EXCEPT
Emergency Surgery
All of the following may be excluded from coverage in a Major Medical Expense policy, EXCEPT...
Warn the applicant about the 10-day free-look period
An agent is completing an application for a long-term care policy. The agent is required to do all of the following EXCEPT
FINRA
An agent selling variable annuities must be registered with
Fair Credit Reporting Act
An applicant is denied insurance because of information found on a consumer report. Which of the following requires that the insurance company supply the applicant with the name and address of the consumer reporting company?
Has at least 50 members
An association could buy group insurance for its members if it meets all of the following requirements EXCEPT
Nothing, due the insured's reaching the maximum age.
An employer provides a group life plan for its employees; it is $50,000 of term to age 65. When one of the employees was hired 10 years ago, he misstated his age and told the employer he was 50, when in fact he was 56 years old. The insured employee died last week. His beneficiary will receive
The insured should contact the insurer to confirm her actual Social Security benefit amount. The SIS rider should pay the difference between the rider amount and the actual benefit.
An insured has a Social Insurance Supplement rider in her disability income plan. Following a disability, she begins receiving benefit payments from the insurer. She then begins receiving Social Security benefits that are smaller than the SIS benefit payments. At that point, her insurer ends the SIS benefit payments. Which of the following best describes the situation?
The surviving beneficiary will continue receiving 2/3 of the benefit paid when both beneficiaries were alive.
An insured has chosen joint and 2/3 survivor as the settlement option. What does this mean to the beneficiaries?
Mutual
An insured purchased an insurance policy 5 years ago. Last year she received a dividend check from the insurance company which was not taxable. This year she did not receive a check from the insurer. From what type of insurer did the insured purchase the policy?
$120 a day
An insured's long-term care policy is scheduled to pay a fixed amount of coverage of $120 per day. The long-term care facility only charged a $100 per day. How much will the insurance company pay?
Medical Information Bureau
An insurer wishes to compare the information given in an insurance application with previous insurance applications by the same applicant but for different companies. What organization can help the insurer accomplish this?
Submit the form to the Commissioner of Insurance for approval
An insurer writes a Disclosure Authorization Notice. Before it is distributed to insureds, what must the insurer do?
Rated
Another name for a substandard risk classification is...
Amanda is 67 and is covered by a basic medical expense policy
Assuming that all of the following people are covered by a High Deductible Health Plan and are not claimed as dependents on anyone's tax returns, which would NOT be eligible for a Health Savings Account?
Not subject to income taxation by the Federal Government.
Death benefits payable to a beneficiary under a life insurance policy are generally
Increase benefit levels without providing proof of insurability
Guarantee of insurability option in long-term care policies allows the insured to
2 or more
HIPAA applies to groups of
24 hours
How many hours of continuing education credits are required in order for a producer to renew his/her license?
A defined contribution plan for a small business
If a company has a Simplified Employee Pension plan, what type of plan is it?
The commissioner
If a producer is suspected of acting in violation of the Insurance Code, what authority would preside over a legal hearing regarding the matter?
The insured's secondary beneficiary
If both the insured and the primary beneficiary died in the same car accident and it is impossible to determine who died first, which of the following will most likely receive the death benefit?
Mental illness
In health underwriting, it would be inappropriate to decline a risk using any of the following factors EXCEPT
Closed panel
In which of the following cases is the doctor considered to be an employee of the PPO?
Accident only
Jacob's insurance policy only pays for medical costs related to accidents. Which of the following types of policies does he have?
The guardian may or may not be accountable for assets
Life insurance benefits for minors must be placed in the hands of either a guardian or a trustee. Which of the following is true?
Coverage for the treatment of Alzheimer's Disease
Long term care insurance policies can exclude all of the following EXCEPT
20 days
Once a claim for loss is received, how many days does the insurer have to pay it before the interest on benefits begins to accrue?
At least 100 employees
SIMPLE Plans require all of the following EXCEPT
Set premium rates
The Ownership provision entitles the policyowner to do all of the following EXCEPT
Funding against general company financial loss.
The following are legitimate uses of insurance in a business setting EXCEPT
2 years
The relation of earnings to insurance provision allows the insurance company to limit the insured's benefits to his/her average income over what period of time?
Integrated Dental Plan
The type of dental plan which is incorporated into a major medical expense plan is a
150 days
The widower of an agent was issued a temporary license 30 days ago. How much longer can he legally serve under this license?
Are made by the business and are NOT tax-deductible
Under a Key Person disability income policy, premium payments
Monthly
Under an individual disability policy, the MINIMUM schedule of time in which claim payments must be made to an insured is
Installments for a fixed PERIOD
Under which of the following annuity options does the annuitant select the time period for the benefits, and the insurer determines how much each payment will be?
Cash values can be borrowed at any time.
What does "liquidity" refer to in a life insurance policy?
Race
What is NOT considered by an underwriter when determining the premium rates for an individual seeking insurance?
Early detection through regular checkups
What is the goal of the HMO?
In a Stock Redemption Plan, the policies are owned by an entity, and in a Cross Purchase Plan, the policies are owned by individuals.
What is the major difference between a Stock Redemption Plan and a Cross Purchase Plan?
Exemption periods
What is the purpose of the Insurance Guaranty Association?
To protect policyowners against insurer insolvency
What is the purpose of the Insurance Guaranty Association?
Cash Value
What limits the amount that a policyowner may borrow from a whole life insurance policy?
Errors and Omissions
What type of insurance protects producers in the event that they are negligent in their duties and are sued by insureds as a result?
Visits by a registered nurse
What types of services may not be provided under LTC's Assisted Living?
Consider decreasing the premium
When Ken purchased his health policy he was a window washer. He has since changed occupations and now manages a library. Upon notifying the insurer of his change of occupation, the insurer should
Purchase a single premium policy with a reduced face amount
When a whole life policy lapses or is surrendered prior to maturity, the cash value can be used to
A statement of good health
When the policy premium wasn't submitted with the application, what should the agent obtain from the insured upon policy delivery?
When the insured reached age 100
When would a 20-pay whole life policy endow?
Application
Where would an underwriter find an agent's report regarding a prospective insured?
Premiums are lower
Which is generally true regarding insureds who have earned Preferred status?
Funds exceeding premium are taxed as income
Which is true about the cash surrender nonforfeiture option?
Extended term
Which nonforfeiture option has the highest amount of insurance protection?
Residential care
Which of the following LTC Coverages would NOT encourage an insured to receive care at home?
Aleatory
Which of the following best describes the concept that the insured pays a small amount of premium for a large amount of risk on the part of the insurance company?
Producer B writes a group policy covering a large hospital where his wife is the comptroller. This represented 27% of his commissions last year.
Which of the following cases would constitute a violation of Louisiana's Controlled Business Statute?
It provides care to people with life expectancies of 1-2 years
Which of the following does NOT describe hospice care?
The 12 months of creditable coverage must all come from the same employer.
Which of the following is INCORRECT regarding HIPAA's creditable coverage?
Denial of coverage
Which of the following is NOT a cost-saving service?
Depreciation Period
Which of the following is NOT a term for the period of time during which the annuitant or the beneficiary receives income?
Workers Compensation
Which of the following is NOT an example of a business use of Life Insurance?
Need is predicted using the number of years until the insured's retirement.
Which of the following is NOT true regarding the Needs Approach method of determining the value of an individual's life?
Death due to plane crash for a fare-paying passenger
Which of the following is NOT typically excluded from life policies?
Policy delivery
Which of the following is the most common time for errors and omissions to occur on the part of an insurer?
They allow several small employers purchase less expensive insurance together.
Which of the following is true regarding METs?
It provides income the beneficiary can't outlive
Which of the following is true regarding a single life settlement option?
Insured is unable to perform duties of the occupation for which he/she was educated and trained.
Which of the following refers to "own occupation" disability?
Medicaid is a state funded program that provides health care to persons over age 65, only.
Which of the following statements concerning medicaid are false?
Private insurers may be authorized to transact insurance by state insurance departments.
Which of the following statements is an accurate comparison between private and government insurers?
Evidence of insurability may be required when insurance is increased.
Which of the following statements is correct regarding Adjustable Life?
Superimposed Plan
Which of the following statements is not true of a Combination Dental Plan?
It transfers the owner's rights under the policy to the extent expressed in the assignment form.
Which of the following statements is true about a policy assignment?
They seldom contain a conversion privilege
Which of the following statements is true concerning employer group dental plans?
The creditors have rights to the proceeds if they can show evidence of valid assignment.
Which of the following statements is true concerning the creditors of the deceased insured?
Target premium
Which of the following would help prevent a universal life policy from lapsing?
Producer C uses her license to write uncontrolled business only
Which of the following would not be a violation of Louisiana insurance regulations?
Free Look
Which provision allows a person to return a Medicare supplement policy within 30 days for a full premium refund?
An executive officer of an insurer
Who can make changes to the policy once it is in effect?
After more than 1 year
With a Single Premium Deferred Annuity (SPDA), when are the benefits paid?
